Loyola University Maryland

Psychology

Why I Launched my Psychology Career in Baltimore

 I’ve lived in 10 states all across America. As a kid, we moved around a lot, and I kept on moving once I was out on my own…that is, until I came to Loyola.

When I came to school here, I fell in love with Loyola, I fell in love with Baltimore, and that worked out perfectly because I also fell in love with my husband, who is from here.

I’ve lived in cities before—I was born in New York City and have lived in Philadelphia—but Baltimore is just the right size for me. I love the diversity, the working class, the grit. I love the East Coast. I love living near water.

There are a lot of issues of systemic racism here, but I’ve connected with a lot of people who are really dedicated to making changes wherever possible. This place just feels like home. I can’t imagine not living here.

The Early Years

Ever since I can remember, I’ve been very analytical and liked talking to people, helping them examine their own behavior. By middle school, I decided I wanted to be a psychologist, and I’ve been on this career path ever since.

As an undergrad, I attended Earlham College, a small Quaker-founded liberal arts school in Indiana. It was a good fit for me because I was raised Quaker, and in my studies issues of diversity and advocacy were part and parcel of what we did. We were always talking about different culture and working within that framework.

When I graduated in 2001, I spent a few years in North Carolina’s Research Triangle. My first year I worked at Duke, studying the social relationships of 4th-grade girls, watching videotapes and assigning codes to the interactions between girls and their best friends.

The next two years, I worked for Frank Porter Graham Child Development Center, owned by University of North Carolina at Chapel Hill. It was a state-funded program that was looking at preschool interventions to help at-risk youth improve their academic trajectory. That was fun and cool because I was traveling all throughout the state of North Carolina working with all these kids.

But I also noticed that that work I was doing was very different than what the Ph.D.s did. They were back at the office just coding the data, while I really loved being with the kids.

That time in North Carolina helped me decide. I didn’t want to be someone who does research. I wanted to be the person working with patients.

Finding Loyola

Now that I knew I wanted to be a clinician, I wanted to find a Psy.D. program—a clinical doctorate program—that helped me acquire the best skills for that. I knew I’d found it from the moment I walked onto Loyola’s campus.

I also discovered that a friend from Earlham, my undergrad, had ended up in Loyola’s Psy.D. program a few years ahead of me. I didn’t yet know what a Jesuit University was, but I knew that this friend and I shared the same values regarding diversity, religious beliefs, and how I wanted to carry myself as a psychologist. That gave me a clue, and then once I got to Loyola, I realized there was a lot of overlaps between my Quaker faith and the Jesuit educational components, particularly the advocacy spirit of what we can do to help the community.

From the moment of my interview, I was moved by how the Loyola Clinical Centers (LCC) prepare future psychologists like me an opportunity to provide care to our neighbors here in Baltimore City.  I was in the second class of students to have rotations at the LCC, which truly show a commitment to location, affordability, and integrative care – an intention to be accessible for all.

Finding a Specialty

After working with the kids in North Carolina, I thought I wanted to specialize in an early childhood population. I even wrote my Loyola application essay on it.

But at the Loyola Clinical Center, under the amazing supervision of Matt Kirkhart, Ph.D., I was “forced” to work with adults, as Loyola strongly believes in training well-rounded generalist therapists. And I oddly found out, adults weren’t all that bad to work with after all. Then in my 3rd year externship at the Kennedy Krieger Child and Family Therapy Clinic, I got to work with younger kids again. But I discovered that as I’d gotten older, the play therapy I used to be good at didn’t fit me as well anymore. Surprise—I was actually better at talk therapy!

In my 4th year, one of my externships was at the Mann Residential Treatment Center owned by Sheppard Pratt Health System, where I worked with adolescents who needed intensive treatment. I hated seeing the trauma that these kids had gone through in their lives, but I really loved working with adolescents. There’s something compelling about how resistant they are to getting help, wanting to individuate, but also wanting support even though they don’t want to tell you that. And I liked working with families who loved their kids but had trouble connecting with them.

I wrapped up my time at Loyola with a yearlong internship at the University of Medicine and Dentistry New Jersey-Robert Wood Johnson Medical School. I got great training, but I missed Baltimore (and my fiancée) like crazy, and I was ready to come back home.

The Turning Point

Back in Baltimore in 2011, I began my two-year postdoctoral fellowship at The Jefferson School, a 12-month special education day school and residential program owned by Sheppard Pratt that is for adolescents with severe emotional and behavioral disabilities. I worked on the girls unit with patients age 13-18.  My time there helped me learn that I  could tackle just about any case that walked in the door, hopefully in a way that supported patients, families, and colleagues.

Toward the end of my time at The Jefferson School, I had a case in residential that really touched my heart.

I worked with a patient who was ready to transfer out of residential (that’s the goal, to get them to a place there they can leave a locked-door facility), but right before they discharged, they disclosed to me that although they were assigned female at birth, they’d always believed they were a boy.

They’d never told anyone about this—and I’d never had a case like that before.

