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Getting to the Top of GoogleHow do you get to the top of the search engines?

Having helped mental health professionals successfully market their practices for the better part of the past two decades, I’ve fielded more than a few therapists’ questions about specific marketing techniques and strategies.

Many of the questions I’m asked are the same from one therapist to the next. In fact, one of the main reasons for starting the Therapy Marketing Institute is to answer more of these questions for more therapists.

And if there’s one question in particular that I’ve received more than any other, it’s:

“How do I get to the top of the search engines?” “How do I get into the top ten on Google search?” “How do search engines work and what do I have to do to get to the top of the list and stay there?”

Okay, that’s three questions. But, believe it or not, I received those three versions of this same basic question from three different therapists in just the past week… Now it’s time for some answers!

But, first, let’s take a quick look at why so many mental health professionals want to achieve first-page search engine visibility for their practices and whether or not you should too…

Should You Care About Your Practice’s Search Engine Visibility?

A couple of years ago, Google stated that 1 out of every 5 searches on Google is related to a location. I’ve seen more recent research suggesting the number is closer to 1 out of every 4 searches.

It’s difficult to know just how many searches that equals, but Google claims to provide results for more than 100 billion searches every month. That’s more than 3 billion searches every day.

Even if only 1 in 5 searches is related to a location, that’s more than 600 million local searches every day conducted by people looking for something in their area.

Now, to be sure, the vast majority of these searches have little to nothing to do with the services you provide. However, phrases such as “marriage counseling denver” and “marriage counseling houston” receive an average of 25 searches per day. That’s 750 per month! And that doesn’t include searches for similar phrases, like “couples counseling denver” and “couples counselor houston,” each of which receive 5-10 searches per day. And people aren’t just searching for marriage counseling. Phrases such as “depression treatment boston,” “child therapist chicago,” and “psychotherapist los angeles” all receive between 30 and 100 searches per month.

So, given that you own a business (your private practice) that provides services to consumers in your local area, if you want to gain as much online visibility as possible to those consumers, you should definitely care about your practice’s search engine visibility.

That being said, there’s more than one way to get your practice listed on the first page of search results.

Breaking Down the Search Results

When most therapists ask me how to get their practices listed at the top of Google, they’re referring to search engine optimization (SEO). You’re likely familiar with the term.

Unfortunately, while many are familiar with the phrase and acronym, most therapists remain unaware of the differences between search engine optimization, search engine marketing or advertising, and the various other methods available to have one’s practice appear on the first page of search results.

In order to fully understand the different options available, let’s take a look at a typical example of the first page of Google’s search results. For this example, I’ve used the phrase “teen counseling mission viejo” as the search term.

Google Search Results - Example 1

Now, let’s look at the same example divided into three sections:

Google Search Results - Example 2

  1. Google AdWords Ads – The areas with a pinkish-red background and labeled with an “A” are all Google AdWords advertisements and are labeled as such by Google’s use of the text “Ad” or “Ads” in orange.
  2. Organic Search Results – The areas with a green background and labeled with a “B” are what are known as the “organic” search results. These are the Web pages Google’s search engine thinks are the best matches given the search phrase entered and are un-paid listings, unlike AdWords ads.
  3. Google+ Local/Map Listings – The areas with the blue background and labeled with a “C” are Google+ Local listings (formerly known as Google Places and/or Google Maps listings).

Let’s take a look at each of these sections in more detail…

Google AdWords Ads

The three major search engines – Google, Yahoo, and Bing – all allow advertisers to place “pay-per-click” (PPC) ads that appear alongside the search engines’ organic search results. (In fact, these ads are a large source of income for the search engines.)

Google’s software that allows businesses to run ads alongside their search results is known as AdWords. While you may be familiar with the name, the name is unimportant. What is important is knowing how these ads work and the pros and cons of using them.

Basically, all you need to do to advertise your practice using Google AdWords is set up an AdWords account (, decide which search phrases you want your ads to appear for, set a monthly budget, and bid on each search phrase you want to target. In other words, Google AdWords uses an auction system in which the highest bids receive the best ad placements for any given search phrase.

The benefits of Google AdWords include:

  1. You can set your ads to appear only to people searching in a particular city, region, or country. This means you can easily target clients within 20 miles of your front door, across the world, or anywhere in between.
  2. There’s no minimum spending requirement. The amount you pay for AdWords is up to you. You choose how much you’re willing to spend each month and how much you’re willing to pay each time someone clicks one of your ads. And you’re only charged when someone clicks on one of your ads, not when they’re displayed (hence the term “pay-per-click” or “PPC” ads).
  3. You can literally have your practice listed on the first page of Google’s search results in a matter of minutes. Just create an ad, set a budget, and pick a search phrase or two to target and your ad will start appearing immediately!

