Elective mutism represents a relatively rare clinical syndrome in which children with normal verbal capabilities totally refuse to speak in select settings for prolonged periods of time. It is often described as particularly treatment resistant. This study describes 20 strictly diagnosed elective mutes treated, using the Hawthorn Center approach. As found in other studies, most of the elective mutes in this sample (90%) were described as controlling, negative, or oppositional, and a high rate (50%) of maternal-child overenmeshment was found. Treatment outcome using the Hawthorn Center approach was found to be at least fair for all cases and excellent for 85%.