Date of Award

Spring 5-21-2022

Document Type


Degree Name

MA - Master of Arts


Expressive Therapies


Lee Ann Thill


Selective mutism (SM) is a rare, yet severe, anxiety disorder that affects primarily children. SM is characterized by a failure to speak in certain social situations (i.e., school), despite being able to speak comfortably in other settings (i.e., home). There is an ongoing effort to understand this diagnosis and best treatments are being debated. The therapeutic relationship is argued to be one of the greatest predictors of positive treatment outcomes, regardless of the diagnosis or treatment method; however, the failure to speak that characterizes SM impacts the development of a therapeutic relationship and that alliance cannot be formed using typical methods. Despite its significance, this topic has not been explored in the current literature. Expressive arts therapy offers many modes of nonverbal expression that could be beneficial to the development of therapeutic relationships with this population. Using the expressive therapies continuum as a framework for therapeutic activities, a method was designed to develop a therapeutic relationship with an 11-year-old girl with SM. Implemented in a therapeutic school setting, the method was conducted over six 30-minute sessions. Observations of the client and therapist suggest that expressive arts therapy may be beneficial in the development of a therapeutic relationship with a child with SM. Further research on this topic could improve treatment outcomes for children with SM.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.




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