While life as we know it has changed drastically, Junior Anna Cohen has continued attending her therapy sessions via an online platform during the pandemic. However, therapists and counseling services have had to adapt to new practices and behaviors to give their patients the best care possible.

Resources:
CAPS Online Programming
Virtual Workshops and Gathering Spaces

HALEY FULLER: From The Daily Northwestern, I’m Haley Fuller.

SAMMI BOAS: And I’m Sammi Boas. Welcome to Speak Your Mind, a podcast dedicated to discussing mental health and self-care on Northwestern’s campus. Our goal is to facilitate a conversation about mental health that goes in-depth about what students are really experiencing and try to shatter the stigma surrounding mental health.

HALEY FULLER: With stay-at-home orders in effect, people aren’t able to access mental health services in the way they’re used to. To adjust, many healthcare providers have modified their practice to provide for patients while they can’t see them in person.

SAMMI BOAS: Claudia Rosen is the co-founder, clinical director and a therapist at Connections Health in Evanston who sees many Northwestern students. Her practice has transitioned into a virtual “telehealth” therapy model as a way to continue seeing patients. These sessions take place through a screen, which has created new kinds of issues.

CLAUDIA ROSEN: Everybody who we’re working with who are students feel a little bit of fatigue being in front of a screen. And so we’ve had to kind of discuss that. What is that? And how do we make that work when we’re having virtual therapy?

It’s a little harder to read people, so we need, as therapists, to be a little bit more attentive on the screen. Let’s say you’re in a live session, somebody’s talking and you look away maybe sometimes to give that person a little bit of sense of not being stared at. But if you do that in a virtual session it can look like you’re not paying attention. So we need to be very attentive to how we’re communicating on the screen. And then being willing to talk about that too, in the session itself, that talking over someone can be a little more challenging and feel more like interruption in a room.

SAMMI BOAS: Despite its challenges, doing virtual therapy rather than in-person therapy has led to more availability for appointments in the evenings and on weekends. Claudia has also noticed that everybody feels a little vulnerable right now, which serves well with therapy.

CLAUDIA ROSEN: We’re always interested in what’s going on in people’s lives, and sometimes, those things that are going on and what they stir up become the topics that are explored in therapy. But because there’s not much going on for most people, there’s an opportunity to get into deeper issues that we might not find time for otherwise. At first, it was a lot of adjustment to what was going on and a lot of feelings about that. But more recently, there’s more opportunity to delve into some deeper topics, things that there isn’t always time to address; what matters to you in life? Existential questions, feelings about religion or certain dynamics that come up in families and so there’s some richness in this experience too, because there’s so few distractions.

HALEY FULLER: While having time to self-reflect can be positive, it can also lead to negative spiralling. In an article from The Independent, counselling psychologist Dr. Lucy Atcheson says that having too much time to think critically about your life can be dangerous for your mental health. The article recommends looking at this current period of isolation as a different period of time in your life — one that requires changes and patience.

SAMMI BOAS: Although it took her time to adjust to virtual therapy, Claudia has found that it’s gotten easier to focus on her patients during sessions and make a real connection with them.

CLAUDIA ROSEN: That’s kind of interesting, too, to see how we adapt and how we can get a little more comfortable with things and find ways to move forward and be with those human elements of ourselves and each other, in spite of the limitations that we have right now. Human beings are resourceful and adaptive. One of the beautiful things that I love about doing therapy is just being able to see that in people and be part of a process that brings out that natural tendency towards adaptation and growth and making things work. And I love that I can see it in myself too as I spend more time with the virtual therapy.

HALEY FULLER: Northwestern’s Counseling and Psychological Services has also adjusted its individual and group therapy sessions to fit a virtual environment. Although research shows that telemental health is as effective as in-person therapy, this is a new situation for CAPS clinicians, including Monika Gutkowska, a staff psychologist and the associate director for outreach and education at CAPS.

MONIKA GUTKOWSKA: I am very grateful that we are able to offer the service, that we live in the times that we have video conferencing, and we can continue to connect with our clients and continue to support them. So the distance does not serve as a barrier to provide therapy at this moment. But also you lose something. Face-to-face, you probably notice it’s very different. The connection, the intimacy that’s being developed in a space where the therapy exists is sacred and sometimes that could be lost. However, from my experience thus far, I still feel very connected to my clients. I still feel like we’re doing good work, so I’m glad that we’re able to provide that.

HALEY FULLER: CAPS has also made adjustments to accommodate students beyond individual and group therapy sessions.

MONIKA GUTKOWSKA: We’re also trying to support students through providing different workshops and gathering spaces and in general, outreach services and programming. So that was my job, to think about what students might need, what might be most helpful at this moment and how to get as many services outside of counseling so students can get involved.

HALEY FULLER: The workshops that CAPS started to provide this quarter include mindfulness practices and topics such as coping with stress. Each of the workshops is a four-part series that will repeat after four weeks.

SAMMI BOAS: CAPS is also offering less structured gathering spaces called COVID Conversations. Each of these conversations is facilitated by a CAPS faculty member and covers a topic that is especially relevant while sheltering at home. You can find links to these in the description.

