Q&A with Former Fellow, Lindsey Hoskins, Ph.D., L.C.M.F.T.

Name: Lindsey Hoskins, Ph.D., L.C.M.F.T.
Current Title: Founder, President and Principal Therapist of Lindsey Hoskins and Associates
Years at DCEG: 2005-2013
Mentors at DCEG: June Peters, M.S., C.G.C., L.M.F.T., and Mark Greene, M.D.

What was your title at DCEG?
Before starting my own practice, I spent eight years working in DCEG in the Clinical Genetics Branch. I started out as a special volunteer in 2005, while doing an independent study as a master’s student at the University of Maryland. Then I joined the branch as a predoctoral fellow and continued on as a postdoc.

Who were your DCEG mentors and what was the subject of your research?
While at the National Cancer Institute, I worked under the mentorship of June Peters, M.S., C.G.C., L.M.F.T., and Mark Greene, M.D. With Ms. Peters, I focused on understanding the psychosocial health of women with BRCA mutations and helped develop an instrument called the Colored Eco-Genetic Relationship Map (CEGRM), which is a counseling tool similar to what is used in couple and family therapy that captures valuable information regarding multiple emotional, social, and psychological domains, but with a medical-genetic layer. I collaborated with Dr. Greene to expand the CEGRM to include the experiences of clinical patients in the Li-Fraumeni Syndrome Study.

My work at DCEG helped me frame my dissertation research, which was an independent qualitative study of young women from families in which a BRCA mutation is present. I interviewed them to explore how their knowledge of their genetic risk influences their decisions about partnering, reproduction, and risk-management.

How would you describe your current work?
My current job is an intensive clinical position. I see a full-time clinical caseload that includes mostly couples, as well as individuals and families. My practice, Lindsey Hoskins and Associates, is a multifaceted systemic therapy practice where my niche is medical family therapy. I work with a lot of people who have hereditary predisposition to a wide variety of diseases, including cancer. The work I did at DCEG has allowed me to better understand and provide mental health support to individuals dealing with decision-making around testing, understanding and coping with results of genetic testing, and communicating with family members.

How do you apply the skills you learned in DCEG to your current job?
With all the medical family therapy that I do, the skills are directly applicable. Many clients facing genetic stressors in their lives have a hard time finding a therapist who is medically versed and understands the difference between dominant and recessive genes, or the nuances of near-term and lifetime risk. I find that many of these clients are relieved to find a psychotherapist they don’t have to educate before getting the help they need.

Understanding the medical and genetic background is a huge piece of what I bring to my job. I was the first couples and family therapy student to have a role in CGB, and I think it was really mutually beneficial because I was able to bring a solid mental health perspective to the branch and develop a medical perspective in my own work. I use those skills every day.

Do you have any memories from your fellowship that you would like to share?
I have a lot! I really appreciated all the opportunities I had to travel and attend conferences to share my work and learn from people across the country. It was a great opportunity to learn from a broad range of professionals. The network I built at DCEG was so important—at that time, there were not that many of us looking at the psychosocial implications of genetic conditions. Allison Werner-Lin, Ph.D., L.C.S.W., and I were the only people in the country at that time looking at these data. Building such networking connections was definitely a positive memory.

What do you do in your free time?
I have two young children, ages five and seven, so I spend most of my free time with them! I love being with my family, and it’s been especially fun to have a new puppy, who joined our family right as COVID was starting. Under normal circumstances, I like to travel and spend extended time in Arizona and on the West Coast with family. I love being outdoors and hiking. Right now, I am obsessed with my Peloton! It’s part of my COVID coping strategy.

Do you have any advice for current or future DCEG fellows?
Yes! The thing I really remember is how many opportunities there were to learn new things and have new experiences—there is so much training available. I really encourage fellows to take advantage of that. You are in a place with so much knowledge to offer and so much to be learned. In retrospect, I think I was a little crazy during that time, but it has served me well. I worked full-time at CGB for the last six years I was there, and I also started my practice. I was working evenings and weekends at my practice, and also teaching aerobics classes; I think I had five jobs at one point! To current fellows, I would just say: work really hard. It is a time of life where you can gain a lot of diverse experiences. It has served me well going forward.

Many fellows struggle with work/life balance—do you have any tips about this?
Exercise is huge for me—it is a great stress reliever. I don’t feel like I’m a totally sane person without it. Sleep is also a huge part of self-care for me. I have learned that it is ok to walk away from something I'm working on, get a good night’s sleep, and finish in the morning. I can often be more efficient that way.

Also, there are so many great people at CGB! We did a lot of socializing and had gatherings a few times a year. I felt so lucky to be in a place where people really enjoyed being together, which made being at work really fun and positive.

Many fellows feel a bit lost if they aren’t planning to become a research scientist or go into academia. What are some thoughts or ideas you’d like to share for fellows seeking a less traditional/typical career path?
Try as many different things as you can! When I first started, I didn’t know which path I would take, and academia was an option I seriously considered. During my time at CGB, I had so much logistical, moral, and emotional support. I was able to try on many different hats. Ultimately, when my first child came along and I had to make a choice among all of the things I was doing, I decided to go with the thing I felt the most passionate about. It was the best problem to have: multiple jobs that I loved. Ultimately, I got to do the job I loved a little bit more.