A pilot study of an online behavioral parent training program for children with selective mutism: feasibility and preliminary effectiveness.

BACKGROUND: Recent approaches to treating selective mutism (SM) have increasingly emphasized parent involvement, and several parent-mediated programs have shown promising efficacy. However, in regions where SM specialists are scarce, families have limited access to appropriate support. In this context, online behavioral parent training (BPT) may serve as a promising and scalable option that can overcome geographic barriers. Nevertheless, empirical studies specifically targeting SM-focused BPT remain limited. This pilot study evaluated the feasibility and preliminary effectiveness of an online BPT program developed for parents of children with SM. METHODS: This pilot study evaluated the feasibility and preliminary effectiveness of a nine-session online behavioral parent training program (SM-BPT) for parents of children aged 3 to 9 years with diagnosed or suspected SM. Seventeen parents enrolled in the program, and 13 completed both the intervention and the pre- and post-assessments. Changes in children's SM symptoms, anxiety, and behavioral problems were assessed alongside parenting behaviors and parental mental health. RESULTS: Following the intervention, significant improvements were observed in children's school-based SM symptoms (p = .04), anxiety (p = .03), and internalizing (p = .03) and externalizing behaviors (p = .02). However, no significant changes were found in total SM symptoms (p = .22) or home/family communication (p = .83). Parents reported reduced negative parenting behaviors (p < .001) and improved mental health (p < .01). In contrast, positive parenting did not significantly change (p = .72). High attendance (mean = 93.5%) and homework completion (mean = 73.5%) supported the program's feasibility and acceptability. CONCLUSIONS: The SM-BPT demonstrated preliminary effectiveness in reducing children's SM symptoms at school, as well as anxiety and behavioral problems, and in improving parental mental health. High attendance rates also suggested good feasibility. Because the program can be delivered online, it may serve as a practical option for families with limited access to specialized support. Further research, including randomized controlled trials, is needed to examine its effectiveness across diverse family situations. Trial registration UMIN Clinical Trials Registry UMIN000043686, registered on 21 March 2021.