This might be for you if you notice
- Nerves before a race, game or meet that feel bigger than the event
- Performing well in practice and tightening up when it counts
- A racing heart, shaky hands or an upset stomach before competing
- Harsh self-talk after a mistake or a loss
- Dreading a sport you used to love
- Feeling lost during an injury, a slump or the end of a season
What sports performance counseling is
Sports performance counseling is talk therapy for athletes. It focuses on the mental and emotional side of competing: nerves, pressure, confidence, and the way sport fits into the rest of your life. It is for runners, swimmers, team players, dancers and anyone else who trains and competes, at any level.
It is counseling with a licensed therapist. It is not coaching, athletic training or physical therapy. We do not write training plans, work on technique or treat injuries. Your coach and medical team keep those roles, and counseling works alongside them.
One therapist on our team is a competitive long-distance runner who works with athletes on performance anxiety. Knowing the start line from the inside can make it easier to talk about what happens there.
Understanding performance anxiety
Some nerves before competing are ordinary. The National Institute of Mental Health describes stress as the physical or mental response to an external cause, and anxiety as the body's reaction to stress, which can occur even when there is no current threat. A big meet is exactly the kind of event that can set both in motion.
For some people the anxiety becomes strong enough to get in the way. The National Institute of Mental Health notes that for some people with social anxiety disorder, the anxiety appears only in performance situations, such as giving a speech or competing in a sports game. It lists signs such as blushing, sweating, trembling, a rapid heart rate and the mind going blank.
Feeling these things does not mean something is wrong with you as an athlete, and reading this page cannot tell you whether you have an anxiety disorder. A therapist can help you sort that out. If worry shows up well beyond sport, our anxiety therapy page may also be useful.
How counseling for athletes works
Your therapist begins by learning about your sport, your season and what happens for you before, during and after you compete. Together you set goals that matter to you, whether that is feeling steadier at the start, recovering faster after a mistake, or enjoying your sport again.
Members of our team use approaches such as cognitive behavioral therapy (CBT), mindfulness-based approaches and solution-focused therapy. The National Institute of Mental Health describes CBT as teaching a person different ways of thinking, behaving and reacting to situations. It describes exposure therapy, a CBT method, as progressively confronting fears so a person can take part in activities they have been avoiding.
Skills athletes often practice
- Noticing unhelpful thoughts and answering them with fairer ones
- Breathing and relaxation exercises for the minutes before you compete
- A simple pre-event routine that keeps your attention on what you can control
- Resetting after a mistake so one bad moment stays one moment
- Protecting sleep and recovery during a heavy season
- Talking with coaches, teammates or parents about pressure
What online sessions look like
Sessions are held by secure video, so they fit around practice, school, work and travel to competitions. There is no office to visit. You need a private space, an internet connection, and a phone, tablet or computer with a camera.
You must be physically located in Pennsylvania, West Virginia or Arizona during each session. If you travel out of state to compete, let your therapist know ahead of time so you can plan sessions around it. Evening and weekend appointments are available, depending on the therapist.
We work with teens and adults, and we match you with a therapist who sees your age group. For younger athletes, our teen therapy page explains how parents are involved. Sessions are confidential, with legal exceptions your therapist will explain.
Getting started
Locascio Wellness does not provide emergency services. If you are in crisis or thinking about harming yourself, call or text 988, or call 911. More options are listed on our crisis resources page.
Athletes train their bodies with patience and repetition, and the mental side of sport can be practiced in a similar way. Many athletes find that with support, competition starts to feel more like a challenge they are ready for. Asking for help is a strong move.
- Book a free consultationA free 15-minute consultation is the first step. You can book online and tell us about your sport and what you would like to change.
- Get matchedWe match you with a therapist licensed in the state where you live. You can ask about a therapist with experience working with athletes, and read about our team.
- Ask about coverageCoverage depends on your plan and your state. Ask us to verify your benefits or see insurance and fees. Self-pay is available.
- Start building skillsYou and your therapist set goals, then practice skills in session that you can try at your next practice or event.
Therapists for sports performance counseling
These therapists describe related experience in their own profiles. We will help you find the best fit and confirm who is licensed in your state.
Questions people ask
Is sports performance counseling the same as coaching?
No. This is counseling with a licensed therapist, focused on the mental and emotional side of sport. We do not give training plans, technique advice or nutrition plans, and we do not treat physical injuries. Your coach, athletic trainer and doctor keep those roles. Counseling adds a private place to work on nerves, pressure and confidence.
What is sports performance anxiety?
It is a common name for strong nerves or fear tied to competing or being watched while you perform. It can show up as a racing heart, shaking, an upset stomach, a blank mind or a wish to avoid the event. Some nerves are ordinary. When they get in the way of competing or enjoying your sport, counseling can help you understand them and practice ways to respond.
How do online sessions work for athletes?
Sessions are by secure video from a private spot, using a phone, tablet or computer. You must be physically located in Pennsylvania, West Virginia or Arizona during the session. There are no in-person visits. Evening and weekend times are available depending on the therapist, which can help during a busy season.
Does insurance cover sports performance counseling?
It depends on your plan. Health insurance generally covers treatment of a diagnosed condition, such as an anxiety disorder, so coverage for counseling that is focused only on performance varies. Ask us to verify your benefits before you begin, or check our insurance and fees page. Self-pay is available.
Do I have to be an elite athlete?
No. Therapists on our team work with people at many levels, including school and club athletes, recreational runners and adults who compete for the love of it. What matters is that your sport is important to you and that nerves, pressure or doubt are getting in the way of it.
Will counseling make me perform better?
No one can promise a result on the scoreboard or the clock. What counseling can do is help you understand your anxiety, practice skills for managing it, and feel more at ease when you compete. Many athletes find that sport becomes more enjoyable when pressure takes up less room, and that matters whatever the result.
Can you help when an injury or the end of a sport is the hard part?
Yes. Time away from sport, a long recovery or retiring from competition can bring sadness, worry or a sense of lost identity. Counseling gives you room to talk about that and think about what comes next. Physical rehabilitation stays with your medical team, and counseling supports the emotional side.
Sources
Published by Locascio Wellness. Last updated October 9, 2026. Clinically reviewed by Anthony Locascio, PsyD, LPC. This page is general information, not medical advice or a diagnosis.