A Therapist's Guide to Starting and Maintaining a Google Ads Campaign

A Therapist's Guide to Starting and Maintaining a Google Ads Campaign

General Marketing

Before You Start

Why Do Paid Advertising?

Paid advertising is a great way to put some fuel on a private practice. It takes an investment to make it work, but it starts working immediately. So if you are in the need for some clients quick  and you have the cash to invest, this is a good road to take.

How To Measure Success

Before you get started on even setting up the account, let’s do the math to understand what success looks like. You do this by using a simple formula: the maximum cost per acquisition.

First let’s figure out some figures...

What’s your profit per session? This is easy to determine when you’re a group practice getting clients for your therapists (session cost - payout to therapist). But if you’re a therapist on your own you’ll need to choose a number. Let’s say your session costs $150, how much can you count as “profit” with your time being the expense?

Once you know that you can discover the value of a new client using this formula of the CLV, Client Lifetime Value = (Profit per Session * Lifetime Sessions) or for example ($50 * 20 Sessions) = $1,000)

Then you need to guess a close rate. This is the rate that a lead from paid advertising turns into one of these average clients, a client that sticks. Let’s assume something low for now, say 20%, 1 out of 5. Then 20% of $1,000 equals $200.

That makes the maximum cost per acquisition to be $200. You need to be getting leads at $200 to theoretically break even on your efforts. Doing anything below that is considered success.

The other factors here not included would be your time to setup and manage the campaign and then the value of having paying customers which means potential word of mouth referrals.

Determine Your Ad Spend Budget

If you are managing the account yourself you have the advantage of spending whatever you like, there’s no real minimum (while paying for management you need to offset the management costs to see real benefit). But take this into consideration:

  1. Take into account your maximum cost per lead. If it’s $200 you need to at least be spending more than that to see that per month.
  2. It takes around 100 clicks to really see success in an ad or ad account. And if a cost-per-click is around $5 it could take $500 of ad spend to see any real data to make changes. 

Choose What You’ll Advertise

Think about, what is your ideal service you offer to clients? What’s your speciality? (ex. Anxiety Therapy or Couples Counseling). We’ll discuss more later with keywords, but this will need to be something that you sell so don’t think about “losing a loved one” think about “grief counseling”.

Then, once you decide on the service, everything you create needs to be speaking towards the one person who needs that service. The more specific you are creating the funnel the more the client sees you’re the one who solves their problems.

Understanding Basic Google Ads Structure

4 quick terms to learn! This will be put into practice later, but to get the basic idea.

  1. Account - You’ll just set up one of these and it’ll contain it all. Typically each URL/Website should have one account and one billing account.
  2. Campaign - Then you will want different campaigns for different targeting locations or separate budgets. Practices with 5 locations would want to have at least 5 campaigns and if you want to separate your budget across different types of ads, you can have different campaigns as well.
  3. Ad Groups - Then you’ll want to think about the services you want to advertise or the types of searches your audience will make. This could be like “Couples Counseling” or “Therapy for Anxiety”. And as the name suggest it contains multiple ads.
  4. Ads - This is where you get specific. This is the actual ad that someone sees on Google

Preparing Your Website

Landing Pages

Once you have listed out the services you want, then you’ll need to create the landing page for it. Landing pages are different than normal website pages. You’ll want to provide plenty of information, but you want a form to be front and center. The main goal is to get conversions and without a clear form that is less likely to happen. 

Typically this format works well for a landing page.

  1. Header - Just the logo so the user isn’t distracted to navigate anywhere else.
  2. First section above the fold - One side that contains just the basic information with all the reasons to start your service and the other side being the form.
  3. Then a few more sections containing all the secondary information.
  4. End with another form

Then when someone submits the form, it needs to lead to another page, the “thank you page” this should be a page to explain what the user should expect (ex. “We’ll be in touch within 24 hours”, etc) and then links to other relevant resources.

Setting Up Your Account

Read This First

To make things easy you can go through the step-by-step easy process that Google provides or jump ahead and do things manually. Google is constantly updating their process and UI, so you might need to jump ahead to the section that discusses the specific settings for each piece. At this point you are setting the basic settings for the overall account. Listed below are all the fields to consider. I’ll name what to select for each and explain when necessary.


General Account Setup

Don’t stress out about these settings, all basic and won’t affect results.


Name this the name of your business


Google Ads Account


United States (or whatever other country you might practice instead)

Time Zone

Where you personally are located (this is only used for your reporting purposes)



Invite Users

Invite anyone who might help you create or manage ads, or help you with billing.


Enter in your business billing information

Specific Account Setup

We’re now going to be diving into some more specific and non-obvious aspects of your campaign setup.

Demographics (Age, Gender, Household Income)

If you do nothing with these categories you will be targeting all ages, genders, and incomes. What you can do here is restrict these categories. Be cautious of restricting these early on. Often therapists are surprised by what they thought was their best targeting approach. But you’ll want to restrict the categories that are obvious:

  1. Client Focus - if you only counsel men, restrict females
  2. Ideal client - If you have an ideal client that you are confident that you know you want, specify that here
  3. Income - For those going for just private pay restrict lower income clients.

