Rachael Lastoff


Rachael Lastoff


Telehealth Available
Professions: Counselor, Licensed Professional Counselor, Mental Health Counselor
License Status: I'm a licensed professional.
Primary Credential: Licensed Professional Counselor - 244830
Secondary Credential: LCMHC - 11682
Billing and Insurance:

I don't currently accept insurance, but I can provide documentation if clients wish to submit to an insurance company for "out of network" benefit coverage

Fees: Free 15 Minute Phone Consultation
$175 for 50-Minute Individual Therapy
$200 for 75 Minute Couples Counseling
$250 for PolyOpen Relationship Coaching
Free Initial Consultation
Evening Availability


Asheville, North Carolina 28806

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My Approach to Helping

I come from a secular background and am LGBTQ welcoming and affirming.

Whether you have experienced a recent setback or are trying to come to terms with an ongoing struggle, my goal is to be an unbiased listener providing reflective and direct feedback to help you gain insight and clarity. I am intensively trained in DBT and utilize an eclectic approach to treatment. I love using humor in sessions and encourage clients to find what brings them joy, even in dark times. I specialize in working with those who struggle with trauma, relationships, eating disorders, and life transitions.

I have over 12 years of experience in the mental health field and help clients navigate boundaries, communication, and trauma. I enjoy working with monogamous, ethical non-monogamy, poly, and open relationships.

I am a licensed clinician in Kentucky, Ohio, Massachusetts, and North Carolina. I provide online counseling to all residents of each state and in-person counseling in Newport, Ky. I do not take insurance but can provide a superbill for out-of-network benefits.

More Info About My Practice

You can schedule your initial consultation easily through my website under the Book Online tab.

Specific Issue(s) I'm Skilled at Helping With

My formal training is in DBT, which has four main parts: Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. DBT was originally created for those in chronic distress, but the skills can easily translate over to helping those struggling with relationships, stress, depression, trauma and life transitions. While I don't exclusively use DBT in my practice, I often utilize different components of DBT to match my client's needs.

My Role as a Therapist

You are the expert in your life's journey. My role is to provide support, encouragement, and the tools necessary to help you get where you are going. Clients have found my approach to be warm, funny and direct. I also assign homework to encourage self-reflection between sessions.

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Services I Provide

  • Consultation
  • Individual Therapy & Counseling
  • Marriage, Couples, or Relationship Counseling
  • Telehealth

Ages I Work With

  • Adults


  • English

Industries & Communities Served

  • Entertainment Industry
  • LGBTQ+
  • Self-Employed and Freelance Professionals

Client Concerns I Treat

  • Abandonment
  • Abortion / Post Abortion Issues
  • Adjusting to Change / Life Transitions
  • Anxiety
  • Body Image
  • Breakup
  • Depression
  • Divorce / Divorce Adjustment
  • Eating and Food Issues
  • Emotional Overwhelm
  • Family Problems
  • Gender Dysphoria
  • Grief, Loss, and Bereavement
  • HIV / AIDS
  • Identity Issues
  • LGBT (Lesbian, Gay, Bisexual, and Transgender) Issues
  • Midlife Crisis / Midlife Transition
  • Polyamory / Nonmonogamous Relationships
  • Posttraumatic Stress / Trauma
  • Relationships and Marriage
  • Self-Care
  • Self-Compassion
  • Sexual Assault / Abuse
  • Women's Issues
  • Young Adult Issues

Types of Therapy

  • Cognitive Behavioral Therapy (CBT)
  • Dialectical Behavioral Therapy (DBT)
  • Feminist Therapy
  • Psychoanalysis / Modern Psychoanalysis
  • Solution-Focused Brief Therapy (SFBT)

See other therapists in Asheville, NC.

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