Research
Davis Life Concepts Clinical Feasibility Study
This clinical project, which began in 2015, has been examining the benefits of a new life development program aimed at helping people to be more focused, less anxious and more effective in managing their daily lives.
In everyday terms, the study has been examining whether the Davis™ Concepts for Life programs, which have been operating around the world for more than a decade, actually work. Are people who have completed the program more able to fully participate in their lives, more able to pursue their goals and express their unique human potential?
Case studies in other countries are showing that the Davis Concepts for Life programs, which were initially developed for people with Autistic traits and Attentional difficulties (ADD and ADHD), have been effective in assisting clients improve their sense of self, their capacity to focus and be more cognitively flexible, while also enhancing participants’ ability to initiate and adapt to change and be more equipped in their social lives.
While we have been keen to ensure we can produce the same positive results for people with Autistic traits here in Melbourne, we have been particularly curious to explore whether some of these Davis Life Concepts would also help people who do not identify as being Autistic or having Autism but who are reporting (varying levels of) self-doubt, difficulties with interpersonal boundaries and being psychologically safe in relationships, perfectionism, over-thinking, cognitive inflexibility, generalised anxiety, social anxiety, stress and struggles with time management, procrastination and sequencing the tasks of daily life.
These 'everyday' psychological difficulties are some of the common reasons people present to clinical psychologists seeking help and we have wondered whether this clay- modelling approach can add a new and important dimension to the "talking therapy"process.
About the study
There are two programs in my study. To date, more than 35 participants from different backgrounds and ages (participants have to be aged eight and above) have completed or are completing one of the two programs outlined below. Further participants are due to commence over coming months.
The Davis Autism Approach - Nurturing the Seeds of Genius: a non-invasive, gentle approach, created by an American Autist Ron Davis, that aims to empower people with Autism, and their families, to better navigate their way through life and draw out the potential within. This method may be particularly appealing for people with Autism who generally function very highly but are experiencing high levels of stress, anxiety, social avoidance and sensory overload. There are three main parts (in order) to this program: helping the person with Autism to individuate by building a stronger sense of self; helping them to develop their identity in the world by exploring life's lessons and, thirdly, enhancing the person's ability to integrate socially by looking at different types of relationships and how they operate.
The Davis Concepts for Life Program: a groundbreaking new program for people (who do not have Autism) who want to create meaningful change in the way that they function in daily life. This program was developed from feedback from parents and carers of Autists and also Davis Autism Facilitators who had noticed that, in helping their Autistic clients, their own lives were considerably better after doing the clay work. This program aims to help people to consolidate their personal identity, to:
Enhance their sense of Self
Be more flexible
Manage their stress and anxiety effectively Increase their focus
Be more organised
Create more order in their life Improve their relationships
Make better decisions
Take more/less appropriate responsibility
How does it work?
The developers of the Davis Autism Approach (DAA) believe their program is effective because it provides people who identify as having Autism or Autistic traits (or attentional concerns) with the foundational tools to create change in their own lives.
The DAA aims to 'plant the seeds' that will enable change, but the resulting growth that comes for each participant is natural and nurtured by their unique capacity and inclinations. They argue that Autism is not an impairment of intellect or cognition, but a problem with 'integration'. The person has not been able to integrate new information and experiences into their life in the same way as non-Autists.
'As the Autist grows and develops, she creates barriers because she cannot develop a set of thoughts and behaviors that the non-Autistic world just takes for granted. The Davis Program provides the missing elements in a simple and direct way that is natural to the person's innate learning style - and these elements lay a path to full integration of knowledge, wisdom and understanding to successfully navigate life' (Marshall and Davis, Autism and the Seeds of Change, 2012)
They also believe these Davis Life Concepts are universally applicable - thus they are likely to smooth the developmental pathway (the hiccups) of people who do not identify as Autistic but who are noticing troublesome stresses and anxieties in managing daily life.
What actually happens in the two programs?
Some of the content, delivery and timing of the programs differs, but the approach, as it is a developmental method that applies to all people, is similar. It is a guided journey through a series of almost 50 Life Concepts (such as Me, Change, Consequence, Cause and Effect, Intention, Motivation, Order and Disorder, Responsibility) that are introduced by the facilitator, modelled in clay by the facilitator and then modelled by the participant, 'mastered' in sessions and then explored as they exist in real life.
The programs have been delivered at the pace and the frequency to suit the needs and capacities of each of our study participants (this is particularly important for people with Autistic traits undertaking the DAA who are required to have a support person, who undertake all activities with direct support from the facilitator and may require modifications in order to complete the program successfully).
