 Psychotherapy
Posted By Dr Fung On 9/16/2003 10:33:44 PM In Read
The psychotherapies are loosely called the "talking cures". They represent a form of treatment that engages patients, fosters and develops a relationship between the therapist and the patient. Through these interactions the patient is assisted in discovering new ways of dealing with life by understanding his/her past. In children, the idea is the same but often use more primitive forms of communication such as play or art. Family therapies consider not just the individual identified patient but the family unit as a whole and how its interactions create problems in one or more of its members. In selective mutism, the idea that there may be psychological trauma comes from the psychotherapy literature. There are a number of case reports that recommend the use of play therapy, art therapy and family therapy to deal with such children. Persuasive as it may seem, its use in selective mutism is questionable. By allowing the child to remain silent in the sessions and have a "safe haven" to escape to, it often results in reinforcing the child's mutism. Even if the intense relationship with the therapist results in a child speaking to the therapist, no strong evidence exist that the child will generalise the behaviour to other situations.
The strength of psychotherapy in selective mutism lies in its ability to foster a good working relationship with the child and family. This can be the basis of some excellent behavioural work. We feel that supportive psychotherapy is the most effective form in this context.
Family work would be useful in identifying some of the maladaptive interactions at home. We often need to explain to parents about the child's condition and to allay their worries or even anger that is being directed at the child.
Thus even though specific resource intensive therapy is not indicated, we believe that a good therapeutic alliance is crucial in helping the child an dfamily with selective mutism.
Read a story about a selectively mute mouse here.
Here is a .
|
