About
Hi, I'm Sarah. I work with individuals experiencing anxiety, trauma, and complicated family relationships often connected to perfectionism, over-achieving, self-doubt, and issues with mood. In our work, we explore how past experiences, current stressors, and relationships have shaped who you are today. We use that information to develop skills to better understand, tolerate, and regulate emotions, creating space for more ease and self-trust. Together we work towards goals that make sense of your needs, whether that’s setting boundaries in relationships, rebuilding self-trust, or lessening the effects of anxiety and depression. I use primarily Acceptance and Commitment Therapy which means we focus on learning how to detach from unhelpful thoughts and perspectives, learn how to accept the difficult things, and keep your values defined and centered throughout the process. Along the way, I also integrate mindfulness practices as well as skills from CBT and DBT to support your growth. If this sounds like you, I’m here to help! You can book a free 15-minute consultation on my website or email me with questions about working together. You don’t need to have it all figured out to start. Therapy is a place to sort through it, get support, and take the next step at your own pace. Specialties: I specialize in helping people who feel worn out, burned out, and ready for a change. Many of my clients are navigating a big transition or have realized it's time for a shift. I'm passionate about helping them reclaim a sense of control and reconnect with themselves. Together, we quiet the inner critic and focus on what you truly want to achieve. Credentials & Experience: I use my experience to pace sessions so you feel supported without being overwhelmed, providing the guidance and structure you need. I believe in direct feedback, with a compassionate tone. We'll communicate openly to ensure this process is working for you.
"I mainly use ACT but also bring in other approaches when it makes sense. What matters most is that you feel safe and connected in session. Building trust and being authentic is at the heart of our work, so we can tackle the tough stuff together. I also explain each step along the way to keep us on the same page and make sure you always know what's happening and why."
I work with

Age groups


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Specialties
Areas of Focus
Therapeutic Approaches
Services & Pricing
Free Consultation
15 min · Online, In Person
Individual Therapy
50 min · Online, In Person
Sliding scale available.
Qualifications
Verified by Calm at Home
Licensed · LCPC
Sarah Puskavich · Verified February 2026
Education and Years in Practice
Attended West Virginia University, M.S. Rehabilitation and Mental Health Counseling in , Graduated 2018
Insurance & Policies
I am in-network with BCBS CareFirst, and Cigna plans. I also offer private pay sessions for those without these plans or who prefer not to have a diagnosis on file. I can provide you with a superbill so you can get reimbursement from your insurance company with out-of-network benefits.
Payment Methods
Location
Balanced Thoughts Therapy
15887 Crabbs Branch Way, Suite B
Rockville, MD, 20855
United States
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My Practice at a Glance
Available both in-person and online
15887 Crabbs Branch Way, Suite B
Rockville, MD, 20855 map
I mainly use ACT but also bring in other approaches when it makes sense. What matters most is that you feel safe and connected in session. Building trust and being authentic is at the heart of our work, so we can tackle the tough stuff together. I also explain each step along the way to keep us on the same page and make sure you always know what's happening and why.
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Anxiety Test
GAD-7 · 7 Questions
Depression Test
PHQ-9 · 9 Questions
Stress Level
PSS-10 · 10 Questions