Selective mutism (SM) is a rare childhood anxiety disorder, which may be markedly detrimental to a child's academic performance and social functioning if left untreated (American Psychiatric Association [APA], 2013). Integrated Behavior Therapy for Selective Mutism (IBTSM; Bergman, 2013) is the only manualized treatment approach developed specifically for children with SM. Previous investigations provide evidence for its efficacy in a clinical research setting (Bergman, Gonzalez, Piacentini, & Keller, 2013), and examined its effectiveness using 8-session (Cotton-Thomas, 2015), 12-session (Siroky, Carlson, & Kotrba, 2017), and 35-session (Khan & Renk, 2018) versions of IBTSM when implemented in real-world conditions (e.g., school setting, community-based clinics). The present study used a nonconcurrent multiple baseline single-case design to examine the adherence, effectiveness, and acceptability of a condensed version of IBTSM (i.e., 16 sessions in a community-based clinic) in decreasing social anxiety levels and speech avoidance for five children (ages four to eight years) diagnosed with SM, exclusively-anxious subtype. Novice clinicians were able to implement the condensed (16-session) version of IBTSM with excellent adherence (i.e., average = 97%) for all five participants over an average of 19 weeks (Range = 16-22 weeks). Visual analyses did not demonstrate a replicated intervention effect across all five children. However, Tau-U effect size indices and Reliable Change Index (RCI) calculations demonstrated significant individual improvements in social anxiety levels and speaking behaviors over the course of treatment. Notably, three of five children (60%) no longer met diagnostic criteria for SM at the end of treatment. Surprisingly, two children who presented with comorbid anxiety disorders (generalized anxiety, separation anxiety) saw a removal of these diagnoses by the end of treatment as well. All five caregivers rated the condensed version of IBTSM as an acceptable treatment approach overall for their child's mental health challenges, with specific endorsements of acceptability in the areas of time required and treatment quality. A majority of caregivers also rated IBTSM as effective in addressing their child's needs. Future research directions and study implications are provided.
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