Cecilia Fitz-Gerald, MD

Dr. Nieves-Alvarado is a Board-certified psychiatrist who completed medical training at Duke University Psychiatry Program. Originally from Puerto Rico, she is fluent in both English and Spanish, which allows her to connect deeply with a diverse patient population.

Her practice combines medication management with insight-oriented therapy during every visit, promoting a comprehensive approach to mental health care. She advocates for her patients to engage in therapy alongside medication management, as she believes this integrated approach leads to better outcomes and sustained improvement. Dr. Nieves-Alvarado's practice is rooted in a collaborative, team-based approach, working closely with her patients to achieve long-term mental wellness.

Dr. Nieves-Alvarado earned her medical degree from the Universidad Central del Caribe School of Medicine in Bayamon, PR. Afterward, she moved to North Carolina, where she completed her residency at Duke University Hospital. During her training, she was nominated for a fellowship in psychodynamic practice by the Psychoanalytic Center of the Carolinas, showcasing her expertise in this area. She is also a dedicated advocate against childhood sexual trauma.

Her diverse training includes significant experience in jail and forensic psychiatry, as well as the treatment of military veterans under the veteran affairs health care system. She has experience in medically assisted treatments (MAT) for substance use disorders, Electroconvulsive therapy (ECT), and family therapy, enabling her to care for patients with complex needs.

Dr. Nieves-Alvarado treats patients across a wide age range, from young adults to the elderly. Passionate about improving access to mental health care, she joined Talkiatry to help patients facing time or transportation challenges receive the care they need.  

In addition to her clinical practice, Dr. Nieves-Alvarado remains involved with her alma mater’s Behavioral Health Department, contributing to academic education and maintaining a connection with the next generation of medical professionals. She continues to seek ongoing improvement in her field, remaining engaged with medical associations including North Carolina Psychiatric Association, American Psychiatric Association, and Alpha Omega Alpha national medical honor society. Dr. Nieves-Alvarado is committed to working hand-in-hand with her patients to achieve mental wellness.”

Jessica Fairchilds is a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP) with over 8 years of experience in many psychiatric settings and populations. She earned her Master of Science in Nursing from the University of Mississippi Medical Center and is passionate about providing high quality, comprehensive mental health services. Jessica prides herself in her patient-centered approach by fostering strong provider-patient relationships to achieve optimal treatment outcomes. In her free time, Jessica enjoys spending time with her husband and young daughters, traveling the globe, or getting lost in a historical fiction novel.

Jessica is highly focused on building a strong therapeutic relationship with her clients while making them feel heard and validated. She strives to provide the highest level of care while exploring different treatment options to find what works best for each individual.

Jessica will focus on learning about the client as an individual and learning the concerns of the client while working to develop an individualized treatment plan. She uses her extensive knowledge of medications and therapy techniques to guide treatment options for the best outcomes.

Dr. Alejandra Vivas is board-certified in adult psychiatry and board-eligible in child and adolescent psychiatry. She completed her general psychiatry residency at Montefiore Medical Center and a child and adolescent fellowship at Mount Sinai School of Medicine. Dr. Vivas brings extensive experience from outpatient, emergency, and telepsychiatry settings. She has advanced training in CBT, Motivational Interviewing, and Psychodynamic Therapy. Fluent in English and Spanish, she is committed to culturally sensitive, individualized care.

Dr. Vivas fosters a warm, respectful, and professional space where patients feel seen and empowered. She values open communication and builds collaborative relationships to align treatment with each person’s values, goals, and lifestyle. Her approach is integrative and flexible, grounded in evidence-based methods to support lasting, meaningful change.

Dr. Vivas begins with a thorough evaluation to understand each patient’s history and goals. She creates customized treatment plans that may include therapy, medication, or both. Drawing on CBT, Motivational Interviewing, and Psychodynamic Therapy, she adapts care to meet evolving needs, aiming to relieve symptoms, foster resilience, and support long-term well-being.

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Dr. Gotsche is a board-certified adult psychiatrist who is dedicated to helping individuals navigate their mental health journey. Originally from Illinois, she completed her undergraduate studies at Illinois State University before earning her medical degree from Kansas City University. She went on to complete her psychiatry residency at the University of Oklahoma. Following residency, she worked at the Kansas City VA Medical Center where she primarily focused on outpatient mental health. Outside of her clinical work, she enjoys cooking, reading, cycling, and hiking.

