What Therapists Need to Know Before Running Google Ads

A practical guide for counselors and group practices

That moment you think: “Maybe I should run ads”

Your caseload dips.

Referrals slow down.

You see one more post in a therapist Facebook group that says something like:

“I turned on Google Ads and my practice filled in 60 days.”

Now you are wondering:

• Am I missing something?
• Do I need ads to stay full?
• What if I try this and just waste money?

You are not behind. You are not “bad at business.”

You are a clinician who cares about doing this right, without turning your practice into a stressful side job in digital marketing.

This article will walk you through:

• When ads actually make sense for a therapy practice
• The simple numbers that show whether ads are working
• What your website design needs before you ever pay for a click
• How to start small, with a clear plan, so ads feel like a tool, not a gamble

By the end, you should be able to say, comfortably:

• “Yes, ads fit my goals right now”
• “No, ads are not the right move for me yet”

Both answers are valid. The win is clarity.

When paid ads actually make sense for a therapy practice

Before you learn how to run ads, it helps to ask a more basic question:

Is advertising really the right tool for the problem you have?

Paid ads tend to work best in a few specific situations.

Solo therapist stabilizing or filling a caseload

You might be here if:

• You want to move from part time to full time
• You are full some months and half empty the next
• You are tired of starting over after a move or life transition

You do not need a flood of leads.
You need a steady trickle of well matched clients.

Ads can help you:

• Fill specific openings more predictably
• Rely less on unstable referral sources
• Reduce the panic of “What if next month is slow again”

Small group practice needing steady flow

Here, you might have:

• A few clinicians on your team
• Different specialties and availability
• Some people with room on their calendars

You are past survival mode. Your new questions are:

• How do we keep everyone reasonably full?
• How do we grow without undercharging or overworking?

Ads can help you:

• Direct attention to certain services or clinicians
• Fill newer team members without lowering fees
• Smooth out dips in referrals

Established clinic growing on purpose

You may be:

• Adding locations or telehealth states
• Building out specific specialties
• Creating programs like EMDR, intensives, or couples work

At this stage, ads are less about “Can we get clients” and more about:

• Where do we want to grow?
• Which services should we promote more heavily?
• How do we keep a stable pipeline over time?

If you are still unsure about your niche, pricing, or basic systems, ads are often too early.

They tend to highlight those issues rather than solve them.

Get your foundations clear before you pay for clicks

Ads amplify whatever is already true about your practice.
If your message is fuzzy, ads make that fuzziness more expensive.
If the intake process is not smooth, then you are just scaling chaos.

There are three things to get clear before you spend any money.

Know who you actually want to attract

Not “anyone who needs therapy.”

Think about the clients you do your best work with:

• Adults dealing with anxiety and overthinking
• Couples on the brink of separation
• Teen girls with school avoidance
• Burned out professionals who look “fine” on the outside

Ask yourself:

• Who tends to get good results with me or my team?
• Who usually stays for a healthy course of treatment?
• Who drains me or falls outside my scope?

Your ads should speak to the first group.

Define a specific offer

You do not need a clever program name. You need a simple statement that feels like a direct answer to what someone is already thinking.

For example:

• “Weekly anxiety counseling for adults in Denver”
• “Online couples therapy for professionals in Texas”
• “Trauma informed therapy for first responders in Portland”

If a stressed person cannot understand what you do in a sentence or two, your ads will feel vague.

Check your capacity and systems

Before you increase demand, make sure you can hold it.

Consider:

• How many new clients per month can you realistically take, or assign to your team
• Who responds to new inquiries, and how quickly
• How consult calls, scheduling, and paperwork currently work

Group practices also need to think about:

• How you decide which clinician gets which case
• How you keep your intake coordinator from burning out

Once you can say:

“We help [these people] with [these issues], we work in [this way], and we can handle about [X] new clients a month”

then ads are more likely to feel like support, not chaos.

The simple numbers you need to understand before running ads

You do not have to love numbers. You do need a tiny bit of information so you can make calm decisions.

There are two main ideas:

• What a typical new client brings into your practice
• What it costs, on average, to get that client through ads

Once you see those clearly, ads stop feeling like a gamble.