Many highly able participants, those who undertake the Davis Life Concepts® Program, enjoy working independently throughout the program and often choose to do additional exploration in their own way outside of sessions.
So who is Ron Davis?
Ron is an American engineer who was born 'deeply autistic' and did not speak in childhood. Highly visual but profoundly confused by the world around him, he modelledthe behaviors of others by building tiny 'clay' models with red dirt and water.Around age 9, and against the odds, he started to come out of his 'autistic void' and began to speak. Later, aged 17, his IQ was measured at 137 (exceptional intelligence, in the top two percent of the population). At this time, speech therapy made it possible for him to speak coherently but he was unable to read due to severe dyslexia. He was functionally illiterate until age 38 and even though he achieved success as an engineer and businessman, he was hiding from others that he could not read or write. Determined to try to help himself, Ron performed an experiment on his own perceptions that profoundly changed the wayhe experienced reality. The breakthrough enabled him to correct and control the involuntary perceptual distortions, which were at the root of his dyslexia. For the first time in his life, he was able to read a book, cover to cover, without struggling. You may have heard of the Davis Dyslexia® Program, an internationally available intervention teaching dyslexic students how to recognize and control the mental state that leads to distortedand confused perceptions of letters, words and numerals.
From there, Ron began working on his Autism, and this is his explanation of his process (in his words):
"Somehow, around the age of nine, I began to individuate and develop out of the state of oblivion—out of the void. In hindsight, I can see there was about an eleven-year delay in my early development. Also, in hindsight, I can see there were three phases that I had to go through to become a human being.
First, I had to individuate, I had to stop being everything and nothing and become just one thing, my body. Second, I had to develop an identity for the thing I had become. And third, I had to adapt to the world of being human and become socially integrated.
So there are three phases our “seed” must go through in the process of becoming human— individuation—identity development—and social integration. I think all “normal” humans, in the first few years of life, go through this same sequence naturally. Although identity development and social integration are never totally completed, there has to be enough to allow the individual to exist as a human being. I also think that some individuals either fail to start or sufficiently complete one or more of these three phases, and therein we can find autism".
What is happening in the Clinical Feasibility Project?
Currently, there is limited access to the Davis Life Concept programs in Melbourne - only New Zealand, South Africa, the USA and parts of Europe. Anecdotal and case study reports from participants who have completed Davis programs in these countries continue to indicate positive and significant, life-changing individual results.
But independent research, such as this project, is only just beginning. The facilitators of the Ron Davis Foundation have been very keen to see our results, as they believe in their work and their findings but, clinically speaking, new treatments need to be shown to work by independent researchers before they can be offered or accepted as valid approaches more widely.
Hence this study is attempting to see if we can demonstrate that clay modelling life concepts does indeed work in achieving its stated goals - and that it is practically and financially feasible for people of all sorts of backgrounds, including people with or without Autism, to undergo these programs.
Some of the specific questions underpinning the research are:
1. Does the Davis Autism Approach meet its goals? Does an improvement in daily functioning reduce overall anxiety and the psychological wellbeing for our participants?
2. Does the Davis Concepts for Life Program achieve its aims? What sort of everyday problems improve for our participants who do not have Autism? What sort of people benefit and in what ways do they benefit?
3. Are these programs feasible - affordable, able to be delivered in time effective manners, can they be delivered effectively in groups?
Initial Qualitative Data - Trends for both DAA and DCLA Participants
• Less overall Anxiety, Reduced Social Anxiety, improved Mood
• Less worry, obsessive rumination
• Greater ability to concentrate and produce written work (some reports of increased reading and comprehension ability)
• Marked reduction in clinical symptoms (OCD, Generalised Anxiety, Social Anxiety )
• Greater and Deeper sense of Self (a stronger sense of self, less fear of what others’ think)
• Less Fear of Life and worry about 'what will happen next'
• Increased functional capacity (able to create order in their daily life, attend new appointments, try new things, use public transport, ask for help in shops)
• Increased cognitive flexibility
• Greater capacity to cope with change
• Reduction in Sensory Overload symptoms associated with Autism
• Reductions in Meltdowns associated with Autism
Due to these promising results, a research partnership has been formed with mental health researcher, Associate Professor Keong Yap, at ACU, who will be undertaking the independent analysis of the quantitative intake data being collected before, after and at the one-year mark following completion of the Davis method.
So far, what has changed for our participants?
CASE STUDY 2: BRIDGET
Bridget, in her mid 30s, works in a senior corporate role and reported social anxiety, difficulties with productivity, restricted cognitive flexibility and managing daily household tasks (low motivation and organisational skills). She has a loving relationship with her boyfriend but has described long-term frustration with her inability to provide herself with consistent self-care (maintaining a healthy diet, balanced eating and an exercise schedule). She commenced the Davis Concepts for Life Program in November 2017 and completed it in March, 2018. She wrote about some of the changes she had noted since commencing her clay work.