There are, however, some drawbacks to using Google AdWords ads:

  1. Less than 30 percent of search engine users click on these ads. In fact, I’ve seen some studies that indicate this figure is 10 percent or less. And demographics definitely play a role in determining who clicks on these ads (women click on AdWords ads more than men and those over 35 years of age are twice as likely to click on these ads as are those under age 35). Regardless, if you rely on search engine advertising alone to get your practice listed at the top of the search engines, your missing out on anywhere between 70 and 90+ percent of the search users who ignore these ads.
  2. Given the auction-based nature of these advertising platforms, running Google AdWords ads will only get more and more expensive over time. Google only runs 10 or so ads on the first page of search results for any given search phrase and 75 percent of search engine users never go past the first page. Obviously, you want your ads to appear on the first page of search results. So does everyone else. Since the only way to have your ad appear on the first page is to be among the top ten bidders for a particular search phrase, as more mental health professionals place ads and bid to have their ads appear on the first page, Google AdWords ads have and will continue to become more expensive.
  3. Once you stop paying for your ads, your Google AdWords ads disappear from view as if they never existed. While this is true of most types of advertising, there are other forms of online marketing and other ways of getting on the first page of search results where this is not the case. For example, writing and distributing articles to other websites, writing guest blog posts, setting up Google+ and Yelp profiles, and even search engine optimization all tend to provide ongoing and lasting visibility, traffic, and results long after your up-front time and/or monetary investment has been made.

In short, Google AdWords ads and other search engine advertising platforms are a great way to get your practice to the top of the search engines and get immediate results. For this reason, I often recommend these advertising platforms to clients who come to me needing more clients yesterday. However, running these types of ads are not necessarily the most cost-effective, long-term solution to achieving first-page search engine rankings.

“Organic” Search Results

As mentioned above, “organic” search results get their name from the fact that these are the “natural” listings on search engine results pages that appear because of their relevance to the search terms entered by search engine users, as opposed to their being advertisements.

The phrase search engine optimization (SEO), when used correctly, means optimizing YOUR website so that it appears on the first page of search results among these organic listings.

There are many companies out there who guarantee they’ll be able to get you listed on the first page of search results. However, the only way someone can guarantee you first-page search rankings is to run pay-per-click ads using platforms like Google AdWords. Only Google controls their organic search results and the sites that appear there.

I say this not to dissuade you from taking full advantage of search engine optimization. And a company may guarantee to get you first page organic rankings or give you your money back (although, I’ve yet to see one who does).

My reason for bringing this up is that most companies who guarantee first-page search rankings are not providing SEO services, despite what they may claim. What they are in fact doing is running Google AdWords campaigns on your behalf. And, given they have to turn a profit in doing so, you’re in essence paying them a percentage of your monthly advertising budget for something you could do yourself. Now, there’s nothing wrong with doing so. I encourage you to outsource as much of your marketing as makes sense. I just want you to know what questions to ask and know what you’re purchasing from anyone who provides “search engine optimization” services or claims they can guarantee first-page rankings.

Now, before we dive into the pros and cons of search engine optimization, let’s take one more look at our example image…

Google Search Results - Example 3

Of the nine websites listed in the organic search results in this example, only one (the last link that’s circled) is for an individual therapist’s website. The other eight links with the red arrows to their right are links to profiles, profiles, Yelp profiles, YouTube videos, and so on…

While this is an extreme example, it is not uncommon for at least half of the organic search results to be directory sites and other similar web properties.

Obviously, there are more ways to get your practice listed among Google’s first page of organic search results than optimizing your private practice website, and you can and should take advantage of as many of these as possible.

Of course, with all of these options for gaining first page search engine visibility, you may be wondering whether or not spending the time and money on optimizing your website is worthwhile. But there are benefits to search engine optimization, including:

  1. When someone clicks on your website link from Google’s results page, you’ve got their undivided attention. This is what is known as a “contained selling environment.” With the exception of properly optimized YouTube videos and, sometimes, Yelp profiles, the links to directories such as,, and take search engine users to a page with listings of multiple therapists’ profiles among which you’re but one choice of many. By contrast, if someone clicks a link to your website, you’ve got at least a few seconds to convince that prospective client that you’re the best service provider and to contact you before searching elsewhere.
  2. As mentioned above, between 70 and 90+ percent of search engine users click only the organic links. Having as many points of entry for your practice as possible among the 9-10 organic links on the first page can only help your visibility and chances of getting more clients, especially if one or more of them is your website.
  3. Search engine optimization can provide lasting results. Unlike Google AdWords ads, once you’ve gotten your website to the top of Google’s search results using SEO, your site will tend to remain there for a good deal of time whether or not you continue to invest time and money keeping it there. This is because search engine optimization is an accretive process and all the work done to get your site to the top creates a barrier of entry to others who are just getting started and trying to target the same search phrases.

