Cognitive therapy for anxiety & depression — in Plano, TX and online across Texas.
Nathaniel Smith, LPC, NCC offers specialized, evidence-based cognitive behavioral therapy (CBT) for adults (18+) navigating anxiety and depression — in person in Plano and via secure telehealth anywhere in Texas.
"The work here targets the root, not just the symptom."
Credentials & Advanced CBT Training
- Beck Institute for Cognitive Behavior TherapyExtensive training in cognitive behavioral therapy — Beck Institute, Philadelphia, PA
- Feeling Good InstituteAdvanced training in TEAM-CBT — Feeling Good Institute, founded by David Burns, MD
- Licensed Professional CounselorState of Texas · License No. 19525
- National Certified CounselorNational Board for Certified Counselors
- 20+ Years in PracticeFocused exclusively on CBT for anxiety and depression in adults
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. Rather than managing symptoms alone, we work to map the deeper patterns generating them. The work is structured, warm, and genuinely collaborative. Clients often describe coming away understanding themselves with a clarity that is hard to unlearn.
CBT therapy explained — what it is, how it works, and why it's effective for anxiety and depression
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.
Is CBT effective for anxiety?
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.
Is CBT effective for depression?
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.
How is CBT different from regular talk therapy?
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.
Anxiety and depression treatment in Plano, TX — specialized CBT, not general counseling
Rather than offering a little of everything, this practice goes deep on the conditions where cognitive behavioral therapy (CBT) is most powerfully effective.
Anxiety
When the mind is always scanning for what could go wrong, daily life narrows. We work to interrupt that cycle at its source.
- Generalized anxiety, worry & overthinking
- Panic, health anxiety & anticipatory dread
- Social anxiety & performance pressure
- Perfectionism & the "never enough" trap
Depression
Depression distorts how you see yourself, your future, and your worth. Cognitive therapy is one of the most evidence-supported treatments available for it.
- Persistent low mood & loss of motivation
- Self-criticism, guilt & feeling "not enough"
- Hopelessness & difficulty engaging with life
- Depression layered with grief or burnout
How cognitive behavioral therapy (CBT) works — evidence-based and built to last
CBT is among the most rigorously researched, effective treatments for anxiety and depression. Three commitments shape every session.
Practical exercises that work
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.
Understanding the core beliefs
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.
Knowing what's happening & why
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.
How a single moment is actually built
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.
What to expect from CBT therapy sessions in Plano, TX
You'll always know where we are and where we're heading. Therapy here has structure and direction from the first session.
Conceptualization
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.
Evidence-Based Tools
You learn and apply research-backed strategies — thought records, behavioral experiments, and skills proven to shift anxiety and depression — building real momentum between sessions.
Psychoeducation
I explain the clinical reasoning behind every step, so you understand what's happening at a deeper level and steadily become your own expert.
Measure Outcomes
Progress is tracked with validated symptom measures — standardized instruments such as the PHQ-9 and GAD-7, readministered over the course of treatment — so change is something we can observe and discuss, not just estimate.
Nathaniel Smith, LPC — Cognitive therapist serving Plano, TX and all of Texas
I'm Nathaniel Smith, a Licensed Professional Counselor and National Certified Counselor with more than twenty years of clinical experience. My practice focuses exclusively on cognitive behavioral therapy for anxiety and depression, with advanced training through the Beck Institute for Cognitive Behavior Therapy and the Feeling Good Institute.
Clients describe the work as rigorous and warm in equal measure, and often say they come away understanding themselves with a clarity that is hard to unlearn.
Learn More About NathanielTherapy fees — transparent, fee-for-service pricing
Sessions are $225 for 50 minutes. This practice is transitioning to fee-for-service and is no longer taking new clients through insurance. A monthly superbill is available for out-of-network reimbursement, and HSA and FSA cards are accepted.
A limited number of sliding-scale spots are reserved for special circumstances.
See Full Fee InformationFrequently asked questions about CBT therapy in Plano, TX
Have questions about how cognitive therapy works, what sessions look like, or how to get started? The FAQ page covers insurance, fees, telehealth, session structure, and more.
Most clients find their biggest questions answered before the first call.
Read All FAQsTake the first step
Reaching out is often the hardest part — and the most important. Send a note below and I'll respond personally to schedule a consultation.
Plano, TX 75024
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