All my clothes are black, I knew this but I never noticed it. I feel good in black, it's comfy, it's safe, I feel relaxed and protected. Looking at clothing with colour or patterns makes me feel uneasy and the thought of trying them on, well that's hard to describe, but it is a combination of fear, concern and refusal. It feels impossible; it's not an option available to me. On occasion my friend has managed to coax me into trying something on in colour. I stand there rigid, like a paper doll with her paper clothes with only those tabs holding them in place. She laughs, I go back to black and we move on.
And then one day I bought a blue dress and I bought a red dress. This change and others came gradually.
It took a while before I noticed myself responding differently to situations than I normally would have. One of the first times I noticed myself being different was the first day back at work after the Christmas break and when I arrived I walked around and greeted everyone in the broader team and asked them about their break instead of catching up only with my friends at work and then heading to my desk. It sounds very simple but this type of interaction would not have occurred to me before, or if the thought had occurred to me because I have seen other people doing such things, then I couldn’t be bothered with it. It felt difficult somehow, like I wasn’t exactly sure how the exchange should go or if they would be interested or how long the conversation should go for, what we should talk about. But on that first day back, it was a little clearer to me.
I also noticed that I was clearer with myself, internally my decisions had more structure, they were more defined.
My compulsive behaviours were easing. I noticed one night when I was watching a movie and it was just passed my bedtime I decided to turn the movie off and go to bed, knowing that I could come back to the movie another day and that I valued getting enough sleep and going to a 6am yoga class more. This was impossible for me only months earlier. Another night after I came home from work I listened to music and read instead of watching TV for hours. Reading and listening to music is something I had often wished I spent my time doing but always found myself watching TV and unable to stop.
The next change I noticed was that I would go to yoga or I wouldn’t. Yoga is one of my favourite things to do but it was always really difficult for me to go consistently. Yoga was meant to be my place of restoration but attending was a battle and I was both armies.
One side was fighting to go each day and the other side which was stronger kept me away and I never really understood why. When I went I felt good and when I didn’t I felt guilty. Going to yoga felt temporary, like it would vanish and that it didn’t really belong to me. So after a stint of attending regularly and I missed that next class, that was the end, it was all over and I wouldn’t go for a while and the whole time I wasn’t going I felt guilty, it wasn’t a clean decision not to go, it was messy and I was in trouble with myself for not going. I was disappointed with myself and I couldn’t understand why I wouldn’t go and I constantly wondered when it would be that I would get there again like it was determined by something outside of me, like it was a magic potion that required a full moon, a snip of a unicorn’s tail and a four leaf clover. And then, after starting the clay work, it was easier for me to go, I would go four times a week for weeks in a row. And when I was tired and my commitments in life meant that I had too much on and that I’d rather not go to yoga then I wouldn’t go and I was ok with that. I knew that I would go again when it was right for me; I was allowed to have a yoga practice.
These internal changes resulted in some very useful external changes. A really important learning for me was about things having a condition and a place. When it came to my homework of taking responsibility for an area that I had not I chose cleaning up some cupboards that I had stuffed with stuff and they had become unworkable. I had stuff that I was keeping but wasn’t sure why, I didn’t feel able to throw it out but I didn’t really want to keep it either. In completing the exercise I learned to identify the thing, identify its condition and then its place and in doing so understood that some stuff didn’t need keeping because it was no longer in the right condition, for example clothes that were too small or boxes that I was keeping which my camera, phone and a speaker had come in. I was keeping them because I still had each of those items but those items each had their own place in my apartment and I didn’t need those boxes in the cupboard.
Place was the concept that really changed things though and is what helped me learn why things became messy in my living space. Sometimes things were messy because things were just out of their place like when I leave my shoes on the floor instead of in the wardrobe where they belong, other times it was because I didn’t know the place for the thing and so it got shoved in the cupboard. In taking responsibility for these spaces I had to decide the right place for these items that I wanted to keep. Since then it’s been much easier to keep my space in order and when I let things get into disorder I enjoy knowing that they are in disorder and I know what it takes to put them in order and that I will put them in order when I have had enough of the disorder. No longer is my space being clean about me being a good person and when my space is dirty am I a bad person, a lazy person or someone who just hasn’t got their life together.
The words that keep coming to me as I’m noticing what has changed since the clay work are; it sounds simple. It sounds simple, I say hello to people, I go to yoga or I don’t, I clean my stuff up. These are things that I’ve noticed other people have had and I have not and now that I have them too it actually feels easier to be me.