There are, of course, also disadvantages to SEO:

  1. It can take some time to see results. Unlike Google AdWords ads – which can start appearing on the first page of search results almost instantaneously – search engine optimization can and typically will take several weeks to several months before you begin seeing results. If you need more clients coming through your door tomorrow, SEO isn’t the way to go about it.
  2. While your website will tend to stay on the first page of search results for some time once you get it there, there are no guarantees it will do so. Google is constantly updating its search algorithm, which means the search engine optimization landscape is an ever-changing environment. What works to get your site to the top of the organic search results today may not work next year, next month, or even next week!
  3. Having a website ranked at the top of Google’s organic search results is no guarantee of success. Too many business owners seem to think that merely having a website on the first page of Google is enough to warrant success. Unfortunately, this is anything but true. If your website doesn’t do a great job of emotionally connecting with prospective clients and convincing them to contact you and schedule an appointment, then having that website appear at the top of the search results only means more people will come to your site only to quickly leave and look elsewhere. And, because Google monitors how long people stay on your site and takes this into account when providing search results, people quickly leaving your site after arriving will, in turn, hurt your search rankings and mean you won’t stay on top for long.

Given the fact that the vast majority of search engine users click on links contained in the organic search results, it should be obvious that this is the section of Google’s results on which you should devote the majority of your effort.

That being said, I’d recommend starting with the online directories such as and Yelp first. Then, and only then, should you begin to optimize your website and create and optimize one or more YouTube videos.

While SEO will take some time to be effective and is more of an advanced marketing strategy, if a new client is worth $1,000, $2,000, or more to your practice’s bottom line, then being able to generate even just one or two new clients a month using search engine optimization can make it a more than worthwhile endeavor.

Google+ Local Listings

Google+ Local pages – previously known as Google Places pages (the two terms are still used interchangeably by Google) – are local business listing pages that appear in Google’s Maps service, in a variety of mobile applications, as well as within Google’s traditional search results.

Google began heavily promoting local listings in their search results in 2010 in an attempt to stay at the top of the local search market. What this means for you is that Google now emphasizes Google+ Local listings in their search results for local search phrases; often pushing the “organic” (the typical, non-paid) listings down the search results page in favor of these Local pages (as shown in our examples).

While Google+ Local listings are not always returned in the results for local searches – and Google+ Local pages don’t always dominate the search results as they do in the example above – as you can see, these listings can take up a large portion of valuable search engine real estate. And each of these listings is powered by a Google+ Local page.

Better still, if you’re not already taking advantage of Google+ Local listings, doing so isn’t going to cost you a thing. Unlike AdWords ads, you won’t pay any fees for clicks through to your website from your Google+ Local listing.

Given Google’s dominance in the search engine marketplace and the real estate Google gives Google+ Local pages in their search results, there’s really no reason not to create, optimize, and maintain one or more Google+ profiles for your practice. And we’ve created an entire report that will walk you step by step through the process. Click here to access The Therapist’s Guide to Getting More Clients with Google+ Pages. If you follow the steps in this guide, you should be able to quickly set up your practice’s Google+ Local listing in the space of a couple of hours.

If you’re at all interested in using Google’s search engine to acquire new clients, you need to create a Google+ account and create or claim your practice’s Google+ Local page… Remember, these pages are appearing at the top of Google’s regular search results!

In Conclusion

While this article has focused on search engine rankings in Google – and for good reason, given that Google receives around 75 percent of all search engine traffic – this doesn’t mean you should ignore other search engines, like Yahoo and Bing. Fortunately, most of the techniques for ranking in the top of search results covered above apply regardless of which search engine you’re trying to rank in.

I hope you now have a better understanding of the various components that make up the first page of search results and the options available to you for getting your practice listed at the top of Google.

Of course, this is just the beginning of the answer to the question, “How do search engines work and what do I have to do to get to the top and stay there?”

We’ve dedicated one of our Therapy Marketing Institute STAR Trainings to the topic of Getting the Most from Online Therapy Directories such as You’ve got access to our special report, The Therapist’s Guide to Getting More Clients with Google+ Pages. And our next STAR Training, Search Engine Optimization Simplified, will explore in greater detail how the search engines work and how you can get your website to the top of the organic search results without spending all of your time and money doing so.

We encourage you to take advantage of all of these resources, implement the strategies and techniques contained in each, and let us know your questions and results by posting a comment below!

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