The sound of crinkling foil whispers through the room as a couple dozen art therapy and social work students bend their heads over balled up sheets of aluminum.  Mónica Sánchez, senior mental health counselor and art therapist at LSA Family Health Service, moves through the room, answering questions.

She is leading the students in a ‘self-acceptance’ art therapy exercise she regularly employs with women at LSA.  She has presented her methodology at NYU, Columbia University, the New York Women’s Resilience Conference, and the national Philadelphia Trauma Training Conference, among others.

What makes Sánchez’ work unique is the way she combines trauma-informed cognitive behavioral therapy with art therapy. She is able to reach immigrant women with literacy barriers whose primarily language may be an indigenous language, like Mixteco. Because these women can be reluctant to seek outside help, even to go to the hospital, they are often “invisible” in traditional systems of care.

“Who is serving women who are indigenous?” Sánchez said recently. “Sometimes they don’t even speak Spanish. The students really want to understand how we do that.”

The key is the art therapy.  Where a patient in traditional cognitive behavioral therapy may be asked to write about her feelings, Sánchez employs artistic mediums such as drawing, photography and clay work.

“We’re designing a program that is tailored for clients of LSA.  Some may not know how to read or write, but they’re very intelligent.”

By sharing her culturally-competent approach to therapy with immigrant women, she helps others understand the complexity of the work. “All of our clients are high-risk,” she explains. On any given day, Monica may be helping a client struggling with domestic violence, sexual abuse, suicide risk, or postpartum depression.

She emphasizes the importance of building a trusting relationship with the client as part of the trauma-informed approach: “I use every moment to make a connection. I’m very privileged because clients really trust the agency. I think they feel safe here. They’re able to express themselves better and advocate for themselves.”

For women who meet weekly in her art therapy group, workshops culminate in exhibits of their art work. Sánchez highlights the exhibit as a clinical goal. “It is an amplification of their voices,” she explains. “It is recognizing a story that has beauty in it, even if it has been tragic and difficult. Clients really like it. Some clients cry when they see their self-portraits. They don’t recognize themselves.”