We started to work on this together, but we didn’t have much time. I did everything that I could with the patient, and made sure to write in the discharge notes that the gender identity  work was very important and  needed to be continued by their next clinical provider.

Just a month before my postdoc was over, I got a phone call that the patient had seriously destabilized and was making attempts to kill themselves again. What I discovered was that the patent’s new provider—was treating their gender identity as pathological.

As psychologists, we know that when people feel they’re not being listened to, they don’t like themselves and they’re more at risk. I was really floored that this could happen in my professional community. I was so shocked – I was really naïve back then!

It was a turning point for me. I knew I had to do everything in my power to make sure this didn’t happen to one of my patients again.

The Path to Private Practice

By this time, I had taken my licensure exam, wrapped up my postdoc, and was pregnant with my first child. I was ready for a change, so after a five-month maternity leave I looked for work that was closer to Baltimore.

That’s how I ended up at Greater Baltimore Counseling Center, a private practice owned by two women—Laura Steensen, Psy.D. and Juliet Goozh, Ph.D.—with its main locations in Glen Burnie and Odenton. I was drawn to their practice because of their structure, which emphasized good quality care to patients, but the owners know that to do that you have to treat your therapists well. 

From the beginning of my time there, I always remembered the case of my transgender patient from the Jefferson School, and I wanted to learn more, so that would never happen to one of my patients again. The admin at GBCC knew I was interested, so I kept getting assigned those cases when they came in. And I really enjoyed being at GBCC because it was a private practice that accepts all insurance types (except Medicaid), to me that was important to work in a setting that understood that not every patient can pay out of pocket.

Royal blue upholstery arm chairs flank the walls of a neutral colored waiting room with artwork on the walls.

I was working halftime at GBCC, and also spending 20 hours a week at the UMMS Midtown Campus in an outpatient client working with mostly Medicare and Medicaid patients. I felt like I was doing my part to dismantle systemic racism at Midtown, a white woman who tried to acknowledge her privilege and to show my care  towards all of my clients . I loved the work, but I kept my eyes open for opportunities for more training and experience with the LGBTQ community.

In 2014, that opportunity came. I was offered a position at Chase Brexton Health Services in Baltimore City, where I could receive mentoring about LGBTQ care, and trans care in particular.

I was  sad to leave GBCC, but the owners knew this was a growing interest for me  and were supportive of me pursuing  it. When I got the job at Chase Brexton, they said, “Go learn this, and if you  decide later it’s not a good fit, please come back to us.”

So I went, and I loved it!  It was so exciting, I really enjoyed what I was doing, and I learned so much from my patients and colleagues. And after 2.5 years there, I had my second child and was ready for a change again.

I reached back out to the owners at GBCC that I’d like to come back. They said, “Okay, but we want you to do something different in addition to you being a therapist with us. You like doing management and supervision, how about you open a 3rd location for us? Make it closer to where you live in Baltimore County.” I was so touched by this opportunity, and appreciative that it was offered by two female psychologists, who were supportive of me and my professional development.

Leading the Way

We opened GBCC Timonium on January 9, 2017, using the model that Laura and Juliet built. We are a group private practice with therapists who offer individual, couples, and family therapy, across the age continuum. And I have worked to help all GBCC locations become a place of choice for the LGBTQ community. I feel like I’m finally doing my part to make sure the  situation at The Jefferson School has less likelihood to happen again. .

For example, I have a trans-identified patient who came to me as a minor. She hadn’t come out to her parents yet, and wanted to get trans-affirming care.  After several months of sessions, she gained the confidence and decided to come out to her parents on her own between one of our sessions.

She wrote the most moving letter to them to explain that she was their daughter, and she emailed it to me to share the news that she had done it! In less than 48 hours, I had a wonderful email from her parents, thanking me for my work with their daughter, and asking if they could come in and meet with me, as they had a lot to learn. And, I noted they used correct pronouns throughout the whole email.

Working with my patient and her family is incredibly rewarding. They have so many questions, and are often anxious. But after we meet, they usually breathe a sigh of relief and thank me. My response is often, “I like working with you, too.” Because it’s true!

To see the confidence that my patient is gaining, to witness the support her family is giving her, and to get to do this as my job—it’s priceless. 

In addition to working with my patients, and overseeing the operations of the Timonium location, I’m also helping to train 16 therapists and 1 psychiatric nurse practitioner across all three of GBCC’s locations to provide LGBTQ-affirming care. Once they have done some reading  and feel ready, we make sure they get cases, and then we provide support for them on those cases. It’s kind of like the mentorship you’d get in a graduate program, but for licensed therapists who want to learn to work with a new population.

Doing this work makes me so happy and balanced in my life. It is nice to be able to be able to use my degree to the full capacity, embracing the ways that Loyola’s program taught me to use my clinical skills, and the ways its diversity statement affirmed my commitment to each unique patient. I look at the proof of my doctorate degree—my Loyola diploma—on my office wall every day, and am thankful for the training that shaped who I am today. 

Jessica R. Rothstein, Psy.D. is a Psychologist and Clinical Director of Greater Baltimore Counseling Center, LLC in Timonium, Maryland.