Healing Charlotte Podcast: Theresa Leskowat, Starting Mental Health Therapy

Today’s podcast features Theresa Leskowat discussing with Katie all the aspects of starting Mental Health Therapy. Together we discuss reasons to go, benefits, finding a Therapist, when to start, payment, and different types of therapy modalities. Theresa is a private practice owner at Clear Vista Counseling, where she works with adults in managing their anxiety.

Why go to therapy

Typically people start therapy during a life event or change, want to start a relationship with a therapist proactively, for self-improvement and growth, may have exhausted their own resources, or noticed familial patterns that they would like to break.

Benefits of therapy

Usually people will increase their self-insight, find that it’s an outlet to process their experiences, want a relationship that is not friends or family and to hear a perspective that challenges them, are looking for a confidential space to share things that may be difficult to talk about, will practice relationship and communication skills, and lastly appreciate a place to share vulnerabilities first.

Barriers to starting

Some people view going to therapy in that it signifies weakness but in actually there is a lot of strength in asking for help and receiving support. For some, they worry about vulnerability and talking about the hard things as it may open up the “flood gates” and dealing with difficult emotions. Lastly, some believe it means they have a problem.

When to start

The best time to start going to therapy is when you decide it will be beneficial. You can start during a crisis and it will be better to establish a relationship when things aren’t as challenging.

Frequency of sessions and duration

People usually start a weekly appointments to establish a relationship and can go down from there once things stabilize. Everyone is individual so it depends on what people come in with and when they feel like they have gotten out of it what they set out to do. Therapists do provide homework for those who want to work on things outside of sessions.

Finding a Therapist

All clinicians who do this work will have at least a Master’s degree in one of the following; Psychology, Social Work, Counseling, Marriage and Family Therapy and have requirements for continuing education. You can start by getting a referral from someone you know personally or professionally. Psychology Today is another place to start by entering the information you are looking for a various profiles of therapists will be available. Visiting the clinicians website could be a good way to start to get to know them and their areas of speciality. Lastly, a Google search may be another way to start getting some names.

Psychologists and Psychiatrists get mixed up quite frequently so to help in keeping that straight; a Psychologist usually does therapy, or Psychological testing, or both, a Psychiatrist has gone through Medical school, prescribes medication, and sometimes offers therapy but not often.

“We {therapists} are people too. If you go and you just don’t feel connected to them or you don’t feel they get what you are saying then maybe that’s not the connection you are looking for. That’s ok and they won’t be offended. It’s more important that you find what you are looking for.”


You can possibly use your insurance where you may have a copay or a deductible to meet. You will need to make sure the therapist you want to see accepts your insurance. Most therapists have private payment options and some offer sliding scale rates or rates based on your income. If finances are a concern, lower rates can be found by students working towards their degree or clinicians that are not fully licensed yet. Some companies offer EAP benefits as well. Most therapists will provide a no-charge consult session or phone call in order to meet before committing. Usually those sessions will be for discussing what you are looking for support around and to learn about the therapists approach to that particular area.


Due to the COVID-19 crisis, most therapists are providing telehealth sessions. With that, there are some pros and cons. Some of the pros are that it is convenient as it may be relaxing in your own home. Cons may be that there is the lack of energy exchange, technology issues, and it’s harder to pick up on non-verbal communication through a screen or phone.

Types of Therapy

When it comes to Mental Health Therapy, there are options for individuals, groups, families, and couples. Also, some clinicians are more seasoned in mental health vs. substance abuse so you will want to find someone who has experience in the type of therapy you are looking for. There are various types of treatment modalities that Therapist’s offer:

  • Rogerian – not a style particuarly but he emphasized that all Therapists should exhibit “unconditional positive regard” for their clients.
  • CBT – short for Cognitive Behavioral Therapy and is fairly common for Therapists to provide this. This type of therapy looks at unhelpful thoughts and unhelpful behaviors and works to reframe those thoughts which in turn helps with more helpful behaviors.
  • Psychoanalytic – not widely practiced anymore but will be a deep dive into the psyche.
  • EMDR – short for Eye Movement Desensitization and Reprocessing which helps process and file unprocessed memories and traumas without talking about it.
  • Yoga & Mindfulness – many Therapists are now getting certified in Yoga. Helps bring the body into the therapy space as it really is a mind-body connection.
  • DBT – short for Dialectical Behavior Therapy, which helps with emotional regulation, mindfulness, and relationships.
  • Experiential – this type of therapy is about “doing it” vs “talking about it.” This may include role play or movement.
  • Neurofeedback – this modality will train the brain to regulate itself. No talk therapy is necessary for this.
  • Motivational Interviewing – usually effective with addictions and teenagers and can meet people where they are even if they aren’t fully bought into therapy yet.

Some Therapists use a “bottom up” vs “top down approach to therapy. You will typically see this when the body and self-regulation comes into the therapy space instead of using the mind to thing about, process the situation, or modulate the body.

“With CBT we are talking about thoughts but a lot of times if we are really anxious it’s really hard to think clearly about those thoughts because it’s a different part of the brain and that Yoga can tap into that relaxation system so that we can make talk therapy more effective so that it can go somewhere and that we can use those coping skills.”


Maybe You Should Talk to Someone by Lori Gottlieb is a book written about a Therapist’s experience with her own life crisis, her own therapy process, and the process of her clients.

Brene Brown is a Doctorate of Social Work, Researcher, Author, Public Speaker, Podcaster, etc whose work focuses on vulnerability, authenticity, and shame. Many of the things that happen or are discussed in therapy!