MONIKA GUTKOWSKA: Places where students can come and connect, share their experience on particular topics, support each other, learn from us a little bit about maybe some coping, maybe some tips on how to navigate difficult situations and learn about resources. So those gathering spaces are support and connect for undergrad students and for grad students, navigating difficult family situations, or challenging spaces at home and dealing with unexpected losses. We are experiencing a lot of loss right now, which is tangible or intangible. I know graduation may not happen the way we want to, maybe loss of friends or loss of supports that we are used to. So we want to have space for people to talk about those. This is not a bereavement group. This is more about the spaces and losses that are more intangible.

SAMMI BOAS: Although daily routines have changed significantly for everyone, students have been able to continue their therapy, even though it’s online instead of in person. Communications junior Anna Cohen is now seeing her therapist weekly through a HIPAA-compliant, video call platform called Regroup, which she started using during her time abroad Fall Quarter. Being HIPAA-compliant means that all of the patient’s health information is protected and private.

ANNA COHEN: I got really excited to see her in person, I saw her in person for the duration of winter quarter, and then I was like, “Well, there we go, gotta go back to our online system.” But she’s super flexible and accommodating with it and we’re both sort of used to it. And it’s really great for me to have that routine still in my life, and I just find it important in general, and now, especially that the world is upside down. I’m very glad that it was already something I had in place and have just been able to revise as needed.

HALEY FULLER: While virtual therapy is a useful tool that enables patients to continue talking through problems and coping mechanisms, at-home therapy does have limitations. Parents or siblings can walk into a room unannounced, and in many homes, sound can easily be heard from a different room, making it easy for confidential conversations to be overheard.

ANNA COHEN: I do have more of a self consciousness. A couple weeks ago, I wanted to talk about something and not be at my home. So I was like, “Can we not use the Zoom platform and use a phone call so that I can walk around my block?” and since I asked permission to use something that was non-HIPAA, it was fine. And also times are crazy, so I was like, I literally do not care what platform it has to be over. I would just like to be able to walk. So that was good. That was helpful. It is a bit limited in terms of freedom to speak.

SAMMI BOAS: Anna hasn’t used any of the online resources Northwestern has provided, but she’s glad the University is acknowledging the difficulties students are facing during the pandemic.

ANNA COHEN: I have skimmed the University’s emails a bit, and it’s nice that they’re providing that. I know I’ve seen commercials on TV for a coronavirus specific crisis hotline, like mental health-wise, which I think is a great initiative. I don’t know how helpful they are because I haven’t experienced them, but I think it helps that there’s conversation around it so that people are aware this is a difficult time. Oh, I hate that phrase, but they’re aware that your normal way of coping with life might not work and you may need something different.

SAMMI BOAS: The pandemic has forced Anna to change some of her normal coping routines.

ANNA COHEN: If I’m, let’s say, lacking motivation because I am a depressed person, then I often will be like, okay, I’ll change up my environment, I’ll go to a coffee shop. That’s not happening right now. But I still have things to get done, and I need to find ways to motivate myself that are exciting. So for me, I try to have my desk space as clean as possible, and then I try to do my homework in a different room than I do my classes so it seems like I’ve gone somewhere. My grand voyage from downstairs to upstairs or whatever, but it does make a difference and it’s something that helps me.

SAMMI BOAS: Anna’s also needed to adapt her social interactions, especially after the sensory overstimulation of spending the entire day in front of a computer screen.

ANNA COHEN: The hardest thing for me as someone who deals with mental health concerns regularly is that it’s hard to stay connected to my social threads and things that keep me going and excited and happy when they’re via Zoom because as much as I really want to schedule Netflix parties and game nights and whatever with my friends on Zoom, after a whole day of staring at the screen, I get headaches, I get burnt out, I don’t want to talk, I don’t want to do anything. Which is a bummer because I miss them a lot. So keeping up those networks has been difficult at this time, but I think little by little I’m getting used to the ways I need to navigate and change things and finding new online platforms that are easier.

SAMMI BOAS: One way Anna has maintained her social networks virtually is by sending her friends videos on Snapchat. In the videos, she asks them questions for them to respond to with a video back to her.

ANNA COHEN: I was actually surprised by how many of my friends did it. The other day I asked if anyone had any hidden talents, and it was so funny just the range of responses. I did ask my friend something and got like a complete answer that I didn’t expect from one of my friends. It was fun. Because then you can engage with them in your own time, but you also get to hear their voice and see them.

SAMMI BOAS: During this unprecedented time, we hope that you are all staying safe and taking care of yourselves. That’s all we have for today on Speak Your Mind. I’m Sammi Boas,

HALEY FULLER: And I’m Haley Fuller. Thanks for listening!

HALEY FULLER: This episode was reported and produced by me, Haley Fuller and Sammi Boas. The audio editor of The Daily Northwestern is Molly Lubbers, the digital managing editors are Kalen Luciano and Heena Srivastava, and the editor in chief is Marissa Martinez.

Email: [email protected], [email protected]
Twitter: @haley_fuller_, @BoasSamantha

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