Nathaniel D. Smith, LPC, NCC provides cognitive behavioral therapy (CBT) for anxiety disorders — in person in Plano and via secure telehealth anywhere in Texas.
of people with anxiety improve significantly with CBT
APA, 2023sessions is a typical course of CBT for anxiety disorders
NICE Guidelineslower relapse rate with CBT vs. medication alone
Clark & Beck, 2010years of clinical experience treating anxiety and depression
Nathaniel D. Smith, LPCAnxiety is not a character flaw or a sign of weakness. It is a learned pattern — a threat-detection system that has become miscalibrated, firing alarms in situations that are not actually dangerous. The more you avoid those situations, the louder the alarm gets.
This is why telling yourself to "just relax" or "stop worrying" rarely works. The anxiety is being maintained by specific cognitive and behavioral patterns operating largely outside conscious awareness. CBT makes those patterns visible — and changeable.
Effective anxiety treatment does not mean eliminating all discomfort. It means learning to respond to anxiety differently, so it no longer controls your decisions, limits your life, or exhausts you.
CBT is effective across the full spectrum of anxiety disorders. Each type has its own maintaining patterns — and its own targeted CBT approach.
Persistent, hard-to-control worry about multiple areas of life — work, health, relationships, finances. CBT targets the worry process itself, not just the topics.
Recurrent panic attacks and the fear of having more. CBT addresses the misinterpretation of physical sensations and the avoidance patterns that keep panic alive.
Intense fear of judgment, embarrassment, or scrutiny in social or performance situations. CBT challenges the beliefs driving self-consciousness and builds genuine confidence.
Excessive worry about having or developing a serious illness. CBT interrupts the reassurance-seeking and checking cycles that maintain health-focused anxiety.
CBT is structured and goal-directed. Here is what the process looks like in practice.
Anxiety is maintained by specific thinking patterns — catastrophizing, overestimating threat, underestimating your ability to cope. In early sessions we map yours precisely.
Anxious thoughts feel true. CBT teaches you to examine them like a scientist — weighing actual evidence rather than reacting to worst-case assumptions.
Avoidance is anxiety's best friend. Structured exposure and behavioral experiments gradually reduce the power anxiety holds over your decisions and daily life.
The goal is not to need therapy indefinitely. You leave with a toolkit — specific techniques you own — that continues working long after sessions end.
Nathaniel D. Smith is a Licensed Professional Counselor (LPC) and National Certified Counselor (NCC) with over 20 years of clinical experience. His practice is focused exclusively on cognitive therapy — not a generalist approach, but deep specialization in the methods with the strongest evidence base for anxiety and depression.
Clients describe the work as rigorous and warm in equal measure. Sessions are structured and purposeful, but never cold. The goal is for you to understand exactly what is driving your anxiety — and to leave each session with something concrete you can use.
A generalist sees dozens of conditions. This practice focuses on anxiety and depression exclusively — the nuances matter, and they accumulate over 20 years.
CBT has more clinical trial support than any other psychotherapy. Every technique used here has a research basis — not intuition or trend.
The explicit goal is for you to need therapy less over time. You leave with a toolkit that works independently of ongoing sessions.
Telehealth sessions are available to clients anywhere in Texas — Dallas, Houston, Austin, San Antonio, Fort Worth, and beyond. Secure, HIPAA-conscious video sessions that fit your schedule without a commute.
Reaching out is often the hardest step. Send a note and Nathaniel will respond personally to schedule a brief consultation.
7150 Preston Road, Suite 100 · Plano, TX 75024 · Telehealth available statewide