When we searched "therapist louisville," the first organic result wasn't a therapist. It's Psychology Today, a directory of thousands of them. Search for therapists who take a particular insurance plan and the directories take most of the spots: Psychology Today, Mental Health Match, SonderMind, Zocdoc and a Grow Therapy page for Anthem.
That raises a fair question for a practice spending money on Google Ads: why pay for clicks when the directory already ranks above you for $29.95 a month? The answer is that the two do different jobs. A directory puts a practice in front of people who are comparing therapists. A Google ad sends them to a page that belongs only to the practice. This chapter looks at what the directories and platforms hold in Louisville, what they cost, and where a paid click should land.
Directories and National Platforms Took 92 of 208 Organic Spots on Our Louisville Therapy Searches
For the research behind this guide we ran 24 therapy searches as someone in Louisville would, from "therapist near me" to insurance searches like "therapist that takes anthem louisville," and recorded every organic result. Across 208 organic results:
- Local group practices: 70
- Directories: 57, including Psychology Today 20, Mental Health Match 6 and Zencare 5
- National platforms and chains: 35, including LifeStance 13 and SonderMind 9
- Local solo practices: 7
- Everything else, from universities to Reddit threads: 39
Psychology Today appeared on 17 of the 24 searches and ranked in the top three on 11. On the broad searches, "therapist louisville," "therapist near me," "anxiety therapist louisville," it was the first organic result. Insurance searches leaned even harder toward directories and platforms, which build pages by insurer.
Specialty searches were different. Child therapy, couples counseling, Christian counseling and EMDR searches surfaced specialty practices in both the map pack and the organic results. That fits what earlier chapters found: the more specific the search, the better a focused practice does, and the more the directories fade. It's also where a practice's own Google Ads do their best work, because a specialty ad pointing to a specialty page is exactly what a directory listing can't offer.
In the Reddit Threads We Read, More People Found Their Therapist on Psychology Today Than Anywhere Else. The Listing Costs $29.95 a Month.
Psychology Today's membership costs $29.95 a month with no contract, about $360 a year. By the standards of anything else in this guide, that's cheap.
And people use it. In the two Reddit threads we read that asked "where did you find your therapist," 20 answers named a channel. Psychology Today came up 7 times, referrals (a doctor, another therapist, clergy, word of mouth) 6 times, Google search 2 times, an insurance list 2 times. It's a small sample, but it matches what clients said elsewhere: Psychology Today was named in 26 Reddit client posts and comments (of 579), and in none of the 679 Google reviews. People use the directory to find a therapist, then review the practice, not the directory.
Clients also use it with some skepticism. One wrote: "Psychology Today profiles are pretty uselessly polished, so I'd use the consult to ask 'what would our first month look like?'" Psychology Today's own member survey found 59% of its therapists offer a free 15-minute consultation, which is how many clients sort through the polish.
Psychology Today also claims its directory is the top Google result for therapy seekers 96.2% of the time. It doesn't say how that was measured, and our 24 searches found it in the top three on 11, so treat the vendor number as marketing.
Our view: keep the listing. Write it as carefully as a specialty page, make sure it links to the practice's own website, and ask every new client at intake how they found the practice, because a directory referral will never show up in Google Ads.
A few things make a profile work harder, in our experience:
- Lead with who you help, not your credentials. The first lines show in the search results, and "I work with couples who keep having the same fight" tells a reader far more than LPCC or LMFT. Those letters turned up in just 3 of the 679 Google reviews we read.
- Say what a first session costs or which insurance applies. The directories are where people compare, and an unclear fee is the easiest reason to skip a profile.
- Say whether you're taking new clients. A profile that leads to a full calendar wastes the click for both sides.
- Use the same specialty words as the website. Someone who clicks from the profile to the site should land on a page that sounds like the profile they just read.
Headway Starts Charging $9.99 a Session for Clients Its Marketplace Sends You
The national platforms work differently from directories. Headway, Alma, Grow Therapy and others handle insurance credentialing and billing for therapists, and many run a client-facing marketplace where people search for a therapist inside the platform.
That marketplace isn't free anymore at Headway. Starting in November 2026, rolled out state by state, Headway charges "a $9.99 marketplace service fee on every appointment with a new client who finds you through our marketplace." Headway also says bookings that come through a therapist's own link, for example on a Psychology Today profile, don't carry the fee.
Headway is explicit that it isn't a one-time charge: "The fee applies for as long as you see that client, not just their first session." Run that against Chapter 3's numbers. A client who stays for about a dozen sessions would cost a practice roughly $120 in marketplace fees over that stretch.
That doesn't make the platforms a bad deal. For a therapist who wants insurance billing handled, they solve a real problem, and in our view, for a new solo practice with an empty calendar, about $120 a year in marketplace fees per client can beat the roughly $282 per client Chapter 3 used as its Google Ads illustration. The math changes as the practice fills and its own ads start booking. At that point, each client found through the practice's own site carries no per-session fee, and the practice keeps the full record of how that client arrived. A marketplace client, by contrast, found the practice through the platform, and the platform knows it. A client who finds the practice through its own site, by way of its own ad, belongs to the practice from the first click.
Every Ad Click You Send to a Directory Profile Buys Your Competitors a Seat Right Next to You
Some practices point their Google ads at their directory profile instead of their own website. We saw it in Google's Ads Transparency Center: one counseling practice's account was running ads that pointed to TherapyDen, and a psychiatric nurse practitioner's practice in New York was running a Psychology Today ad.
It looks efficient, since the profile is already written. It's the wrong destination for three reasons, in our view:
- The page isn't yours. A directory's job is to help people compare therapists, so its pages are built to show alternatives. A paid click that lands there can end with a call to someone else.
- Google Ads can't count it. A booking made through a directory never reaches the practice's Google Ads account, so the conversion tracking from Chapter 1 has nothing to report. The campaign can't learn which searches book, and Smart Bidding never gets the data it needs.
- The specialty page does the job better. A couples search should land on the couples page from Chapter 4, which answers that person's questions and nothing else.
The directory profile is fine as its own channel, at $29.95 a month. Paid clicks belong on pages the practice owns and can measure.
Bidding on "Talkspace" Buys Clicks From People Who Already Chose Talkspace
The platforms' own names get a lot of searches. Across the US, according to Keyword Planner, "talkspace" and "sondermind" each draw about 49,500 searches a month, "thriveworks" about 33,100, and "psychology today therapist" about 27,100. The high end of Google's top-of-page bid range tops $12 for two of them.
Those searches aren't for a local practice. Someone typing "talkspace" wants Talkspace; some just want to log in ("talkspacelogin" alone draws 3,600 a month). Chapter 5 put platform and directory names on the negative keyword list for exactly that reason, and the search terms report should keep them there as broad match and AI Max reach further (Chapter 13). For a therapy practice, bidding on a platform's name is the same kind of auction Chapter 7 said to walk away from: expensive, crowded with national budgets, and full of people who already decided.
Next: Surprise Bills Are the No. 2 Complaint in Therapy Reviews
The directories and platforms win on one thing besides reach: they're clear about which insurance each therapist takes. Chapter 15 covers how a practice's own ads and pages can be just as clear about insurance and cost, and why that matters so much in therapy reviews.
For the conversion tracking a directory can't feed, see Chapter 1; for the specialty pages a paid click should land on, Chapter 4; for the negative list, Chapter 5; and for auctions to walk away from, Chapter 7. Every chapter is on the guide home.
When practices hire us for Google Ads management, every paid click lands on a page the practice owns, and we ask at intake how each new client found the practice so the directory gets its share of the credit.