Ad Schedule

If you are running just text-based ad campaign you can leave this wide open. But if you are running a call campaign you’d want to limit when people can see your ads. Once you have significant data (say 1,000 clicks) this is something to evaluate in the future, what days or hours have the best conversion rate.


Leave this wide open until you have significant data to evaluate (see “Management”)

Setting Up Conversions

Now we want to make a connection between Google Ads and your website. We want Google Analytics to know when someone “made a conversion” so it can better measure how your campaign is doing.

Decide, what type of conversion do you want? Typically this is going to be someone filling out a free evaluation form on your website.

Under “Tools & Settings” > “Measurement” > “Conversions” > Hit the “+” Button to add a conversion. > Click “Website” > Category: “Submit Lead Form” > Name = whatever you’d like > Value of conversion = your maximum cost per acquisition > Count = One > Click-through conversion window = 30 Days > View-through conversion window = 1 Day > Include in "Conversions" = yes > Attribution model = Last Click

This will then give you a code to put onto your “thank you page”.

This is a page that you’ll need to create that someone automatically visits after they submit the form. This is the best way to know someone submitted a form and converted.

Hooking up Google Analytics

You can take the extra step and connect your Google Ads to your Google Analytics account, this will give you more insight into the results. Follow the instructions in your Google Analytics account under “Acquisition” and “Google Ads”

Negative Keywords

Under “Keywords” and “Negative Keywords” you can create a negative keyword list. This allows you to restrict paying for anyone searching certain words like “free” or “degree” something you know won’t be a good fit.

You can use our standard list here

Setting Up Your First Campaign

Now it’s time to set up your first campaign! Under the campaign account click the plus button. Your goal is “leads” and campaign type is “search”, and ways to reach your goal is “website visits”.


Search Network


You’ll obviously want to target only the state that you’re licensed to practice. Then if you are targeting non-virtual clients you would want to target the driving radius of your practice. If you are solely focused as an online practice you still might consider targeting those around you because there’s still a subtle bias in wanting a therapist near you. But if you have issues reaching enough people you can always open it up.


Speaking language of your ads and audience




Take your monthly budget and then divide by 30.4 (the average number of days in a month) put this as your daily budget. (Google will use this as an average, some days might be higher or lower than others).


Focus on Conversions (this allows Google to automatically put the focus on your ads that get the most conversions.) Then insert your target CPA like we discussed in the exercise earlier. This will help Google appropriately automate bidding.

Site Link Extensions

Choose four pages on your site you want to promote and write titles and descriptions for them 

Callout Extensions

This is a good spot to “callout” extra benefits of the services (free evaluations, online sessions, etc)

Call Extension

You can add your phone number, giving people the option to call you. Then you can even set the time so they call you the hours it makes sense.

Setting Up Ad groups


This is where you want to choose the specific services you want to promote. What is your ideal service to offer to clients? What’s your speciality? (ex. Anxiety Therapy or Couples Counseling)


Now you need to choose keywords that fit for that service. Keywords are what Google will use to match with what users search. If someone searches for “Couples counselor near me” Google could see your keyword for “Couples Counseling” and determine to show your ad. 

Note: How do keywords work? How does Google choose to show your ad?

Google uses the tried and true bidding method to shows ads on their platform. When someone searches on Google, Google looks for everyone advertising with keywords that match in that area, time, etc. Then it determines the quality score of the ad (do people often click on the ad? Do they bounce from the page after clicking the ad?) and then how much someone bid. That then determines how they show.

Setting Up Ads

Now it’s time to set up your ads! You want to have at least 3 different variations of ads for each ad group to give Google options on what to show, then whatever performs the best they show more of. Let’s look how to write a good ad.

Final URL

This is the landing page you want someone to see. isn’t seen by the user


  1. Include keywords
  2. Use Title Case
  3. Use as much of the character limit as possible
  4. Other Writing Tips: Ask a question / Add a little humor / Include number or statistics / Use simple language / Be Clear

Display Path

Use the keywords in a way that’d make sense, this is what Google shows as the URL


Write an eye catching description of what you’re offering. 



Check in on your account to make sure things are running smoothly and as you’d expect. And check in on the following milestones below. Go into your “search terms” and figure out what people are searching to pull up your ads. You’ll want to adjust your keywords or add negative keywords based on what you see.

When you have 100 clicks in an ad group

If you have 3 ads to test, pause the worse performing one and then copy and edit the best performing one, trying to take a different approach. This is a never ending process to continue improving your ad copy.

When you have 1,000 clicks on a campaign

Now look across the board at many of the settings you have to adjust bid modifiers. This is telling Google to bid more on certain areas that are getting better results. For example, if you see females convert 20% more, increase their bid amount by 20%. You should do this for locations, demographics, devices, and ad schedule.


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