About Rebekah
Rebekah Machiela, MD, LCSW-C supports people facing stress, anxiety, grief, and major life changes. She welcomes conversations about relationship strain, parenting challenges, self-esteem, and the exhaustion that comes with caregiving. Her approach is warm and straightforward and meant to help people find clearer ways forward.
With 13 years of clinical experience, she has worked extensively in medical settings. That background informs how she helps people cope with chronic illness, cancer, hospice and end-of-life concerns, and caregiver stress.
Background and approach
She also offers support for postpartum adjustment, pregnancy and childbirth related concerns, and aging or geriatric issues. Sessions focus on practical skills and personal storytelling. She draws on Client-Centered Therapy to follow the client’s lead and build understanding.
Cognitive Behavioral Therapy is used to identify unhelpful thinking patterns and practice new behaviors. Narrative and psychodynamic ideas help people make sense of family of origin themes, codependency, and patterns that maintain shame or guilt. Solution-Focused techniques are brought in to set small, achievable goals and track progress between sessions.
People can expect clear communication and tools to use between meetings. Rebekah encourages self-compassion while helping clients try new ways of coping. She works by listening first, then tailoring approaches to each person’s needs and goals.
Therapeutic approaches suited to online care
Client-Centered Therapy focuses on listening and following the person’s priorities, which helps build trust and clarity about what to work on. This approach is useful for anxiety, grief, and relationship concerns because it centers the person’s own experience and goals.Cognitive Behavioral Therapy (CBT) helps people notice patterns of thought and behavior that increase anxiety or low mood, and then practice alternative responses. It tends to fit well with video or phone sessions where homework and short skill practice can be reviewed together.
Narrative Therapy helps people reframe the stories they tell about themselves and their relationships. It can be especially helpful for addressing shame, family of origin issues, and caregiving stress by separating the problem from the person.
Finding the right approach is collaborative. The therapist will work with each person to decide which methods feel most useful, adjust techniques over time, and set concrete goals that match needs and preferences.
Online formats offer flexibility. Video calls allow face-to-face conversation for coaching and skill practice. Phone sessions can be easier if bandwidth is limited or a shorter check-in is needed. Live chat and text-based messaging work well for brief updates, homework checks, and ongoing support between longer sessions.
Questions people ask
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What this therapist works with
Most often
- Stress, Anxiety
- Relationship issues
- Grief
Also listed
- Aging and geriatric issues
- Cancer
- Caregiver issues and stress
- Chronic pain, illness, and disability
- Codependency
- Communication problems
- Compassion fatigue
- Coping with life changes
- Depression
- Family conflicts
- Family of origin issues
- Family problems
- Forgiveness
- Guilt and shame
- Hospice and end-of-life counseling
- Intimacy-related issues
- Narcissism
- Parenting issues
- Postpartum depression
- Pregnancy and childbirth
- Self esteem
- Self-love
Therapeutic approaches
- Experience
- 13 years
- Licensed
- Maryland
- Languages
- English
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