Aspire Counseling

Aspire Counseling

Prioritizing the mental health of low-income mothers

| Published:
Aspire therapist Cristina Astrada-Keeling (left) with Jacqueline Camara and one of her children. Photo by Michael Ventura

Jacqueline Camara didn’t recognize her perinatal depression until she had her second child in 2013. She felt overwhelmed, and a friend recommended she seek counseling. As a single mother, she’d been accustomed to pushing through emotional pain and the stress of caring for her family.

“The main thing is [there’s] nobody you can ask for help,” she says, explaining how some of her friends and family members showed a lack of compassion for her situation. “Everybody just wants to pull you down. …I was feeling the negativity.”

When Camara had her third child in 2017, she found support in the Healthy Mothers, Healthy Babies (HMHB) program of Aspire Counseling, a Gaithersburg-based nonprofit that has provided free and reduced-cost therapy and case management to low-income families in Montgomery County for more than 40 years.

Camara, 32, who’s unemployed, lives in Silver Spring with her four boys—ages 7, 6 and 1, plus an infant. Before giving birth in April, she babysat other children in her home to make some money, but she’s found it difficult to maintain that income while caring for a baby by herself. She has again sought help from HMHB and says her weekly in-home therapy sessions with Cristina Astrada-Keeling, a licensed therapist who directs HMHB, are essential for her mental health. Camara has grown to value her counseling sessions and says others shouldn’t be embarrassed to take a step back and accept their need for mental health support.

“The more you hold on to your problems, the more it’s gonna get worse, and you might end up hurting yourself or hurting somebody else,” Camara says. “For me, it’s like the way you go to the doctor—you can have time to sit down and talk to a counselor about your situation.”

HMHB started with 15 mothers in 2003, and served 160 in 2018. According to Aspire’s 2018 annual report, 86% of participants showed reduced depression symptoms after 10 to 12 therapy sessions.

Since Astrada-Keeling took over HMHB in May, she’s received three or four referrals to the program each day from other community organizations in the county. She says 85% of the women currently helped by HMHB are Latina. The program’s therapists are bilingual, including Astrada-Keeling, whose parents are from Argentina. “Even with their own children, [our clients] have a language barrier at times,” Astrada-Keeling says. “Having somebody to talk to in their own language, and to have that rapport…it helps build that relationship.”

Samantha Dellosso, Aspire’s director of operations, says recent research shows significantly higher mortality rates and a lack of perinatal care for African American mothers and infants, so one of HMHB’s goals for 2020 is to increase the number of African American women served.



Aspire Counseling ( offers mental health services to Montgomery County’s diverse citizens. Aspire works to ensure its mental health services are affordable and accessible to all. They serve the insured, the uninsured and those with Medicaid, Medicare and Tricare. Services take place in trusted and accessible locations, including primary-care clinics, local schools, senior housing venues and homes. Aspire ensures vulnerable individuals get treatment where they are most comfortable and accessible.

Headquartered: Gaithersburg

Serves: Montgomery County

What a donation buys:

  • $250 helps fund support groups for seniors with aging-related depression.
  • $1,000 provides 12 sessions of in-home therapy to a very-low-income mother with postpartum depression.
  • $10,000 provides a year of mental health counseling to 40 children who are uninsured.

Volunteer opportunities:

  • Ongoing: Provide Spanish translation assistance.

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