Google Ads for Therapists: Why Your Campaign Isn’t Working [13 most common reasons]
- Mike Zoladkowski
- Nov 7
- 9 min read
Here's how it sometimes goes: You are a therapist, you've heard Google Ads is a great way to get more clients (usually, it is), so you start the campaign, and... Nothing. Or almost nothing.
If you're currently running a Google Ads campaign and don't see the results, read on, because in this post, we'll do 100% practical troubleshooting :)
The essence of the problem
The truth is that finding out what's wrong with your campaign is usually not easy. In some cases, testing and experimenting is necessary. You'll also need some time (in 9 out of 10 cases, you can't figure it out overnight). And here's the main issue that Google Ads marketers (including ourselves) have to deal with:
It's not always the campaign problem! Sometimes, it can be a website problem, a conversion tracking problem, or even an offer problem.
In some cases, the campaign is properly structured, the keywords are okay, and the budget is sufficient, and still, you're not getting enough leads. That's where you need to dig deeper and look for the issue elsewhere.
How can I tell whether it's a campaign problem or a website problem?
The short answer is this: If your campaign numbers (especially CTR, clicks, and CPC) look good, you have properly working conversion tracking, and there are little to no bookings, it's usually a website problem or an offer problem.
Some time ago, we were trying to get the campaign going for one of our US clients. At first, we were focused on the campaign side of matters. We tested different services, different ads, different keywords, and even different locations.
Once we found out that those changes were leading us nowhere, we switched our attention to the website and the client's offer. We rebuilt the website's copy and created new landing pages specifically for Google Ads purposes. We also worked with the client on the offer itself.
And the campaign suddenly started! Almost overnight.
Here's the takeaway for you: Don't treat Google Ads as a magic wand that's supposed to get you clients no matter what.
Google Ads is just one piece of the puzzle. An incredibly important one, but not the ONLY one. If the campaign seems okay, and there are no leads, you need to look elsewhere. And yes, there can be dozens of reasons why your campaign is not profitable.
Below, we're sharing several common reasons. At some point, we've encountered all of them in our work. We hope this list will help you take a different look at your campaign and your offer.
As we've mentioned earlier, there are four main reasons why your Google Ads campaigns don't work:
Common reasons why Google Ads campaigns don't work
Campaign problems
First off, we have campaign problems. Usually, your campaign does not perform the way you wanted because of those reasons:
Too low advertising budget
The other day, we had a discussion with a potential client who claimed that you can run a successful campaign for $200 per month. And that's what they wanted for their campaign in Florida. Let's break it down:
First of all, in some RARE cases, yes, you can succeed with a $200 budget. But only if:
You've been running your campaign for at least a year
There are very few/no competitors in your area (if you're advertising in a small town)
You are comfortable with just one or two leads per month
Your offer is extremely attractive
Unfortunately, you cannot run a successful campaign for $200 in a large city (or even a medium-sized city) where there are dozens of competitors fighting for the same keywords and the same clients.
It's a typical math problem. Let's say your CPC (cost per click) is very attractive at $3.00 per click. Now, Google Ads experts will tell you that you need at least 10 clicks per day to get statistically significant data to work on your campaign and implement any optimizations.
$3.00 times 10 gives us a $30 daily budget. That's around $900 per month. We recommend $1,300 because it's safer and it's easier to make your campaign work if you have a little wiggle room. But what if your CPC is $10? That's not uncommon, especially in super-competitive areas, such as GTA (Toronto), NYC, Los Angeles or Florida. In such cases, $1,300 will not hack it, and you simply need more money to make it work.
Wrong campaign settings
It's probably a story for a whole separate article. But if you have the wrong settings on, Google will do an amazing job of wasting your money. You need to put a leash on your campaign and control every single aspect of it. If you just let it run without paying much attention to the settings, you will lose money and gain nothing.
Some of the common no-go settings include:
Auto-apply Google recommendations (never, ever turn that one on!)
Search network and display network on
Location targeting: Presence or interest
Broad-match keywords in the early stage of the campaign
Go and check your campaign. If you have one or more of those on, fix them ASAP.
Wrong campaign structure
I've seen campaigns with just one ad group and 50 keywords just tossed there. For your Google Ads campaign to succeed, you need relevance. Organize your ad groups by theme. Don't advertise trauma therapy and couples counselling in the same ad group (we've seen that happen). If you want to go with two or more different themes, you need two or more ad groups. The same with the keywords. One ad group should not target "trauma therapy texas" and "couples counselling dallas".
No negative keywords
Another very common problem. You need to organize your search terms regularly (we do that twice a week for every client) and add negative keywords as you go. Some marketers skip this point and focus on what they are targeting. But if you're not excluding anything from the campaign, you will soon find out that you've spent hundreds of dollars on irrelevant terms.
The most drastic case we saw was during one of our Google audits. One client spent over $700 on one completely irrelevant term and around $400 on the other. Why? Because no one was checking search terms, and no one eliminated those irrelevant terms from the campaign.