I have noticed that when I interact with others, particularly strangers or those whom I don’t know so well, I am less in my head, I am less concerned with what others think or are thinking about me. I am freer to just be and see what happens. Interacting with other people is far simpler these days. I don’t retreat to my mind during social occasions. I used to spend 90% of the time I was out with people in my head and now it’s probably 30%. I still really enjoy being in my mind and I still think it’s a better place to be than dealing with some of the people that I come across but I have much more freedom to be where I am. This has resulted in some enjoyable social occasions.
I was invited to attend my boyfriend’s sister’s hen’s day. And for the first time I was excited. I saw it as a chance to try out what I had learned in the program and to see what might be different and possible. Rather than spending the weeks leading up to the event dreading it, being nervous and worried about what they would all think of me and if I would speak to anyone or would I spend the day standing alone being awkward I was aware that we were all attending because we wanted to celebrate and that this time round I was more aware of the social rules. In a previous almost identical occasion I had wondered why the other guests didn’t include me immediately and why we weren’t fast friends and by the time they had all warmed up several hours and drinks later I was over it, tired, disappointed and wanted to go home. This time though I knew the social rules, that I’d be spending time with the family whom I knew first, that a few friends would be more polite than others, that they all knew each other and so it would take a while for them to get to me, if at all, and it would all be ok because it didn’t mean anything about me, it was a group of people coming together. As a result I stayed for hours and hours, much longer than I ever would have before. I had more in-depth conversations with some and nothing at all with others and it was all ok. A couple of times I noticed that I was in my head and worried about whether they thought I was nice or not and that after 8 or so hours I was really tired and was out of social graces so I left, and I was very ok with that decision.
In my professional life I attend industry breakfasts and these have always been the source of anxiety for so many reasons, I’m constantly worried about not knowing what they are talking about, that people will be able to tell that I am incompetent and that I just have no idea what to say to people. You are meant to get there 15 mins early to network but I always try to get there right as the formal part starts so that I can avoid people but the last time I did that the traffic was really bad and I missed the whole event which I was really disappointed about because I get so much out of it. So the next time I made sure I was there early and when I walked in the room I decided I couldn’t be bothered with the worry and I would just let happen what would happen. And what happened was a bit of an awkward start but momentum gathered and I ended up having a really interesting conversation with a couple of different people and I met another practitioner who wanted to catch up for a coffee at another time to have a more in depth conversation.
It feels easier to be me, not everything is fixed, I still have bouts of depression and I still get overcome by worry, concern and fear but it seems to be more contextual and when that context clears up so do the afflictions. The changes sound simple and straight forward but have meant that I participate more fully in my life and I’m really happy about that.
PILOT CASE STUDY: EMMA
EMMA, aged 30, had been struggling with chronic anxiety, among other difficulties, for the past 10 years. She now identifies as having Autism after extensive discussion and assessment as part of the therapeutic process. Despite graduating with a law degree, and finishing in the top of her private school's VCE class, she had reported to many therapists that she was living with debilitating levels of anxiety that were making it impossible to function beyond the familiarity and safety of her home. She was the first participant in this current study and commenced the clay modelling in February 2016 as part of a pilot case study. Attached here is a summary of the results of Emma’s work with the clay method, which was accepted as a paper to the Australian Psychological Society’s National Clinical Psychology Conference in May, 2020 (additional paper presented May 2022).
PART A: N = 1 CASE STUDY (JAN 2016-JULY 2018)
The study commenced with the delivery of the Davis Autism Approach (DAA) to a patient in Dr Ryan’s Clinical Psychology practice - a 28-year-old socially isolated, agoraphobic, unemployed law graduate who presented with multiple treatment resistant DSM 5 Axis 1 disorders and was diagnosed with Autism Spectrum Disorder, nine years after her initial hospitalisation for Anorexia Nervosa.
PATIENT BACKGROUND: The patient had never worked, was living in her father’s home and had received psychiatric and clinical psychological care from multiple practitioners for approximately 10 years prior to commencement of the DAA in January 2016. Due to chronic mental health distress, high levels of frustration and overwhelming sensory symptoms related to ASD, she volunteered to test the method after failing to achieve and sustain meaningful symptom alleviation and functional life change with Psychiatric, CBT and Mindfulness-based Therapies.
METHOD: A tailored 18-month fortnightly intervention paced to the client’s mental health and functional status using clay to make concrete models of abstract developmental concepts that were subsequently explored with behavioural experiments.
