“Before I went to New York I felt I had superglue on my mouth. But now I don’t because I practiced brave talking.”

The speaker is an 8-year-old girl named Lily, who lives in Arizona. Lily had selective mutism — she had never spoken a lot, and her struggles intensified when she entered preschool. Last year her family came to the Child Mind Institute for an intensive treatment program called Brave Buddies. Afterwards, her mother said, she talked to more people in a week then she had in her whole life.

Selective mutism, or SM, is a condition in which a child who is comfortable talking at home is unable to speak in other, more public settings, including school. You see kids with this anxiety disorder shut down with fear when they’re expected to talk. Some go through years of schooling without uttering a word.

Learning to speak up

Brave Buddies uses a classroom-like setting to let kids practice speaking in a safe place with a great deal of positive reinforcement for using their voices, or “brave talking.” The cornerstones are one-on-one attention from trained counselors and constant opportunities for crucial peer-to-peer interactions. Activities are geared towards building skills so kids can speak in more and more challenging situations, and continue their gains after the program is over.

Lily recently came back to the Child Mind Institute, along with two other graduates of the program, to speak about her experiences to a room full of parents and Brave Buddies alums. In a small but perfectly audible voice, she began by describing her family, including a rat named Sprinkles, a bird (Petey), a snake (Lennon), two cats (Katie and Jasmine), and two spiders (Charlotte and Scoobie Doo).

Wearing a T-shirt with the words “Pretty and Brave,” and with B-R-A-V-E spelled out on her fingernails, Lilly explained her favorite parts of Brave Buddies: “Field trips and learning brave talking.”

How Brave Buddies Works

Brave Buddies is based on evidence that behavioral therapy for children with selective mutism works best when kids get intense practice at brave talking, and practice their skills across as many different settings and activities as possible. So Brave Buddies offers two week-long programs a year, and several one-day programs. And kids practice their skills not only in the simulated classroom but also on trips to places like the local ice cream store, restaurant, library, and park.

Lily’s favorite field trip? “Going on a scavenger hunt to an American Girl Doll store—asking where things were, like Coconut the dog, and different dolls. We talked to a lot of people.”

Autumn, a 7-year-old veteran of Brave Buddies who was also on the panel, explained to parents the purpose of the field trips. “I would practice bravery by buying cheese puffs at the deli and asking how much they cost.”

Related: Parents Guide to Selective Mutism

Fun tempers fear

The program includes a series of fun activities that prompt kids to talk. “Physical activity often make kids feel less inhibited, which helps them engage overall,” explains Rachel Busman, a clinical psychologist and the head of the Selective Mutism Service at the Child Mind Institute. “And since talking is very hard work for these kids, we integrate fun into the work.”

Autumn recalled that one of the most fun things she did in Brave Buddies was “practice trick or treating. My mask was a cat.” The menagerie didn’t stop there. “We made balloon animals during a brave talking practice,” she recalled. “I made a duck.”

Each Brave Buddies day ends with a trip to the prize store — a chance for children to practice buying a toy on their own with the points they’ve earned for brave talking. “When we’re asking kids to do something hard we use Brave Bucks, or prizes or praise to help them be brave,” explained Laura Kirmayer, a clinical psychologist and the director of the Brave Buddies program.

Braving the outside world

Brave talking, with support and encouragement, continues at home and at school. “Parents are taught the same skills that we’re using with the children,” said Dr. Kirmayer. “So when they go home, they’re continuing to maintain the gains, or even build more momentum, because the skills are being used on a daily basis.”

Nika, the third child participating in the Brave Buddies panel, shared a scrapbook of all the brave talking she had done at school, including entries, drawings, and the Brave Bucks she had earned. Talking at recess was one of them.

The most difficult brave talking Nika has done: “Talking to my Spanish teacher, Miss Jefferson.”

Autumn’s toughest brave talking success: “Talking to my priest at church. He has a loud voice, and is big!”

Dr. Busman explains that for kids with SM, some people may be harder than others to talk to—especially those who have an imposing voice or size.

When asked, the children allowed that they can still sometimes feel anxious or worried when expected to speak in public. Dr. Busman noted that treatment is all about helping them develop stress tolerance. “The goal isn’t to get rid of all anxiety, but to learn to tolerate it, and be able to talk despite it.”

Nika was asked if she is still doing brave talking with her Spanish teacher.

“No,” she said clearly. “Now it’s just regular talking.”