Susan Wakefield Gibbons was doing very well in the corporate world. She had an excellent job and a good salary, and for many in her position that would have been enough, but the Bermudian mother took stock of her life and realised that she was getting older and nothing she was doing gave her real job satisfaction so she began taking a correspondence course in psychology, a subject which had always interested her.

"Then I got sick and realised life was too short (to waste opportunities), so I decided to take it further and attend a seminar on mask making," she says. "I was always artistic and I realised through that whole experience that expressive art therapy was a combination of two things I liked: psychology and the arts."

With her mind made up to undergo a "life change", Mrs. Gibbons, already the holder of a Bachelor of Science degree from New York University, duly enrolled in Lesley University in Cambridge, Massachusetts where she successfully gained her Master of Arts in Expressive Therapies and Mental Health Counselling after three years' study. Now back home, the graduate is pursuing an independent career in expressive arts therapy, which she defines as "a therapeutic process incorporating a full range of the arts, including creative writing, dance, music, and visual arts".

"The goal is to improve clients' health, socialisation and quality of life by encouraging them to explore and express their imaginative and creative processes and potential," Mrs. Gibbons says.

Based on established psychological and theoretical principles, this form of therapy is a helpful tool in dealing with a broad spectrum of health problems, including Alzheimer's, brain injury, cancer, chronic illness, diabetes, multiple sclerosis, movement disorders, trauma, palliative care, depression and stress. Mrs. Gibbons not only travels with a variety of arts-related materials, including musical instruments, crayons and pastels and drawing paper, but also balls which she uses for movement and to test coordination.

Each client's therapy programme is tailor-made for that individual, and can include various mediums: physical activities such as singing and role-playing. For example, movement is beneficial for children with learning disabilities.

"It can help with integration of both sides of the brain, improving coordination and also socialisation. Some children have problems picking up visual cues of what is and is not socially acceptable, so by doing movement, role playing or drama with them, they learn body, hand and visual cues through interaction with other children with whom they are working," Mrs. Gibbons says.

Expressive art therapy assists people with chronic illnesses, cancer and multiple sclerosis (MS) by, among other things, strengthening healing imagery, alleviating feelings of helplessness, developing better coping skills, and improving the quality of their lives.

"For example, I am not going to cure people with MS," Mrs. Gibbons says, "but what I can do is focus on the remaining strengths they have, which will end up making them feel better emotionally. I use a lot of positive psychology. If you speak to people who have illnesses, they often say if a crisis is over that the illness gave them a gift: they learned what is important in life."

In terms of dementia/Alzheimer's patients, the therapist's aim is to stimulate the brain with a view to slowing its deterioration, and hopefully open occasional rational opportunity for the person to express their feelings. Artwork can also be used as a diagnostic tool to track progression of the disease.

Visual art (painting, drawing, making collages, for example) also helps clients to express their feelings about their illness, where they are now and where they would like to be in future. In between those two poles, Mrs. Gibbons will assist them to draw up a plan aimed at reaching that goal.

Music, be it singing, playing percussion instruments, listening to recorded music, imagery or guided visualisation, teaches clients to relax and go to a place in their minds where they feel safe and stress-free.

"They learn that there is a safe place inside them which they can imagine no matter where they are or what they are undergoing, such as a medical procedure. People who experience anxiety attacks, for example, can learn that, by retreating to that safe place in their imagination, their symptoms are alleviated and they become relaxed."

Music is also beneficial in stimulating the brain of non-verbal clients, whose speech is impaired by a stroke, for example. Since speech emanates from one side of the brain and singing from another, working on a familiar song can unlock bottled up words and open an avenue of communication through alternative non-verbal avenues.

"One difference between me and other professional counsellors is that I stimulate non-verbal communication through the arts, whereas others need to have the patient talk to them," she says.

Mrs. Gibbons also teaches various relaxation techniques, including breathing exercises.

While expressive art therapy has different mediums or 'modalities' to address a client's needs, they are by no means compartmentalised. The therapist may use more than one medium in her treatment programme.

"Sometimes I go from one modality to another," Mrs. Gibbons says. "For example, I asked one person to draw their illness, then I got them to focus on what their illness meant to them while they are listening to music, then they moved to art work with chalk pastels, and explored what the image looked like through physical activity, and the session ended with writing poetry in a journal."

Since art is an evaluation tool, it does not matter how well or how badly the person has drawn something. What is important is understanding what the person is going through, and what they learn from this exercise.

In addressing situations where a client is in denial (such as a diabetic whose physical condition is unnecessarily dire) Mrs. Gibbons teaches them to take responsibility in dealing with their problem. For those suffering from depression, anxiety and emotional stress, she works to give them coping tools.

"It is all about improving the quality of life and investing in yourself - learning about yourself and what you can change to help make your life better," she says. "It is about creativity and imagination, and how you would use them in a mind/body connection."

For very ill clients, Mrs. Gibbons also provides a safe "haven" where they freely express the fears, anxieties and emotions they don't wish to share with their families. For the caregivers whose lives have been turned upside down by a serious illness, whose roles have changed, and who are experiencing a sense of loss, she offers appropriate support.

Those with other worries, such as financial or relationship problems, can also be treated through this form of therapy.

As broad as professional scope is, however, the therapist stresses she does not "replace" other forms of therapy, such as physical and occupational, nor medication in the case of those with mental conditions such as depression. In the latter cases, her role is to focus on cognitive therapy: understanding and addressing the underlying problems through the arts.

Mrs. Gibbons also stresses that there is no such thing as a "quick fix" when seeking therapy.

Asked what qualities it takes do the work she does, the expressive arts therapist says: "You have to be empathetic, compassionate and insightful, and I personally believe that you have to continue your own personal growth to be a good therapist. You can't help other people if you are not working on things that cause your own problems."

Mrs. Gibbons is an independent consultant who operates through Transitions Ltd. 237-0888.