Integrating Behavioral Techniques With Experiential Play Therapy for Selective Mutism: A Single-Case Experimental Design

This study investigated the preliminary effectiveness of Experiential Play Therapy (EPT) integrated with behavioral techniques for a 4.5-year-old girl with selective mutism (SM). Using a single-case A-B-A experimental design, the study examined phase-based changes in anxiety, communication, social interaction, and behavioral responses. The research adhered to the SCRIBE 2016 reporting guidelines, with the A1 (baseline), B (intervention), and A2 (follow-up) phases consisting of 6, 23, and 2 sessions, respectively. Anxiety levels were assessed using the parent-reported Revised Preschool Anxiety Scale (RPAS), while clinical progress was evaluated through systematic therapist ratings. Data were analyzed using visual analysis, phase medians, the Theil-Sen slope, non-overlap indices (NAP), and Tau-U. Results showed a substantial reduction in total RPAS scores, decreasing from 113 during the A1 phase to a final measurement of 66 at the end of the B phase, with further improvement to a final measurement of 59 during the A2 follow-up phase. Systematic therapist ratings demonstrated substantial and consistent improvements across all behavioral and communicative domains. These findings provide preliminary evidence supporting the integration of EPT and behavioral techniques as a promising intervention for preschool children with SM. Further comparative research with larger samples is warranted to confirm these findings.