Conversation: When the words won’t come

Barbara Devaney in conversation with husband William Pattengill

William: You are able to use the arts to help your clients access their feelings in addition to the verbal exchanges of traditional talk therapy. Can you share how you first encountered this way of working and what led you to adopt it in your practice?

Barbara: Years before my formal training began as a therapist in California, in my late 20’s, I enrolled in a sculpture class after a challenging life transition. Through making art and journaling I found a way to new insights into my healing process and a potential transformation.

A few years later I had the opportunity to facilitate an art group for the inmates transitioning back to the community from federal prison. The goal was to help them, mostly ‘white-collar criminals’, prepare for a return to society by offering access to the arts to express themselves and process whatever was coming up for them at a challenging time. Once again, I was inspired by how the arts could help people find ways of communicating without words. This job led to another similar position for the same organisation that helped mothers who had birthed their babies while in federal custody, using the arts in the same way.

William: So, you already had experience in working this way before you began your education as a therapist. Did that influence your choice of your graduate program?

Barbara: Living in San Francisco at the time, I was fortunate in being able to attend the California Institute of Integral Studies (CIIS) which has a faculty with a wide range of experience in different modalities, some being pioneers in their fields. Among them were Natalie Rogers for person-centered approach, and Gabor Maté for working with trauma.

Before graduation I served as a program director for Independent Living Network, a small nonprofit dedicated to help women with disabilities live independently with access to supports as needed, as opposed to life in a group home. Here I was also able to incorporate art into the programme.

William: Were you able to use art therapy soon after graduation from CIIS?

Barbara: In order to accumulate the 3,000 hours of clinical experience towards licensing in the State of California, I successfully applied for a job at a San Francisco Community Mental Health Clinic. My master’s degree practicum consisted of work with severely mentally ill clients, who were well suited to benefit from alternative methods to talk therapy. I organised a gardening group, and was also able to use the arts with this population.

I later became programme director for adult women clients with comorbid developmental disabilities and mental health diagnoses. So often clinicians are unsure how to work with this population, but I found the arts and other non-verbal approaches are a perfect fit in their case. During my tenure at the county clinic, I was responsible for hiring and supervising other clinicians who were also working towards licensing.

After four years of internships, I became licensed in 2006 and began my private practice, incorporating as “Explore and Express Family Counseling” because that phrase describes the process that can enable clients to work through life challenges when words don’t come easily.

William: Please say something about the range of clients you have worked with since beginning your private practice.

Barbara: It has been an interesting mix of high functioning individuals and people with special needs, including those on the autism spectrum, with cerebral palsy, Down’s syndrome, seizure disorder, and intellectual disabilities. I work with families as well.

William: What are some of the methods you are using?

Barbara: I use painting, drawing, clay, symbolic cards, and even coloured scarves to engage the client in a playful manner. I have used sandplay therapy as a way for clients to express past and present issues by choosing personally significant objects from my large and diverse collection. They then arrange them within the safe confines of the sand tray. Some clients much prefer this indirect way of expressing emotions that may arise from difficult life situations. I later photograph their arrangements for my case files.

In cases involving traumatic memories and PTSD, I sometimes use EMDR (Eye Movement Desensitisation and Reprogramming) therapy which uses somatic sensations in conjunction with a limited amount of dialogue. It can be effective when people struggle to talk about buried feelings and memories, and it can also benefit those with complex childhood trauma, as well as single experience trauma.

William: Have you observed better outcomes with these methods for your clients who had little success with talk therapy?

Barbara: Most definitely. It is a psychotherapeutic process that engages both left and right sides of the brain which some people respond to much better than activating just the left or logical side.

William: When you relocated to Ireland in 2019 you became an early adopter of working online, with what we now know as telehealth. You no longer had a shared space for working with art materials, so how did that affect your way of working in that realm?

Barbara: It wasn’t as difficult a transition as it seemed at first. I just asked the clients who liked working in the arts to provide their own materials and make art at home instead of at my office.

William: In May of this year (2022) the Regulation of Social Care Professionals known as CORU launched a five-year Statement of Strategy. Do you have an opinion on the tightening of standards in your profession?

Barbara: Having the experience of working through a long and rigorous licensing process in California, I can appreciate both the challenges to therapists to comply and the benefits to our clients over the long run, when everyone has a more even playing field.

Barbara Devaney, MIACP, is a marriage and family therapist in private practice working both remotely, internationally and in clinic in Cork. She is a graduate of the California Institute of Integral Studies with a Master of Arts in Counseling Psychology and in 2020 received the Kennedy-Shriver Award for excellence in the treatment of people with special needs presented by the University of San Francisco School of Medicine. Her speciality in practice is using the expressive arts to work with trauma and special needs. She is also certified in EMDR in Europe and the U.S.

William Pattengill is a member of the editorial board and occasional contributor to Inside Out. After retiring from the home renovation field, he has enjoyed the opportunity to return to his roots as a journalist.

IAHIP 2022 - INSIDE OUT 98 - Autumn 2022