Abstract
Selective mutism is an anxiety disorder in which an individual is unable to speak in certain social situations though may speak normally in other settings (Hua & Major, 2016). Selective mutism in adults is rare, though people with this condition might have other methods of communicating their needs outside of verbal communication. Healthcare professionals rely on a patient’s ability to communicate to establish if they have decision-making capacity. This commentary responds to a case of a young adult patient with selective mutism and social anxieties that significantly limited his ability to communicate with anyone in the healthcare team. This required a creative, patient-centered approach to engage in meaningful communication.
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References
Appelbaum, P. S. (2007). Assessment of patients’ competence to consent to treatment. The New England Journal of Medicine, 357(18), 1834–1840. https://doi.org/10.1056/NEJMcp074045
Chambers, H. G., & Chambers, J. A. (2015). Effects of caregiving on the families of children and adults with disabilities. Physical Medicine and Rehabilitation Clinics, 26(1), 1–19. https://doi.org/10.1016/j.pmr.2014.09.004.
Ganzini, L., Volicer, L., Nelson, W., & Derse, A. (2003). Pitfalls in assessment of decision-making capacity. Psychosomatics, 44(3), 237–243. https://doi.org/10.1176/appi.psy.44.3.237.
Ganzini, L., Volicer, L., Nelson, W. A., Fox, E., & Derse, A. R. (2005). Ten myths about decision-making capacity. Journal of the American Medical Directors Association, 6(3), S100–S104. https://doi.org/10.1016/j.jamda.2005.03.021.
Garcia, A. M., Freeman, J. B., Francis, G., Miller, L. M., & Leonard, H. L. (2004). Selective mutism. In T. H. Ollendick, & March J. S. (Ed.), Phobic and anxiety disorders in children and adolescents: A clinician’s guide to effective psychosocial and pharmacological interventions (pp. 433–455). Oxford University Press.
Grisso, T., Appelbaum, P. S., & Hill-Fotouhi, C. (1997). The MacCAT-T: A clinical tool to assess patients’ capacities to make treatment decisions. Psychiatric Services (Washington DC), 48(11), 1415–1419. https://doi.org/10.1176/ps.48.11.1415.
Ho, A. (2008). Using family members as interpreters in the clinical setting. The Journal of Clinical Ethics, 19(3), 223–233. https://doi.org/10.1086/JCE200819304.
Hua, A., & Major, N. (2016). Selective mutism. Current Opinion in Pediatrics, 28(1), 114–120. https://doi.org/10.1097/MOP.0000000000000300.
Karakaya, I., Şişmanlar, Ş. G., Öç, Ö. Y., Memik, N., Coşkun, A., Ağaoğlu, B., & Yavuz, C. I. (2008). Selective mutism: A school-based cross-sectional study from Turkey. European Child & Adolescent Psychiatry, 17(2), 114–117. https://doi.org/10.1007/s00787-007-0644-x
Kumpulainen, K., Räsänen, E., Raaska, H., & Somppi, V. (1998). Selective mutism among second-graders in elementary school. European Child & Adolescent Psychiatry, 7(1), 24–29. https://doi.org/10.1007/s007870050041.
Markowitz, J. T., Cousineau, T., Franko, D. L., Schultz, A. T., Trant, M., Rodgers, R., & Laffel, L. M. (2014). Text messaging intervention for teens and young adults with diabetes. Journal of Diabetes Science and Technology, 8(5), 1029–1034. https://doi.org/10.1177/1932296814540130.
Mason, M., Ola, B., Zaharakis, N., & Zhang, J. (2015). Text messaging interventions for adolescent and young adult substance use: A meta-analysis. Prevention Science, 16(2), 181–188. https://doi.org/10.1007/s11121-014-0498-7
Muris, P., & Ollendick, T. H. (2021). Selective mutism and its relations to social anxiety disorder and autism spectrum disorder. Clinical Child and Family Psychology Review, 24(2), 294–325. https://doi.org/10.1007/s10567-020-00342-0
Newton-Howes, G., Pickering, N., & Young, G. (2019). Authentic decision-making capacity in hard medical cases. Clinical Ethics, 14(4), 173–177. https://doi.org/10.1177/1477750919876248.
Nobles, A. L., Glenn, J. J., Kowsari, K., Teachman, B. A., & Barnes, L. E. (2018). Identification of imminent suicide risk among young adults using text messages. In Proceedings of the 2018 CHI Conference on Human Factors in Computing Systems (pp. 1–11). https://doi.org/10.1145/3173574.3173987
Seely, K. D., Higgs, J. A., & Nigh, A. (2022). Utilizing the teach-back method to improve surgical informed consent and shared decision-making: A review. Patient Safety in Surgery, 16(1), 1–9. https://doi.org/10.1186/s13037-022-00322-z.
Sharp, W. G., Sherman, C., & Gross, A. M. (2007). Selective mutism and anxiety: A review of the current conceptualization of the disorder. Journal of Anxiety Disorders, 21(4), 568–579. https://doi.org/10.1016/j.janxdis.2006.07.002.
Stephens, J. D., Yager, A. M., & Allen, J. (2017). Smartphone technology and text messaging for weight loss in young adults: A randomized controlled trial. The Journal of Cardiovascular Nursing, 32(1), 39. https://doi.org/10.1097/JCN.0000000000000307.
Wasserman, J. A., & Navin, M. C. (2018). Capacity for preferences: Respecting patients with compromised decision-making. Hastings Center Report, 48(3), 31–39. https://doi.org/10.1002/hast.853.
Wichmann, A., & Krakauer, D. (2023). Communicating with intubated patients: Adaptation of orientation and capacity assessments to elicit preferences and goals. Chest, 164(4), A1944. https://doi.org/10.1016/j.chest.2023.07.1336
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Mercado, N.R. Can We Be Creative with Communication? Assessing Decision-Making Capacity in an Adult with Selective Mutism. HEC Forum (2024). https://doi.org/10.1007/s10730-024-09523-8
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DOI: https://doi.org/10.1007/s10730-024-09523-8