Single session exposure therapy for children with school-based selective mutism


Dr. Björn Bergström is the Director of Research for the Portland Anxiety Clinic (LLC), and the Chair of the Anxiety Research Team (Pacific University), and an active clinician who specializes in tailoring empirically-supported treatments. In his full-time Assistant Professor role with Pacific University, he teaches, supervises and conducts research on evidence-based treatments for anxiety disorders. He actively publishes and presents his research regionally, nationally and internationally.

If your organization is interested in having Dr. Björn Bergström provide a talk/seminar, training or general consulting services, feel free to contact him at

One of his most recent projects was presented at the 75th annual conference for the Oregon Academy of Science (OAS) on selective-mutism, exploring the potential benefits of adapting single-session designs: Morgan Bolen, Blake Gimbel, Kate MacLeod, and Björn Bergström / Pacific University, Hillsboro, OR

Selective Mutism is a childhood anxiety disorder that primarily affects school-aged children. It is characterized by the inability to speak in certain settings (e.g., school), despite being able to speak in other settings (e.g., home, in the community). Exposure-Based Cognitive-Behavioral Therapy for Selective Mutism is a multimethod approach that accounts for symptoms in the larger context of the child’s environment, such as the school setting (Wong, 2010).

One-session treatment (OST), a variant of Cognitive-Behavioral Therapy, combines graduated in vivo exposure, participant modeling, reinforcement, psychoeducation, cognitive challenges, and skills training in an intensive treatment model (Davis, Ollendick & Ost, 2009). As noted by Ost (2012), intensive treatment is thought to produce more rapid and lasting change than spaced practice.

Examination of the effectiveness of OST for Selective Mutism is worthy to pursue because findings could have implications for children from rural or underserved areas, parents who have limited time for multiple sessions, or others that may have motivational difficulties attending sessions over a longer term (Davis et al., 2009). Additionally, OST may reduce costs of intervention and allow clinicians to address client needs in a more efficient manner.

Despite the potential benefit of OST for Selective Mutism, questions concerning comorbid diagnoses and format of delivery must be addressed. This presentation discusses research for the use of OST for Selective Mutism and proposes areas for further research in possible utilization of OST as a treatment for this disorder.

There is ample evidence for Exposure Therapy as the gold-standard of treatment for anxiety disorders. Despite this, exposure therapy is highly underutilized. In addition, there is still room for further exploration and research on how to adapt and tailor exposure-based methods to fit unique client presentations and needs, methods for maximizing treatment impact, and reducing barriers to treatment (for both client and practitioner, alike). Dr. Bergström is also active in training clinicians, and providing educational seminars to various professional organizations.