How much a typical client represents for your practice

This is sometimes called “lifetime value,”(LTV) but you can think of it as:

How much revenue you usually receive from one new client.

A simple way to estimate:

1. On average, how many sessions does a new client attend?
   • Let’s say 12 sessions
2. What is your average fee per session?
   • Let’s say 150 dollars
3. Multiply them:

12 sessions × 150 dollars = 1,800 dollars

So one typical new client brings in around 1,800 dollars in gross revenue.

Your real numbers might be different, but the method is the same.

How much it costs to get one client from ads

This is sometimes called your “cost per acquisition.” (CAC)

Think of it as:

How much you spend on ads, on average, to get one new client who actually starts therapy.

To calculate this:

1. Pick a month
2. Add up what you spent on ads in that month
3. Count how many new clients started that month from ads
4. Divide ad spend by number of new clients

Example:

• You spent 1900 dollars on ads
• 9 new clients started therapy that month from those ads

$1900 ad spend ÷ 9 new clients = $211 / client

So in this example, you spent 211 dollars in ads to get a client who represents about 1,800 dollars in revenue.

What this means in real life

In that scenario, the rough pattern is:

• 211 dollars out
• 1,800 dollars in over the course of treatment

That is about a 8.5 to 1 return.

You do not have to chase a perfect ratio. You simply want to make sure that, over time:

The revenue from new clients is several times higher than what you spend on ads.

Once you see that, decisions become easier:

• If you invest 600 dollars per month and get 2 to 3 solid new clients regularly, that feels good.
• If you invest 600 dollars per month and get zero or one, something in the system needs to be changed.

Choosing where to run ads: search vs social

You brainstorming and thinking about different channels and it feels like too many choices:

Google. Facebook. Instagram. Maybe TikTok.

The good news: you do not need to be everywhere.

Think about where your ideal client is when they are most ready to act.

Search ads (like Google)

On search engines, people type in what they are looking for:

• “therapist near me”
• “marriage counseling [your city]”
• “online therapist [your state]”

They already know they want help. They are trying to find a fit.

This means:

• Fewer clicks, but more serious intent
• A clearer path from search to consult call
• Easier tracking between ad spend and new clients

Search ads are often a strong fit when:

• You offer services people actively look for
• You work in a metro area or state with enough searches
• Your goal is booked sessions, not just brand visibility

Social ads (like Meta and Instagram)

On social platforms, people are not usually searching for a therapist. They are scrolling.

Your ad interrupts that scroll.

This can be useful when:

• You have a very clear niche and message
• You are comfortable creating content
• You want to build awareness and recognition over time

The tradeoff:

• More creativity required to stop scrolling
• More people may click out of curiosity
• Fewer may be ready to book right away
• The path from click to client is usually longer

Where most therapy practices should start

For many therapists and group practices, the simplest first step is:

A basic, well structured search campaign on Google.

You show up when someone in your area types “therapist in [your city].”

Once that is stable, you can decide later if it makes sense to add social ads. You do not have to do everything at once.

What your website needs in place before you run ads

Ads only do one thing: send people to your site.

If your site is confusing, vague, or hard to use on a phone, your ad money gets wasted.

Here is what to check first.

Service pages that speak clearly to specific clients

If someone clicks an ad about couples therapy, they should land on a page about couples therapy, not a generic “we treat everything” page.

On each key service page, make sure you answer:

• Who this is for
• What they are likely experiencing
• How you help
• What therapy might look like with you
• What the next step is

Think of the page as saying:

“I see what you are going through. Here is how I can help. Here is how to start.”

A simple, low pressure next step

Many potential clients drop off because the next step feels confusing or too heavy.

Make it:

• Obvious
• Simple
• Safe

For example:

• “Schedule a free 15 minute consultation”
• “Request an appointment”
• “Call to talk with our intake team”

One primary call to action per page is ideal. You can have several buttons, as long as they all go to the same place.

Mobile friendly and fast

Most people will click your ad from their phone.

