Alumni in Social Services Rachael Madden-Connor ’00

ALUMNI IN SOCIAL SERVICES

TELEHEALTH FROM A PRACTITIONER’S PERSPECTIVE

By Cathy Morrison

Rachael Madden-Connor ’00 is a Licensed Professional Counselor (LPC) who lives and works in Fairbanks, Alaska. She treats adults and her mission is to help clients improve physical and emotional self-care so they can enjoy the highest quality of life possible. Her primary treatment areas include depression, anxiety, relationship problems, and work and school stress. Person-centered therapy, cognitive behavioral therapy and transactional analysis are her theoretical orientations. She is one of a number of Bishop’s alumni who specialize in mental health and social services, and she generously shared how the pandemic has affected her line of work and how she has helped others cope during this time. This conversation has been edited for length and clarity.

How has your practice changed in the last year?

My practice has changed so much! About 80 percent of my appointments are via telehealth now. I do in-person appointments upon request; we meet in the waiting room because it’s bigger than my office, so we can spread out. At first it was a major adjustment doing appointments with face masks on and sitting farther apart, but one year into the pandemic, it feels natural. I was afraid I’d miss a lot of body language with face masks, but that hasn’t been the case. There is so much emotion in the eyes!

How do you build connections virtually?

One benefit of telehealth in the COVID-19 era is you get to see a whole other side of patients’ lives. Over the past year, I’ve met lots of pets and young children that I wouldn’t have during a traditional office appointment. Internet speed is a challenge in the Alaskan interior. Many patients do their therapy appointments in their cars; they’ll drive to a spot in town where they know we’ll have a good connection and pull up the telehealth app on their phones. I’ve learned to adjust my expectations for sessions and to anticipate at least a few hiccups during the therapy hour.

Are you seeing new issues or an exacerbation of existing issues?

Definitely both. I specialize in treating depression and anxiety in teenagers and adults. One of the most challenging things about this pandemic is a lot of my patients’ preferred coping skills for managing their symptoms, such as going to the gym or spending time with friends, were abruptly taken away. Developing a new toolbox has been a focus of a lot of sessions this past year. Alternatively, some patients self-isolate as a symptom of depression, so COVID-19 precautions have complicated treatment. Then there are all the other challenges of pandemic life, such as marital stress, working from home and home-schooling children, that have added a new set of therapy goals to treatment plans.

What activities/advice bring the most comfort?

Approaching the pandemic through a lens of bereavement has been very helpful. Some patients feel guilty about grieving canceled trips, postponed weddings, closed gyms and more. Giving them a safe space to grieve our old normal has been very validating. My patients also respond very well to humor as an intervention. I’ll often joke with them about how this is my first time being a therapist in a pandemic and that, just like them, I am making this up as I go. Self-disclosure about my own struggles during COVID-19 is well-received, too. Lastly, I encourage my patients to take breaks from reading and watching the news and to focus on their self-care. My favorite part of my job is helping patients improve self-care. It opens this whole new world of possibilities for them, and it is such a delight to witness.

How will what you’ve learned and experienced carry forward as things become more open and settled?

Being a small business owner during the pandemic has been such a roller coaster. I’ve learned to ask for help and to use my resources. It was scary to be in only the third year of my private practice when everything first happened. At times, when I was really stressed, I wished that I was still working at a group practice or an agency, so that a supervisor or boss would tell me what to do. Creating new systems, policies and procedures by myself was daunting, but it taught me that I am more adaptable than I thought I was. It was always my dream to have my own practice, and I now have a whole pandemic playbook to go with it. I now feel confident to face whatever business challenges come my way in the future.

What has helped you navigate the pandemic’s challenges?

I’m very fortunate to have a good colleague in town with whom I talk several times a week. We’re both solo practitioners here in Fairbanks. For the past few years, we’ve been doing formal case staffing for two hours once a month and providing support to each other throughout the week, as needed. So, when COVID-19 happened, we already had a whole system in place for supporting each other. Whenever anyone asks me for advice about starting a private practice, I always tell them that the most important thing is to not be an island unto yourself. Consultation with other professionals is key. In my case, I’m very lucky because we’ve also become good friends.

How did your Bishop’s experience lead you to this work?

I remember one of my ninth-grade teachers telling our class that we were going to change the world! It was such a bold statement. It made me think that whatever I ended up doing someday, I wanted to leave the world a little better than how I found it. That said, while service and excellence were frequent topics of discussion in the 1990s, self-care and mental health were not. I’m so grateful for all of the work that Mr. Kim is doing to help promote a culture of wellness at Bishop’s. I didn’t master the art of self-care until I was well into my 20s; once I did, it was game-changing. I used to have this fantasy of going back in time and teaching my 14-year-old self how to live her best life. I became a counselor because I wanted to help others learn how to live their best lives, too.