Therapy is one of the few categories where the person searching is often in distress, and that changes how the advertising has to work. The searches are urgent and private. The ad copy has to be calm rather than persuasive. And the targeting rules are stricter than most practices expect, because mental health sits inside Google’s restricted categories.
Done properly it fills a caseload quickly. Done the way a generic agency runs a lead generation campaign, it wastes money and can get the account restricted.
What does a therapy client cost to acquire?
Above the all industry average on cost per click, and usually worth it because a client is a recurring relationship rather than a single transaction.
Across 13,474 US search campaigns the all industry benchmarks were $5.42 per click, $66.69 per lead and an 8.18% conversion rate, per WordStream.
The number that matters in therapy is not cost per enquiry. It is cost per client multiplied against how many sessions they attend. A client at $180 to acquire who attends twelve sessions is a completely different proposition to one who attends two. Most practices never calculate the second half.
| What you measure | What it tells you |
|---|---|
| Cost per enquiry | Very little. Enquiry volume is easy to buy. |
| Cost per booked intake | Better. Still not revenue. |
| Cost per attended first session | The real acquisition cost. |
| Cost per client, against average sessions attended | The only number that decides budget. |
What this means for you: optimize toward attended first sessions and judge budget on lifetime sessions. Our cost per lead benchmarks put healthcare alongside other categories.
What Google will not let you do here
This is the part most practices and most agencies get wrong, and it is specific to mental health.
Google restricts personalized advertising around sensitive categories, and mental health is one of them. In practice that means you cannot build audiences or target people based on inferred mental health status, and you should not write copy that implies you know something about the individual’s condition.
Practical consequences:
- Remarketing is limited. Do not assume you can retarget visitors to a condition specific page the way you would in ecommerce.
- Copy must not address the person as a diagnosis. Speak about the service, not about what you assume they have.
- Crisis terms are not yours to advertise on. Searches around self harm or suicide surface crisis resources, and bidding on them is both ineffective and wrong. Block them.
- Some services need certification, particularly anything involving addiction treatment, and requirements differ by country.
If ads start getting disapproved, our audit guide covers where to look before the problem compounds.
Match the search to the modality and the logistics
People do not search for “therapist”. They search for a problem, a format or a constraint.
The three things that decide whether someone books are usually practical:
- Format. In person or online. Online therapy widened the market enormously and it is a different campaign, because the geography is different.
- Payment. Whether you take insurance, and which. This is the most common reason an enquiry dies.
- Availability. How soon someone can be seen. A waitlist loses to an opening every time.
Put all three on the landing page above the fold. A practice with immediate availability that says so will outperform a better known practice that does not. Our post on high converting landing pages covers the rest of the page.
Keywords, and what to block
Worth bidding on: modality terms tied to what you actually offer, format terms like online therapy or in person counseling, insurance terms if you accept it, and local terms kept to a travelable radius for in person work.
Worth blocking:
- Crisis terms. Block them outright.
- Training and careers. How to become a therapist, counseling degree, licensure, CEUs, supervision.
- Free and low cost. Free counseling, sliding scale, community services, unless that is what you provide.
- Self help and research. Symptoms of, quiz, test, is it normal, definitions.
- Apps and competitors, unless you have a deliberate reason.
For in person work, set location targeting to presence rather than presence or interest. Our post on negative keywords covers building the list.
Track the intake, carefully
Therapy enquiries arrive by form and by phone, and a large share never convert to an attended session because of fit, insurance or availability.
Send attended first sessions back into Google Ads as the conversion bidding optimizes toward, and keep raw enquiries as a secondary action you watch. Do that without passing any clinical detail. You are sending a conversion event and a value, not information about a person.
From 15 June 2026 Google moved offline conversion imports to the Data Manager API and blocked them in the Google Ads API, so check any older integration from your practice management system. Our guide to conversion tracking covers the setup.
How to choose an agency for a mental health practice
- “What are the restrictions on advertising mental health services?” If they do not know it is a restricted and sensitive category, stop there.
- “How will you handle remarketing?” The right answer involves caution, not a standard retargeting plan.
- “What will we optimize toward?” Attended sessions, not enquiries.
- “How will you handle insurance and availability in the copy?” These are the two biggest drop off points.
- “What would make you tell us to stop?” No answer means they are selling.
Our post on choosing a Google Ads agency covers contracts and management pricing covers fee models.
Common questions
How much should a practice spend?
Work back from caseload. Decide how many new clients you can take, divide by the share of enquiries that attend, and multiply by cost per enquiry. Solo practices often need less than they expect, because a full caseload is a small number.
Can we retarget people who visited our site?
Treat it as restricted rather than assuming standard remarketing applies. Mental health is a sensitive category and personalized advertising rules limit what you can build audiences on.
Is online therapy worth a separate campaign?
Yes. The geography, the competition and the copy are all different. Running it inside a local campaign wastes both.
Should we bid on insurance names?
If you genuinely accept that insurance, yes, and say so clearly on the page. It is one of the highest intent searches in the category. If you do not accept it, block it.
What if we have a waitlist?
Pause or reduce rather than paying for enquiries you cannot serve. Lower the budget instead of switching off, so Smart Bidding is not relearning when you reopen.
How long before it works?
Enquiries usually arrive within the first two weeks because the intent is immediate. Judge the economics at ninety days on attended sessions.
Where to go from here
Work out one number before changing anything: the average number of sessions a client from ads attends. Multiply by your session fee. That is what you can afford to pay to acquire one, and it is almost always higher than practices assume.
Our Google Ads management page explains how we work, our case studies show the results, and you can get in touch for a straight read on your account.