Your site should:

• Load quickly
• Use readable font sizes
• Avoid long, unbroken blocks of text
• Have buttons large enough to tap easily

Before you run ads, pull your site up on your phone and ask:

• Can I tell who this is for within a few seconds?
• Can I see how to get started without scrolling forever?

If the answer is no, the priority is fixing that, not launching ads.

How to think about ad budget without spinning out

“How much should I spend on ads?” is usually an anxiety trigger.

You can calm this down by anchoring your budget to:

• A clear time frame
• Your practice size
• The numbers you already worked out

Choose a clear test period

Ads need time to:

• Collect enough clicks and inquiries
• Show patterns
• Be refined

A common starting point is about three months.

That does not mean you ignore things for three months. It means you commit to a window where you are willing to learn and adjust, rather than judging everything by week one.

Set a starter budget that matches your size

Here is a rough guide, not a rule:

• Solo therapist
  • Often somewhere in the 300 to 800 dollars per month range
• Group practice
  • Often somewhere in the 800 to 2,000 dollars per month range, depending on number of clinicians and fees

The key question is:

Can you invest this amount each month for your test period without putting your practice in danger?

Tie budget back to your numbers

Using the earlier example:

• A typical new client brings in about 1,800 dollars
• You are thinking about a 600 dollar monthly ad budget

Ask:

“How many new clients would I need from ads for this to feel worth it?”

If one client represents about 1,800 dollars, then:

• One new client roughly covers the ad spend
• Two or more new clients put you ahead

Now the question is not “Is 600 dollars a lot?”
It becomes “Is one to three new clients from ads per month a realistic goal, and would that feel good for my practice?”

The anatomy of a simple therapist friendly ad setup

Ad platforms can feel complicated. Underneath the settings, you are really just paying to:

• Appear in front of specific people
• Say something helpful
• Invite them to a clear next step

You can think of your setup in three pieces.

 Targeting: who should see your ads

For search ads:

• Set your geographic area to match where you are licensed and want clients from
• Use phrases that line up with how people look for you, such as:
  • “therapist in [your city]”
  • “anxiety therapy near me”
  • “marriage counseling [your city]”
  • “online therapist [your state]”

Avoid vague, broad words like “help” or “mental health” on their own. They are too wide.

Ad text: what your ad actually says

Your ad does not need to be clever. It needs to be clear.

A simple pattern is:

• Who you help
• A common struggle
• A gentle next step

For example:

“Anxiety Therapy for Adults in Seattle
Tired of constant worry and overthinking
Schedule a free 15 minute consultation”

The tone should feel similar to how you speak in a consult call:

Warm. Direct. Respectful.

Landing page: what happens after the click

When someone clicks, they should land on a page that matches your ad.

That page should:

• Acknowledge what they are going through
• Explain how you help in simple language
• Show what working with you looks like
• Point clearly to one main next step

Think of it as a short, focused conversation:

“I see you. Here is how I can help. Here is what to do if you want to take the next step.”

What to track so you know if ads are working

Running ads without tracking is like trying to evaluate treatment without any notes. You are left with a vague feeling.

You do not need a complex dashboard. A few simple checks are enough.

Clicks and cost per click

From your ad account, look at:

• How many times your ad was clicked
• How much, on average, you paid per click

This tells you:

• Whether people are noticing and clicking your ad
• Whether the cost per visit to your site is reasonable

By itself, this does not tell you if ads are profitable. It is just the first step.

Inquiries that came from ads

Next, track how many people reached out as a result of your ads.

You can do this by:

• Adding “How did you hear about us?” to your contact form
• Using a dedicated phone number for ad traffic when possible
• Noting “from Google” or similar in your intake notes

You are looking for approximate numbers, not perfection.

New clients who start from those inquiries

Finally, count how many of those inquiries actually became active clients.

Over a few months, patterns will emerge, such as:

“On average, 10 inquiries from ads lead to 3 new clients who start therapy.”

Now you can connect:

• How much you spent
• How many people reached out
• How many turned into ongoing clients

That is the information you need to evaluate your investment.

Once a month, ask:

• What did we spend on ads?
• How many inquiries came from ads?
• How many new clients started from those inquiries?

Then compare:

Is the cost per client noticeably lower than the revenue a typical client brings in?

