Practitioner record · Checked 9 Oct 2026
Nat Pacini has been in practice 35 years and is licensed in Texas. Nat lists stress, Anxiety, anger management and self esteem among 32 subjects on the BetterHelp roster.
Everything below is either quoted from Nat's own BetterHelp listing, taken from public licensing records, or written by Maker Therapy and labelled as such. Nothing here is an availability promise, a review, or a rating.
01 · Who Nat works with
Nat lists 11 specialisms and 21 further focus areas. Specialisms are the subjects Nat chose to list first, which is the closest a listing gets to “this is my actual practice”.
02 · In Nat's own words
Reproduced in full and unedited - not summarised, not tightened, not rewritten in a house voice.
My approach to therapy follows a simple format delivered with the utmost respect and enthusiasm. I must earn your trust. This is supposed to help you. My communication style is generally void of jargon, tired sayings or "psychobabble". I follow Cognitive Behavioral Therapy as a model.
Initially some mutual understanding of the problem must be established. Definition fosters clarity; clarity strengthens meaning; meaning empowers solutions. The goal is for both of us to understand more fully just what it is about your situation that makes it a problem. For many this discussion alone brings a bit of relief. It feels good to be heard and understood.
However very personal issues, secrets, about your life, about you, about what you think, must remain secrets to the extent that you are more comfortable with them being your secrets. I will not venture there. You will learn that some things are irrevocably secrets and nobody can ever know. I will teach you how to protect those secrets, and their effects, and only you will decide, and under what circumstances, which secrets, if any, you will ever release, including to me.
Next we learn more about the cognitive behavioral model. We know it is effective but we will decide how it will apply to you and how will you best incorporate the model comfortably into your life. We will discuss and negotiate what you can do. I respect your comfort level but I also respect your ability to overcome limitations. You are here to make a change. The two of us will decide how that will look.
I keep in mind the expense required of you. I will go month to month with the goal of helping you establish an improvement in your life in one to two months if possible. There will be an amount of work you will do. The beneficial effects of this work you will soon know. I very much encourage full use of this platform. We can utilize the most beneficial device available in this format which is the frequent contact via messaging. This lends itself well to the model we use.
The techniques employed here are time honored and supported by research and experience. There is a vast amount of resources to explore. Or we make new ones.
My typical schedule is Tuesdays,Thursdays, and Saturday and Sunday from 8 AM until 4 stopping time.
I received my education from the University of Texas at Austin and was awarded Master of Arts in Clinical Psychology from the University of Houston-Clear Lake in 1986. I spent over 20 years in an in-patient facility in Texas as an Associate Clinical Psychologist. I have served as therapist to individuals from diverse backgrounds and with unique challenges. Some of the people I have worked with, in an alliance to make their lives at the very least tolerable, are among the coolest and most admirable humans I have ever known. I owe them a lot for the skills I bring here.
Nat Pacini, on the BetterHelp listing · read 9 Oct 2026
03 · How Nat works
These are the clinical methods Nat lists. The descriptions are Maker Therapy's, not Nat's - a general explanation of what each method is, so the list means something before you have spoken to anybody. They are not a claim about how Nat runs a session.
04 · What happens next
Nat practises through BetterHelp, so the route in is BetterHelp's. This is that sequence, written by Maker Therapy from the platform's published process - not a description of Nat's own practice, and not a promise about how quickly anything happens.
BetterHelp opens with a set of questions about what you are dealing with, what you want from therapy, and any preferences on the therapist. You are not booking Nat at this point.
BetterHelp matches algorithmically by default, so asking for Nat is a step you have to take. There is a field for requesting a specific therapist during sign-up, and you can switch afterwards from your account. Starting from a link on this page does not by itself assign you to Nat.
You will be offered somebody else rather than put on a waitlist. Worth knowing, because it is easy to assume a match is the person you asked for.
A first session is typically history and orientation: what brought you, what has been tried, what you want to be different. It is also where the questions in the next section belong.
Changing therapist on BetterHelp does not need a reason. A first session that does not click is common and is not a verdict on therapy. That option existing is the main practical difference between a platform and a private practice.
05 · Before you commit
Built from what Nat actually lists, so they are answerable and specific rather than generic. Maker Therapy's, not Nat's - Nat has not seen them and is under no obligation to answer any of them.
“You list both Cognitive Behavioural Therapy and Client-Centred Therapy. Which do you lean on with someone like me?”
Those two point in different directions - one structured and led by the therapist, the other led by you. The answer tells you what the sessions will actually feel like.
“With 35 years in, what has changed most in how you work?”
Long experience is only an advantage if it has been examined. This tends to surface whether it has.
“How do you handle the gap between sessions if something comes up?”
On BetterHelp this varies a great deal by therapist. Better to know the rhythm now than to discover it on a bad week.
06 · Practical details
07 · Provenance
Nat's name, credential, state, subjects, approaches and biography are read from BetterHelp's therapist roster, which Maker Therapy re-reads once a day; this page reflects the reading taken on 9 Oct 2026. The licence number and NPI are cross-checked against public registers.
The plain-English method descriptions, the first-session walkthrough and the questions are written by Maker Therapy and labelled as such wherever they appear.
Maker Therapy is not BetterHelp, does not take bookings, and has not met Nat. There are no reviews or ratings on this page because we have no way to verify one. If you start therapy through a link here, we may be paid a commission - it does not change your price and it does not affect who appears here or in what order.
Something on this page wrong or out of date? Report it and it will be checked against the source.
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