Keyword research for a therapy practice usually starts with a blank page and a guess: "therapist," "counseling," the name of the town. Those words aren't wrong, but they're the same few every practice in the area guesses too, and they miss the ways real clients search for the specific help they want.
A richer source costs nothing. The practices already advertising near you have built websites full of the words their clients use, and Google's own research tool will turn any of those websites into hundreds of keyword ideas. The catch is that the tool doesn't know a client search from a blog headline. This chapter covers both: where to get the ideas, and how to sort the ones worth paying for from the ones that only look useful.
A Rival Practice's Ads Show You Which Searches Already Pay
Start by finding out who's already in the auction. A quick Google search on your own phone feels like the obvious way to see who's advertising, but it muddies the picture and counts as an impression on every ad you see. The cleaner view lives in your Google Ads account under the name Ad preview and diagnosis. Google built it for exactly this, and using it doesn't add to your own impression counts. And keep your finger off a rival's ad. You'd be charging a fellow practice for your curiosity.
For history rather than a snapshot, open Google's Ads Transparency Center and search a practice's domain. You'll see the ads it has run and roughly when. We searched 48 local practice domains from our example market, Louisville, and 13 had Search ads within the previous 90 days. Most were group practices. Those are the sites worth studying, because someone there is already paying to show up for the searches you want.
One Competitor's Website Can Hand You Hundreds of Keyword Ideas
Keyword Planner, Google's free research tool inside every Ads account, has an option called "Start with a website." Paste in any web address and Google suggests keywords based on what that site's pages say.
One setting matters before you press the button: location. Pick the counties or metro you serve, or the numbers may describe a much wider area than the one you work in.
We ran the 12 practice websites from our example market through it. Together they returned 5,486 unique keyword ideas, anywhere from 129 for a small site to 1,385 for a large group practice. For most of them, the ideas were overwhelmingly therapy searches: seven of the 12 came back with 92% or more of their ideas about therapy.
That's a lot more than anyone would guess from a blank page, and much of it is good. Reading a competitor's list also shows you how they think about their own business: which specialties they've written the most about, which neighborhoods they name, which insurance plans they mention. Patterns like that tell you where the competition is thick and where a specialty is barely covered In our experience, that thin coverage is often where a smaller practice can win clicks at a lower price. A group practice with strong couples pages handed back hundreds of couples and marriage counseling variations. A trauma-focused site turned up EMDR phrasings worth a group of their own.
Keyword Planner Put "Narcissist" First for One Counseling Site. That Search Wants a Definition, Not a Therapist.
Then there are the sites that show you the tool's blind spot. One of the largest practices in the example market, Kentucky Counseling Center, has a website full of articles alongside its service pages. Keyword Planner returned 1,176 ideas for it. The top idea, by volume, was "narcissist," at 3,600 searches a month in the example market. Second was "definition of a narcissism," at 1,600. Another 146 ideas were about psychiatry and medication.
Only about 60% of that site's ideas were therapy searches, against 92% or more for most of the others. Nothing is wrong with the site. Articles are good for readers and can be good for search rankings. But Keyword Planner reads them as literally as it reads a service page, so a post about narcissism produces keyword ideas about narcissism, and someone searching "narcissist" usually wants an explanation, not an appointment.
A small solo psychologist's site showed the same effect from the other direction. With little text to work from, its top idea was a variation of plain "psychology," at 3,600 a month. Big volume, no intent.
The lesson isn't to avoid big competitors' sites. It's that every idea gets a human look before it goes anywhere near a live campaign.
Every Idea Belongs in a Specialty Ad Group, on the Negative List or in the Trash
Sorting is where keyword research actually happens. Every idea goes into one of three piles.
A specialty ad group. Ideas that a future client would type go into the ad groups from Chapter 4: couples, anxiety, trauma and EMDR, children and teens, or whatever you actually offer. Keep each group to a handful of close variations, about five or six, so its ads can repeat the search. For a new account, these go in as exact match in the Isolation campaign from Chapter 2.
The negative list. Some ideas look like your business but aren't. Add them as negative keywords so your ads never show for them:
- Platform and directory names. Psychology Today draws 550,000 searches a month in the US, Grow Therapy 246,000, and Headway and LifeStance about 200,000 each. People searching those names are looking for that company, not you.
- Career searches. "How to become a therapist," "therapist salary," "masters in counseling" and similar searches add up to about 101,000 a month in our US pull. They're students and job seekers.
- Crisis lines. As Chapter 2 covered, people searching for a crisis hotline need one right away, not an ad.
- Free and cheap, unless you offer a sliding scale or low-fee intern sessions, in which case a few of those searches may be worth testing.
One thing that doesn't belong on the negative list by default: insurance. Searches like "therapist that takes Aetna" carry some of the highest bids in our data, up to $70 at the high end. Whether to bid on them depends on which plans you take. That's a choice for each practice, not a rule.
Searches for your practice or a clinician by name skip this sorting entirely; Chapter 2 gave them a campaign of their own.
The trash. Definitions, other professions and anything you don't treat. While the account runs only exact match, there's no need to list them as negatives; revisit them when Exploration starts. Symptom and research searches are a different case: as Chapter 2 explained, they're an earlier stage you may reach later, so set them aside rather than throw them out.
The negative list matters most later. While the account runs only exact match, it rarely shows for the wrong searches. Once broad match comes in with the Exploration campaign, the negative list does the heavy lifting, and it needs checking every day at first. Chapters 6 and 7 cover that stage.
Google Won't Let a Practice Bid on Drug Names or Rehab Searches Without Certification
A few kinds of therapy-adjacent keywords come with Google's own restrictions.
Medication names. Google keeps a list of restricted drug terms, and it includes ADHD medications such as Adderall and Vyvanse, Xanax, Suboxone and naltrexone. A practice can mention them in ad text, but targeting them as keywords requires certification. Google also says the list "is not an exhaustive list," so a drug that isn't named, such as ketamine, isn't necessarily open.
Drug and alcohol recovery. Google restricts "recovery-oriented drug and alcohol addiction services." In the US, advertising them requires LegitScript certification plus Google's own approval. LegitScript's certification lists outpatient counseling, so in our reading that includes outpatient substance use counseling too. It doesn't cover gambling or other behavioral addictions, which fall outside that policy.
For most talk-therapy practices, the simplest answer is to leave these terms out.
Google Builds Keyword Ideas From Your Own Pages. Off-Target Ideas Mean Off-Target Pages.
Once you've studied the competition, run your own website through Keyword Planner the same way. It's the fastest look you'll get at your site through Google's eyes.
If your own ideas come back full of the specialties you want clients for, your pages are doing their job. If they come back full of definitions, other professions or services you don't offer, the problem isn't the tool. Your pages are telling Google something different from what you want to be found for, and the specialty pages from Chapter 4 are the fix.
One note on the bid estimates you'll see beside every idea. Both figures look backward at other advertisers' winning bids for a top spot, and your own clicks will settle wherever your ads and pages earn. In our experience, treat that range as a rough guide that can land about 30% higher or lower once your ads are actually running.
Next: Clients Search "EMDR Therapy Near Me" and "IFS Therapy," Not Only "Therapist"
You now have keywords sorted into specialty groups. Chapter 6 looks at the searches you didn't think to list: the long tail of specific therapies, modalities and phrasings that clients actually use, and why that tail is where a growing account finds room to scale.
Catch up on Chapter 4 for the ad group structure these keywords go into, or see every chapter on the guide home.
When practices hire us for Google Ads management, we run this research on every competitor in their market and sort it by hand, idea by idea, before a single keyword goes live.