If yes, you are likely on the right track. If not, it is time to adjust or pause.

Common ad mistakes therapists make (and what to do instead)

Many “ads do not work” stories come from a handful of very common missteps.

They are fixable.

Running Google Smart campaigns on autopilot

Google will happily encourage you to launch a Smart campaign with just a few clicks.

It feels easy.
But the results are often:

• Very broad, unfocused keywords
• Ads showing for searches you would never want
• Clicks from people outside your area or not actually looking for therapy
• A vague feeling that “Google Ads does not work”

Smart campaigns hide a lot of the settings that matter

Using vague keywords

Bidding on words like “healing” or “mental health” often brings in people who are not looking for therapy with you.

Instead: focus on phrases that combine service and location, like:

• “therapist in [city]”
• “trauma therapist [city]”
• “couples counseling [city]”

Targeting too wide an area

Setting your ads to show “everywhere” might sound good, but it usually wastes money on people outside your license area or realistic reach.

Instead: match your ad location to where your ideal clients actually live and where you can ethically practice.

Sending ad traffic to a cluttered homepage

If someone clicks “couples therapy” and lands on a busy homepage that talks about everything you do, they may quickly leave.

Instead: send them to a focused page that speaks directly to what they searched for.

Turning ads off too quickly

Running ads for a few days, then shutting them down in a panic, makes it impossible to learn anything.

Instead: commit to your test window, make small changes week by week, and evaluate the overall pattern after enough time has passed.

How ad strategy shifts from solo practice to group practice

“Running ads” means something different when it is just you, versus when you have multiple clinicians.

Solo practice

Your main goal:

• Fill and stabilize your own caseload

Your ad setup can be simple:

• One or two campaigns
• A short list of focused keywords
• One or two service pages you send people to

You can often manage this yourself if you have a bit of time and curiosity.

Group practice

Your goals shift to:

• Keeping several clinicians reasonably full
• Balancing different specialties and locations
• Not overwhelming your intake processes

Your ads may need:

• Separate campaigns for certain high priority services
• Thought about where each lead should go
• Systems for tracking which inquiries came from which efforts

At this stage, the bottleneck is often your own time and attention. Even if you could manage the ads yourself, it may not be the best use of your energy.

Deciding between DIY and getting help

Sooner or later you may wonder:

“Should I keep doing this myself, or bring someone in to help?”

When doing it yourself can work

DIY can be a good fit when:

• You are genuinely curious about how this works
• Your budget is modest and you want to get your feet under you
• You can check your campaigns at least once a week

You will learn a lot about your local market, what people search for, and what lands with them.

When it is probably time for support

It might be time to bring in help if:

• You feel dread every time you log into the ads dashboard
• You are spending money but cannot tell what is actually working
• You are running a group practice and already wearing five other hats

The right partner should:

• Understand the counseling world and respect your ethics
• Speak in plain language
• Connect your clinical and business goals to a clear advertising plan
• Show you the numbers that matter without overwhelming you

How to think about the cost of help

Come back to your numbers.

If:

• A typical client brings in around 1,500 to 2,000 dollars
• A well run ad strategy consistently brings in new clients each month

Then the question becomes:

“Does this partnership help us bring in enough additional, well matched clients to make the investment feel helpful and sustainable and frees up my time?”

A calm next step if you are thinking about ads

If you feel both hopeful and slightly overwhelmed after reading all this, that is completely normal.

You care about:

• Filling your practice with the right people
• Protecting your time and your nervous system
• Growing in a way that feels ethical and steady

You do not have to figure this out alone.

At CounselingSEO, we work only with therapists and group practices. We live in the world you live in: clinical realities, ethics, scheduling constraints, no interest in sleazy tactics.

If you would like help thinking this through, you are welcome to book a free strategy conversation.

In that call, we can:

• Look at your current site, services, and capacity
• Walk through the basic numbers together in simple terms
• Talk honestly about whether ads make sense right now for your practice
• Sketch what a straightforward ad plan would look like if you choose to move forward

No pressure to sign up for anything.

Just clarity, so you can decide what is right for you, your team, and your clients.