Nathaniel D. Smith, LPC, NCC offers specialized, evidence-based cognitive behavioral therapy (CBT) for adults navigating anxiety and depression — in person in Plano and via secure telehealth anywhere in Texas.
"Lasting change happens when we treat the root, not just the symptom."
Anxiety and depression are exhausting — and they rarely respond to advice you've already heard a hundred times.
You may be high-functioning on the outside while feeling like something underneath is quietly running the show: the spiral of worry, the heaviness that won't lift, the harsh inner voice that questions everything you do.
Therapy here is different. We don't just manage symptoms — we map the deeper patterns generating them, so the relief you find is one that holds. The work is structured, warm, and genuinely collaborative. You'll leave understanding yourself with a clarity that's hard to unlearn.
Cognitive behavioral therapy (CBT) is a structured, evidence-based form of psychotherapy that focuses on the relationship between thoughts, feelings, and behaviors. It is one of the most extensively researched treatments in psychology, with decades of clinical trials demonstrating its effectiveness for anxiety disorders and depression.
The core principle of CBT is that unhelpful thinking patterns — not situations themselves — drive emotional distress. By learning to identify and evaluate automatic thoughts and the deeper core beliefs behind them, clients develop lasting skills to change how they feel and act.
Yes. CBT is considered a first-line treatment for generalized anxiety disorder, panic disorder, social anxiety, and health anxiety, with strong evidence from hundreds of randomized controlled trials.
Yes. CBT for depression is as effective as antidepressant medication for mild-to-moderate depression, and research shows it reduces the risk of relapse more than medication alone.
CBT is structured and goal-directed. Sessions follow a clear agenda, include between-session exercises, and focus on specific thinking patterns — not open-ended exploration.
Rather than offering a little of everything, this practice goes deep on the conditions where cognitive behavioral therapy (CBT) is most powerfully effective.
When the mind is always scanning for what could go wrong, daily life narrows. We work to interrupt that cycle at its source.
Depression distorts how you see yourself, your future, and your worth. Cognitive therapy is one of the most evidence-supported treatments available for it.
CBT is among the most rigorously researched, effective treatments for anxiety and depression. Three commitments shape every session.
Each session includes concrete, research-backed strategies you can use between visits — thought records, behavioral experiments, and skills that build real momentum, not just insight.
Together we map how your situations, automatic thoughts, emotions, and behaviors connect — and trace them down to the core beliefs quietly driving the whole pattern.
You'll never be left guessing. I explain the clinical strategy behind the work so you understand what's happening at a deeper level — and become your own expert over time.
Most distress feels like it comes out of nowhere. In reality, a thought, a feeling, and a reaction are all downstream of deeper beliefs formed long ago. When we can see the whole chain, we gain real leverage to change it.
You'll always know where we are and where we're heading. Therapy here has structure and direction from the first session.
Using the cognitive model, we map how your automatic thoughts, feelings, and behaviors connect — and trace them to the core beliefs that shape how you see yourself and the world.
You learn and apply research-backed strategies — thought records, behavioral experiments, and skills proven to shift anxiety and depression — building real momentum between sessions.
I explain the clinical reasoning behind every step, so you understand what's happening at a deeper level and steadily become your own expert.
We track your progress with validated measures and, where helpful, brief testing to clarify symptoms — so change is something we can actually see, not just hope for.
I'm Nathaniel Smith, a Licensed Professional Counselor and National Certified Counselor with more than twenty years of clinical experience. My work centers on cognitive therapy because, time and again, I've watched it produce change that holds — not just relief that fades when life gets hard again.
My clients are often thoughtful, capable people who are tired of white-knuckling their way through anxiety or quietly carrying a depression that doesn't match the life they've built. They want a clinician who is both warm and rigorous — someone who treats them as a full collaborator in the work.
That collaboration is the heart of it. I'll explain the strategy behind everything we do, so you don't just feel better — you understand why, and you keep the tools for life.
This is a fee-for-service practice. Working outside of insurance protects your privacy, removes diagnostic requirements imposed by third parties, and lets your treatment be guided entirely by what serves you.
50-minute sessions, in person at the Plano office or via secure telehealth anywhere in Texas. Rate reflects specialty expertise and a focused, results-oriented approach.
HSA and FSA cards accepted.
Many clients use out-of-network benefits — a detailed monthly superbill can be provided for you to submit for partial reimbursement.
A limited number of sliding-scale appointments are reserved for special circumstances. Please ask during your consultation.
Therapy is one of the few investments that pays dividends across every part of your life — your relationships, your work, and the way you experience an ordinary day.
This is a fee-for-service private practice, with sessions at $225 for 50 minutes. Many clients use out-of-network benefits, and I can provide a monthly superbill for reimbursement. A limited number of sliding-scale spots are available in special circumstances — just ask.
Yes. Secure, HIPAA-conscious telehealth sessions are available to clients located anywhere in Texas, with in-person appointments offered at the Plano office at 7150 Preston Road, Suite 100.
Cognitive behavioral therapy (CBT) is a structured, evidence-based treatment that focuses on the connection between thoughts, feelings, and behaviors. In sessions, you learn to identify automatic thoughts and the deeper core beliefs driving anxiety or depression, then develop practical skills to evaluate and change those patterns. It is one of the most researched and effective treatments in psychology.
Yes. CBT is considered a first-line treatment for anxiety disorders and depression by major clinical guidelines. Research consistently shows it produces lasting results — not just symptom relief, but a reduction in relapse risk — because it teaches skills clients keep for life.
Traditional talk therapy often focuses on exploring feelings and past experiences in an open-ended way. CBT is structured and goal-directed: sessions follow an agenda, include between-session exercises, and target specific thinking patterns. Clients leave with concrete tools, not just insight.
It depends on your goals and history. Many clients notice meaningful shifts within the first several weeks as they learn to recognize and respond to automatic thoughts, with deeper belief-level work unfolding over a focused course of treatment. We'll set direction together and revisit it openly.
Yes. The Plano office at 7150 Preston Road is convenient for clients throughout the Dallas–Fort Worth area, including Dallas, Frisco, McKinney, Allen, and Richardson. Telehealth is also available for clients anywhere in Texas who prefer to meet online.
Reach out through the consultation request below or by phone or email. We'll have a brief conversation to make sure it's a good fit, answer your questions, and schedule a first session that works for you.
Reaching out is often the hardest part — and the most important. Send a note below and I'll respond personally to schedule a consultation.
Tell me a little about what brings you in. There's no pressure — just a first conversation.
Your message is sent securely and goes directly to Nathaniel. This form is not a substitute for emergency care.