Dr. Gotsche takes a holistic, integrative, and evidence-based approach to mental health care. She emphasizes the importance of building a strong therapeutic alliance and working closely with each patient to ensure treatment fits their unique needs and goals. She is experienced in treating a variety of psychiatric conditions including mood disorders, anxiety, trauma-related disorders, and ADHD. She is committed to providing comprehensive care in a supportive environment.

Dr. Gotsche will conduct a thorough evaluation to learn each patient’s medical history, current symptoms, and treatment goals. She values open communication and a collaborative approach, ensuring that patients are actively involved in the decision-making process. An individualized treatment plan will be developed which may include medication management, psychotherapy, or referrals to additional services as needed. Her goal is to provide integrated, patient-centered care that promotes long-term well-being.

Dr. John Lundeen earned his medical degree from the Medical College of Georgia and completed his psychiatry residency at TriStar Centennial Medical Center. He has worked with adults of all ages in both outpatient and inpatient settings, bringing a wide range of experience to his practice.

Dr. Lundeen approaches every patient with respect, empathy, and a genuine desire to understand their unique experience. He recognizes that seeking treatment can be intimidating and strives to create a welcoming, non-judgmental environment where patients feel safe and heard.

Dr. Lundeen believes in a collaborative treatment process, prioritizing each patient’s goals, values, and input. He emphasizes mental health education as a core component of care, empowering patients to better understand their treatment options and take an active role in their well-being.

Dr. Ruiz is a compassionate psychiatrist specializing in adult and maternal mental health. She develops personalized treatment plans to address anxiety, depression, bipolar disorder, ADHD, OCD, PTSD, PMDD, and perinatal conditions. Her goal is to help patients reconnect with their values and live balanced, fulfilled, and meaningful lives.

Her passion for medicine began in childhood, inspired by curiosity about the mind and body. She earned an Honors Chemistry degree with  magna cum laude and completed her medical training and psychiatry residency at Texas Tech University Health Sciences Center. With a strong scientific foundation, Dr. Ruiz understands the role of medications, and embraces holistic healing through connection, gratitude, and spirituality.

Dr. Ruiz has experience in diverse clinical settings and has received national awards including the AWP International Fellowship and ADMSEP Innovations Award. She is dedicated to advancing maternal mental health screening and treatment through clinical care and education.

Dr. Ruiz combines pharmacotherapy (medication) with psychotherapy to create individualized treatment plans. Therapy provides powerful tools to manage thoughts, emotions, and behaviors that support balanced brain chemistry. Research shows that medication helps restore this balance more quickly and effectively, especially in moderate to severe cases.  

Dr. Ruiz likens medication for the brain to fertilizer for a garden. Imagine your mental health as a vibrant garden—when well-nourished, it can thrive with resilience, beauty, and balance. But when symptoms like depression, anxiety, ADHD, or mood instability take hold, they act like invasive weeds, crowding out healthy growth and making it hard to enjoy the space. Medication acts like fertilizer, strengthening the garden’s natural systems so the healthy parts can reclaim their place and flourish. Just as some gardens need only seasonal care while others require more consistent tending, medication plans are personalized to support each person’s long-term mental wellness. When the garden is healthy, there's more room to grow, connect, and fully enjoy life.

With a strong background in chemistry and pharmacology, Dr. Ruiz prioritizes educating her patients about how medications work and why they can be helpful. She believes patients should take an active role in understanding their diagnosis and treatment. Her approach emphasizes diagnostic clarity, medication management, patient education, and brief psychotherapy based on cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT).

Your first appointment is a supportive, in-depth conversation to share your story, challenges, and goals. Dr. Ruiz will review your medical and psychiatric history and assess symptoms using a whole-person approach that considers biological, psychological, and social factors.

Together, you’ll develop a personalized plan that may include lab work, medication, and therapy. Initial visits last 60 minutes for thorough evaluation; follow-ups typically last 20–30 minutes, focusing on medication management and brief therapy. If needed, Dr. Ruiz can refer you to in-house or community therapists for add-on therapy support.  

Throughout your care, Dr. Ruiz prioritizes shared decision making to ensure you feel informed, empowered, and supported.

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