RESULTS: The patient’s self-reported levels of Social Anxiety, Generalised Anxiety, Panic Disorder, Agoraphobic Disorder, Depressive Disorder and Obsessive Compulsive Disorder decreased from between 60-70 percent to 30-40 percent (patient rated subjective symptom alleviation). There was a clinically significant increase in her ability to complete daily functional tasks, to socialise with family and friends, to initiate new recreational and vocational pursuits and to implement long-term goals, such as moving out of the family home and commencing post-graduate study. She demonstrated an ability to learn and adapt from her life experiences rather than only understanding life on an abstract, intellectual level.
The patient’s Autism Quotient Scores were reduced from 40/50 to 34/50 at One-Year Post and her self-reported Sensory Symptom Profile scores dropped across multiple domains. A parent and sibling report post Program and One Year Post program both described multiple behavioural changes in family, daily life and functional domains. At two-year follow-up, her AQ score had dropped to 29 - a score above 32 is the cut-off for which 80 percent of people would be likely to receive a formal diagnosis of ASD or significant traits.
CLINICAL OBSERVATIONS: The patient achieved remarkable personal gains - she reported being able to read again (after being too obsessive to focus for reading), she began to wear new outfits to therapy (after wearing the exact same outfit for two years), she socialised for the first time in 10 years with old school friends and relatives, completed a volunteer teaching course, began teaching English as as second language, she attended family functions for the first time in 10 years, she enrolled in a post-graduate medical-based degree and has been living away from home for 18 months. She has since driven her car, used eftpos machines and visited the supermarket for the first time as an adult. She manages to attend lectures, participate in group assignments and complete workplaces based assignments and has achieved high distinctions in her course. At March 2020, the client was due to complete her final placements for her course, with the aim of graduating next year.
The patient reports a profound shift in her sense of self, her self-care and assertion skills, her ability to initiate and tolerate change and undertake activities with personal meaning.
DISCUSSION: This single case study demonstrated that the DAA, as a novel method, made a clinically remarkable contribution to this patient’s ability to function and achieve a significant improvement in her overall mental health profile. It also appeared to reduce aspects of this client’s Autism in terms of increased cognitive flexibility, stronger ability to learn from experiences so less anxious in new situations, less sensory disintegration, improved communication. She reported and displayed evidence of a stronger sense of self and that reduced her overall anxiety and avoidant behaviours, which has important implications for Mental Health Clinicians. The results indicated that further examination of this tool in a clinical setting was highly warranted.
CHIEF CLINICAL INVESTIGATOR: BACKGROUND
The clinical feasibility study was established by Dr Jacinta Ryan (BA Honours, Phd) in her Clinical Psychology Clinic in central Melbourne in 2015.
She has received training and supervision in the delivery of the Davis Life Concepts method from Lorna Timms, the International Director of the Ron Davis Autism Foundation. The design and implementation of the study is being conducted fully independently of the Ron Davis Autism Foundation and she has received no payment from them for her role in the establishment of this feasibility research program.
* Dr Ryan is a registered Clinical Psychologist who has expertise in the treatment of Anxiety Disorders with a particular focus on Social Anxiety, Generalised Anxiety, Panic Disorder and Agoraphoia, OCD, and Mood Disorders and she worked for seven years at The Melbourne Clinic, a specialist inpatient and outpatient psychiatric facility, where she led the Social Anxiety Program and developed a CBT Day Program for Major Depressive Disorder.
She established her private practice in 2001 and treats patients with Anxiety and Mood Disorders, Personality Disorders and ASD - she consults privately and from a general medical practice in a community setting and provides CBT, Mindfulness and Psychodynamic informed therapies. She has consulted to a private specialist OCD Clinic and also to the Alfred Hospital’s Urology Department, providing assessment and brief interventions for patients presenting with complex mental health needs to a Continence Service.
Dr Ryan completed her undergraduate degree at the University of Melbourne from 1994-1997 before graduating as the recipient of the Australian Psychological Society’s annual APS Prize for Academic Excellence as dux of the University of Melbourne Psychology Honors’ Class of 1997. She was offered a full scholarship to Monash University and commenced her Doctorate of Clinical Psychology degree in 1998, before graduating with a PhD on Institutional Betrayal Trauma (with completed Clinical Doctorate coursework) in 2005. Dr Ryan was a previous recipient of a full Rotary scholarship for Academic Excellence for one year of university study in the United States (Michigan) and the winner of the 2001 Mental Health Services Conference Special Media Award across Australia and New Zealand - the award was allocated for a newspaper feature article she wrote on people living with Anxiety for “providing accurate and sensitive courage,breaking down stigma and educating the community about mental health”.