Conversion tracking problems
Your account needs conversion tracking. It's just a fact. And yes, theoretically, you can run your ads with no conversion tracking, but then, Google doesn't know what to optimize for. In other words, you cannot utilize lookalike audiences. Here, there are two main issues:
No conversion tracking
Your account is completely blind. You have no conversion tracking, so your ads optimize only based on the keywords and locations. If you get any leads, there's no way of knowing whether they came from GAds or from somewhere else.
Fake conversion tracking
Many accounts track activities that do not show whether someone reached out to you or not (that's what conversion tracking is for). For example, if you're tracking visits to your contact page (believe me, many advertisers do that!), that doesn't tell you anything, does it? The mere fact that someone opened yourwebsite.com/contact doesn't mean they've reached out to you, right?
Track real conversion actions, such as:
Contact form submissions
Calls
Calendar bookings
Newsletter sign-ups, etc.
This way, you can clearly see how many leads you got thanks to Google Ads. And Google algorithms can use this knowledge to optimize your campaign and make it more effective! :)
Website problems
Okay, now the website. Tons of things can go wrong here, so let's focus on the most important issues.
No easy booking system
We have a whole article about booking systems, go ahead and read it :) In short, you can have a contact form or a booking calendar. Both can be effective, but you need at least one of them (and you need to make sure they're working!).
Why? The email address and phone number are not enough. You want to make it easy and convenient for your clients to reach out to you. If you tell them to close the website, go to their mailbox, write you an email and send it... Many just won't do that.
The contact form/booking calendar should be on every page you advertise. Remember, your goal is to make it easy and convenient for your clients, the less they need to do to get in touch with you, the better.
No/poor photos
Do you know what sells mental health services? To a large extent, your face. People need to see you before they book with you. And you need a nice, high-quality photo (at least one, two or three are even better). If you don't have high-quality photos of yourself, your team, and your office, people will likely not reach out to you.
No specifics
Usually, when a potential client reaches out to us, the first thing I want to establish is their location. And believe me, sometimes, it's impossible to figure that out based just on the website. In many cases, I've had to go to PT to find out where that therapist is located.
The same is true concerning other specifics:
Office location
Payment options
Availability
Cost per session
In-person/virtual
Many therapists simply "forget" to mention this stuff on their websites. And people want to know. If I don't know if I can afford you or even if you are in the same province/state, I will NOT reach out to you.
No services
Your website must highlight therapy services that you provide, specifically:
The issues you work with (anxiety therapy, trauma therapy, etc.)
Modalities that you use (EMDR, CBT, DBT, ACT...)
Populations you work with (couples counselling, therapy for women, teen counselling)
And that's what you should advertise. If your website only says, "I'm a great therapist, call me now", you're not resonating with your target audience. Your clients need to know more about your approach and your experience before they book. Again, relevance!
There are more things you need to have on your website to make it work with Google Ads. I invite you to read this article: 10 essential features every therapist website needs.
Offer problems
Lastly, let's have a look at three common offer-related problems. And I can tell you this: Many therapists simply don't look here. They just assume everything is okay. But the truth is that the best campaign in the world and the best website in the world will not fix an offer problem!
No/very limited availability
Oh, how many times I've seen that! The client has 2h available during the week for free initial consultations. To make things worse, both are before noon during work days.
I'm sorry, but it just won't work. If people see that you're available only when they are at work, they will not reach out to you, even if you spend millions on ads. And it doesn't matter that it's just for free consultations, and for full sessions, you are available almost the whole week.
But your potential clients don't know that! They only see those 2 hours before noon. So, they will go elsewhere. End of story. If you're advertising your services, open as many free consultation spots as possible.
Too high fees
So, you're in a small town in Saskatchewan/Oklahoma and you want to charge $300 per hour. Again, I'm sorry, but it won't work. There is no marketing strategy that can fix the fact that people can't afford you. Your fees need to be realistic. They need to be tailored to:
The services you offer
Your credentials and experience
Your location
Do your due diligence and take a look at normal fees in the area. If they are between $130 and $180, your fees should be around that as well, unless you have a very good reason why they are higher and you are okay with the fact that you might get fewer leads.
Too niche-down offer/wrong target audience
Niching down is good, in most cases. You need a specialty to stand out and showcase your experience to potential clients. But if your niche is too narrow, you will not find enough traffic on Google.
Secondly, who's your target audience? The most important question is whether they can afford your services. Let's say you are a teacher turned therapist. Naturally, teachers are your ideal target audience; the relevance is off the charts, right? But, in most cases, it's not the most affluent target audience...
So, you will likely struggle to find such clients and work with them long-term. If that's the case, find a different niche and advertise mostly for it, and keep teachers as a backup plan.
Wrapping up
As you can see, there are many moving parts, and you need to be aware of them if you want to succeed. If you're not getting the results you're expecting, in many cases, you need to dig deeper and analyze your website and your offer as well.
If that's something you need help with, reach out! We specialize in Google Ads and web design for therapists, and we're happy to have a look at what you do and help you make every dollar work for you.
Start for free today! :)
We look forward to talking to you!
Monika & Mike
