Children are informed that they will be required to gradually talk to familiar people in the presence of others and then to talk to others. The use of rewards and punishments is introduced for motivation for change. Anxiety reduction Treatment can incorporate several methods for anxiety reduction. Medication therapy, discussed below, can reduce anxiety reactions through changes in chemical reactions within the brain. Anxiety reduction can be accomplished through the use of training in deep muscle relaxation.
Training is done with the parent or other family member present to increase the child's confidence.
The child is expected to listen only during these sessions. Muscle relaxation methods are taught and practiced, and children are then guided to use these with deep breathing efforts. Tapes of instruction are made for home use and children are expected to practice twice a day for several weeks so that they have the ability to calm themselves easily. For mutism, this means the gradual introduction of people into situations in which the child is talking comfortably. Desensitization is the process of achieving comfort in the presence of formerly anxiety-arousing situations.