For those with many questions on medication, we suggest the NEW CD-ROM/Audio CD's presented by Dr. E. Medication: Why, When and HOW to use Safely and Effectively in the Treatment of Selective Mutism.
What percentage of patients at the SMart Center are placed on medication?
Based on our present patient population, for approximately 30-40% of patients, medication is recommended as an adjunct. However, please keep in mind the following:
- Since children/teens with SM are our entire focus, we see patients of varying degrees of severity. Due to Dr. Shipon-Blum's specialty, many families who present to the Smart Center have been to multiple treatment professionals in the past and minimal progress has been made. By the time many present at the Smart Center, they have exhausted many forms of treatment.
- The older the child, The more severe and co-morbid problems that exist, the more likely medication may be recommended.
- The younger the child, the less co-morbid problems that exist the less likely medication will be recommended.
If my child needs medication, can our child receive medication and monitoring at the SMart Center?
Absolutely!. Dr. Shipon-Blum is a medical doctor. Therefore in addition to providing SCAT, she will prescribe medication if necessary. Monitoring is individualized and done carefully and ranges from every two weeks/ONCE per month in the beginning of treatment to every three months once stable. Monitoring is done very carefully. Dr. E requires parents to update via email or phone (to staff) every week (in beginning of medication usage) to indicate child's tolerance and response to medication.
What if we are against medication, but Dr. E recommends medication, will my child not be treated at the SMart Center?
Dr. E respects your decision whether to use or not to use medication as an adjunct to treatment. However, many parents are uninformed about 'medication' and form opinions without completely understanding. If Dr. E recommends medication and a parent is against medication, Dr. E will simply ask the parent to read about the medication and to ask her about the questions they may have. IF after a thorough understanding, parents are still against the use of medication, treatment will continue without medication being used.
What types of medication are used at the SMart Center?
If medication is recommended, 99% of patients are placed on a Selective Serotonin Reuptake Inhibitor (SSRI) (I.e., Prozac, Zoloft, Paxil, Celexa, etc) or a medication very closely related to an SSRI (I.e., Effexor)
Why is medication recommended?
Medication is used as an adjunct to help lower anxiety just enough to do the necessary behavior therapy necessary to build coping skills. For some children/teens, anxiety is so high, that a short course of medication enables for the lowered anxiety needed to accomplish therapy.
How long does a child remain on medication?
The goal is 6-12 months depending upon clinical response.
How does Dr. E monitor medication?
Very Carefully! Dr. E believes that 'less is more.' and manages 95% of her patients on less than the equivalent of 20mg of Fluoxetine (Prozac). Prior to using medication, Dr. E will ask a series of questions to be sure medication is safe to use with your child. She will exam your child, supply you with a handout, answer your questions about medication and will explain to you the purpose and how medication will be used. Side effects will be discussed in detail. Your child will return within 2 weeks of beginning medication.
Dr. E will ask you to email her after the first few days of beginning medication. Prior to your follow-up visit, you will be asked to fill out the SM-Follow-Up Eval. (c) that assesses your child's treatment progress and clinical response to the medication. At your visit, after treatment status and degree of progress has been determined, Dr. E will exam your child and determine whether to continue present dosage, increase or decrease the dosage. It is very rare to have to decrease dosage.
Typical Treatment Course for children/teens with Selective Mutism.
There is an initial consultation for each patient needing treatment. This includes time with the parents and child.
Depending upon whether the family chooses a comprehensive or Per Service consultation will dictate the length of the consultation as well as what is provided at or following the consultation.
Follow Patients are typically seen every two weeks to monthly at the SMart Center and fees are dependent upon the professional providing the service.
Follow-up appointments include assessment of the SM Follow-Up Form (c) and the SM School Evaluation Form (c), a one hour consultation and handouts and/or an Appointment Summary for each consultation.
For parents who are cost conscious, our rates and total fees are actually LESS than many other treatment programs.
For example, if a child goes thru treatment for four months and is seen every two weeks:
- Costs for Dr. Shipon-Blum's treatment would include the cost for the initial consultation (Range: $550-$1495 depending upon requested service). At $275 per follow up consultation at two times per month, PLUS one school consultation, costs would average $2475.
- Costs for Dr. Crenshaw or other Licensed Psychologists would range from $550-825. At $210 per follow up consultation at two times per month, PLUS one school consultation, costs would average $1890.
Since treatment at the SMart Center is often shorter than in other locations and treatment occurs less frequently, overall costs are usually lower than one would expect!
For questions please feel free to contact us by:
Phone: 215-887-5748 or email