When is fewer searches... a very expensive problem?
I recently had a follow-up Google Ads coaching call with Ariel, a psychotherapist who offers online and in-person services. She came to me because her Search campaign performance had stalled.
Specifically, Google was spending her full $2,000/month budget, but CPCs had jumped to an average of $29! That meant she was getting just 2 clicks a day, and almost no form fill conversions.
When we looked at the data over the past several months, I saw a clear pattern. Impressions were dropping each month, but search impression share was actually going up. I asked Ariel about the optimizations she had been making, and she mentioned that she had been pausing keywords regularly.
To try to control costs, Ariel had recently paused several high-volume keywords. The higher her CPCs went, the more keywords she paused, so that now her Search campaign was down to just seven exact match keywords.
This "optimization" had made her problem exponentially worse. Trying to force a full $2000/month budget through a few narrow keywords meant that she was inflating her own CPCs. Since there weren't many searches available that matched her targeting, her campaign was bidding very high, and stretching into every possible close variant, in order to spend her budget.
And that wasn't the only problem. As any therapist will know, competition for therapy searches is intense. Large, VC-funded platforms are bidding on the exact same terms as individual psychotherapists like Ariel. Because these giant competitors spend boatloads on brand awareness - and they accept insurance - their ads get higher click-through rates (and, likely, better Quality Scores). This allowed them to pay less per click than folks like Ariel for the very same searchers.
So how can Ariel turn things around? Here is the exact strategy I put together for her, and all therapists should take note:
This issue of The Insider is sponsored by Optmyzr
Optmyzr's MCP just landed in Claude's official MCP Directory. It's gotten sharper lately, too ā€” it can now create and apply new keywords for you right in the chat (with your sign-off before anything goes live), and LinkedIn Ads data just joined Google, Microsoft, and Meta in the mix.
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- Unpause keywords! We brought back core keywords like "relationship counseling," expanding her keyword pool to 5 to 15 targeted exact match keywords per ad group. This gave Google more relevant options to spend the budget on, rather than over-bidding on just a few terms.
- Overhaul ad copy. Instead of only generic headlines like "Counseling for Couples," or trying to compete with corporate platforms who take insurance, I suggested that Ariel shift her messaging to highlight her unique value. For example, showcasing her 15+ years of experience, the fact that she's a published author and thought leader, and that she offers a premium, highly discreet client experience. This would make her ads instantly stand out to the right prospective clients.
- Move up the funnel. Rather than competing solely on high-intent Search keywords against massive budgets, I recommended adding a $7/day Demand Gen campaign to her account. By targeting married people in her city with image ads, Ariel can build her own very targeted brand awareness, and differentiate her therapy services before prospective clients ever hit the search box.
By (re-)expanding her keyword footprint and sharpening her ad copy to emphasize her unique strengths, Arial can work to boost CTR, improve Quality Score, pull CPCs back down to earth, and most importantly - book more therapy clients from her Google Ads investment.
Want me to take a look at your Google Ads account to find out where your budget is leaking? Book a call with me and let's get your campaigns back on track.
