Online Therapy for Adults in North Carolina

Telehealth therapy across North Carolina, with particular care for small-town privacy. Licensed statewide.

At a Glance

Therapist: Haley Speer, LCSW Licensed Clinical Social Worker in North Carolina (License C018240)

Format: All sessions conducted via secure video

Fee: $180 per 55-minute session. Please do not hesitate to ask about a sliding scale adjustment if you need one.

First step: book a free 30 minute consultation

Also licensed in: Also licensed in: South Carolina, Tennessee, New York, Florida, Kentucky, and Arkansas (useful if you split time between North Carolina and another state)

Who I Help

I work with adults who are smart, self-aware, and still stuck. Most of my clients are well into adulthood (30s - 60s), though I occasionally work with with young adults and college students when the fit is right. The people I work with tend to carry a lot, professionally, relationally, and often physically. At some point, the load becomes too heavy to keep going the same way.

I most often work with people facing:

Burnout and chronic stress that builds quietly over year
Chronic illness and medical trauma, including years of feeling dismissed, misunderstood, or failed by the healthcare system, as well as specific frightening experiences
High-control or high-pressure upbringings (religious, cultural, or familial), and the beliefs and patterns instilled early that still run in the background
Complex family dynamics, both overinvolved and neglectful, and childhood roles that no longer fit adult life
Complicated relationship patterns with partners, parents, friends, or siblings, and the ongoing question of what you actually want from relationships
Long-term recovery from self-harm, disordered eating, or substance misuse, for people with several years of stability who are ready to work on the patterns underneath.

Training & Clinical Background

I earned my Master of Social Work from the University of South Carolina in 2008 and became independently licensed in 2012.

I trained in Cognitive Processing Therapy (CPT) through the Medical University of South Carolina, and I've used it regularly since, including at Cherokee Health Systems (now River Valley Health), a Federally Qualified Health Center serving a rural, underserved community in East Tennessee. There, I treated adults with PTSD, anxiety, and depression and facilitated DBT skills groups, an ACT group for chronic pain, and a process group for serious and persistent mental illness.

From 2019 to 2024, I worked as a therapist for Headspace, the mindfulness and mental health platform, supporting high-functioning adults dealing with trauma, anxiety, obsessive-compulsive patterns, and low motivation.

No matter the setting, my approach centers on building a trusting, respectful relationship first. I'm trained and experienced in several evidence-based modalities, including:

Dialectical Behavior Therapy (DBT)
Cognitive Processing Therapy (CPT)
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
Exposure & Response Prevention (ERP)
Acceptance & Commitment Therapy (ACT)

I draw from a wide range of evidence-based techniques, but the care I provide isn't cookie cutter or one size fits all. We adjust pace and focus based on what you're ready for.

Serving All of North Carolina, with Particular Care for Small-Town Privacy

I'm licensed to provide telehealth therapy throughout North Carolina. I live in a rural area between Charlotte and Asheville. I know what it's like in a small town where everyone seems to know everyone else's business. More than one client has told me they chose telehealth specifically because they didn't want a therapist who might cross paths with or have opinions about the people they were struggling with. Telehealth solves that. It also means you can find the right expertise, and fit a session in without losing half a day to an appointment.

For clients in my nearby area, I'm open to occasional walking sessions or specific in-person exposure support, when that's clinically useful. This is the exception in my practice, not the default; I work primarily by telehealth.

I also work with adults across North Carolina more broadly, including those working in healthcare, attorneys, consultants, small business owners, and professionals in startup environments who are managing long hours and high expectations.

Whether you're in Charlotte, Cary, in the mountains outside of Boone, or elsewhere in North Carolina, we can work together through secure telehealth sessions.

Is This a Good Fit?

This work may be especially right if:

You are managing life relatively well on the outside but feel deeply exhausted and frustrated underneath.
You have had therapy that was just okay. Maybe you did not quite click, or you got coping skills that helped briefly, but whatever shifted did not last.
You are curious about your own patterns, not only looking to manage symptoms.
You can sit with some discomfort. Insight does not always feel good right away.
You want a therapist who will be honest with you, not just validating.

This is probably not the right fit if:

You are in active crisis or need same-day or emergency support. Please call or text 988, or go to your nearest emergency room.
You are currently experiencing active substance use, active self-harm, or active eating disorder symptoms that need a higher level of care or a specialized program.
You are seeking court-mandated therapy, custody evaluations, or documentation for legal purposes.
You want purely skills-based symptom management with little interest in what lies underneath. Most clients start with a concrete problem and find the deeper work along the way. Some finish in months and others stay over a year.

A Note on History and Recovery

I work with adults who have a history of self-harm, eating disorders, or substance misuse, specifically those who are in stable, long-term recovery and are looking to understand and address the patterns that drove those struggles in the first place.

I do not specialize in active eating disorder treatment, active addiction treatment, or acute self-harm intervention, as that level of care requires a different kind of support than what I provide.

I do work with clients who experience suicidal thoughts without a current plan or intent. Having these thoughts is not uncommon, and therapy is often exactly the right place to address it: thoughtfully, honestly, without panic. What I'm not set up to provide is crisis intervention or emergency response. If you are in crisis, please call or text 988, or go to your nearest emergency room.

Practical Details

Format Telehealth (secure video); occasional in-person sessions in WNC for clinical purposes

Who I see Adults (30's - 60's, occasionally younger adults or college students)

States licensed North Carolina, South Carolina, Tennessee, New York, Florida, Kentucky, Arkansas

Session length 55 minutes

Fee $180 per session (sliding scale available). Payment is due at the time of session.

Insurance Limited availability through Alma. Superbill provided; clients verify out-of-network benefits directly

First step Free 30-minute consultation

Next Step

If this sounds like the kind of work you've been looking for, start with a free 30-minute phone consultation. We'll talk briefly about what's going on and whether working together makes sense.

Book a Free Consult

Therapy with Haley