Online Therapy for Adults in North Carolina
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Telehealth therapy across North Carolina, with particular care for small-town privacy. Licensed statewide.
Provider & Licensure
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.
Payment: Due at the time of the appointment, collected via a secure online system.
Insurance: I am in-network with select insurance plans through Alma when space allows. Check my Alma profile or contact me to ask. For private pay clients, I can provide a monthly superbill for possible out-of-network reimbursement; it's best to check with your provider ahead of time about your out-of-network benefits.
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)
Training & Clinical Background
I earned my Master of Social Work from the University of South Carolina in 2008 and became independently licensed in 2012, 18 years in the field, 14 of them as a fully licensed clinician.
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, 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:
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Dialectical Behavior Therapy (DBT)
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Cognitive Processing Therapy (CPT)
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Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
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Exposure & Response Prevention (ERP)
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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 or have opinions about the people they were struggling with. Telehealth solves that. It also means you can find the right expertise, and you can 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.
Who I Help
I work with adults, who are smart, self-aware, and still stuck. Most of my clients are in their 30s, 40s, and 50s, though I work with young adults 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 continue in the same way.
My work tends to be a strong fit for:
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Burnout and chronic stress — the kind that accumulates quietly over years
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Chronic illness and medical trauma — including people who've spent years feeling dismissed, misunderstood, or failed by the healthcare system and those who had a specific traumatic experience
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High-control or high-pressure upbringings — whether religious, cultural, or familial in nature; examining the beliefs and patterns instilled early that are still running in the background
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Complex family dynamics — overinvolved families and neglectful ones, roles from childhood that no longer fit adult life
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Complicated relationship patterns — with partners, parents, friends, siblings, or the ongoing question of what you actually want from relationships
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Adults in long-term recovery — people with several years of stability from self-harm, disordered eating, or substance misuse who are ready to do deeper work on the patterns underneath
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.
Is This a Good Fit?
This work may be especially right for you if:
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You're managing life relatively well on the outside but deeply exhausted and frustrated underneath
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You've had therapy before that was just "okay" — maybe y'all didn't quite click, maybe it gave you coping skills or a place to talk that helped briefly, but whatever shifted didn't last
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You're genuinely curious about your own patterns, not just looking to manage symptoms
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You can tolerate sitting with some discomfort — insight doesn't always feel good right away
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You want a therapist who will be honest with you, not just validating
This is probably not the right fit if:
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You're in active crisis or need same-day or emergency mental health support — please call or text 988, or go to your nearest emergency room
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You're currently experiencing active substance use, active self-harm, or active eating disorder symptoms requiring a higher level of care or a specialized treatment program
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You're seeking court-mandated therapy, custody evaluations, or documentation for legal purposes
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You're looking for purely skills-based, symptom-management therapy with no interest in the patterns underneath (most clients start with a concrete problem and discover the deeper work along the way — some finish in months, others stay over a year — but symptom relief alone isn't what this work is built for)
Practical Details
Format Telehealth (secure video); occasional in-person near Greenville/Spartanburg for clinical purposes
Who I see Adults, including college students and young adults
States licensed North Carolina, South Carolina, Tennessee, New York, Florida, Kentucky, Arkansas
Session length 55 minutes
Fee $180 per session (sliding scale available)
Insurance Limited availability through Alma. Superbill provided; clients verify out-of-network benefits directly
First step Free 30-minute consultation