A colleague recently sent me a link to a competitor’s blog post, RevKey’s “The Best Google Ads for Therapists: RevKey vs Counseling Wise & Therapy Flow,” and asked what I thought.
Here’s the thing: I don’t disagree with everything they wrote. We share some genuinely good principles about therapist marketing, and I’ll get to those at the end. But there are also some pretty big things they got wrong about how we work, and one really important thing they didn’t talk about at all: what it actually costs you over a year.
So let’s run that comparison. And while we’re at it, let’s tackle the bigger question lurking under the whole article: Should a therapy practice really choose between SEO and Google Ads?
(Spoiler: no. Even Google doesn’t.)
Who Says You Can’t Focus on Both SEO and Google Ads?
The framing of the RevKey article is that we’re an “SEO-first” agency and they’re an “Ads-first” agency, and you should pick the one that matches what you want most.
We’d push back on that pretty hard.
If you want to fill your private practice as efficiently as possible, you should be attacking your local search market from both angles, organic search results and paid ads. Each one captures a different chunk of the people who are searching for a therapist in your town this month.
Think about your own behavior on Google. Sometimes you click an ad at the top of the page because it gets you to the answer fastest. Sometimes you scroll past the ads because you trust organic results more. Sometimes you do both. Your future clients are no different.
This isn’t a contrarian opinion. Google itself runs both organic search and its own paid ads platform: they literally do both. Most of the biggest, most sophisticated marketers on the internet run both. Telling a private practice owner to “focus” on one channel and ignore the other is, frankly, leaving easy money on the table.
The right question isn’t “SEO or Ads?” It’s: How do I make sure I show up in both places, without overpaying for either?
Let’s Talk Money: The Real Year-One Cost Comparison
This is where I think the original comparison really misses the mark.
The RevKey article makes our pricing sound expensive by quoting our 90-day setup fee one month at a time, as if it were a recurring cost. It isn’t. You pay it once at the start, and then, for most solo and small group practices, you’re done with management fees for a good long while.
Here’s what a typical year actually looks like, side by side:
| What You’re Paying For | CounselingWise | RevKey (estimated) |
|---|---|---|
| Setup & 90-day fine-tune | $1,097 (Basic) to $1,497 (Silver) — one-time | Rolled into recurring monthly fee |
| Management included during setup phase | Yes — first 90 days | Yes — but billed monthly from day one |
| Ongoing fees after launch | $150–$250 per periodic fine-tune (every 6–9 months), OR $450+/mo for active management when ad spend exceeds $1,000/mo | ~$900/month standard group-practice plan |
| Estimated Year 1 total (management only) | $2,500 – $3,500 | ~$10,800 |
*Numbers above cover agency fees only — not your actual click spend, which is paid directly to Google in both models.
Imagine you’re a solo practitioner, let’s call her Amanda. Amanda runs a small practice with two or three specialties she wants to advertise. On RevKey’s standard group-practice management plan, she’d be paying roughly $900 per month. That’s $10,800 in her first year, every year, just in management fees, on top of whatever she spends on actual clicks.
On our Silver Campaign, Amanda pays $1,497 once for the setup and the 90-day fine-tune. After that, she has options. If her campaign is humming, she might check in with us every six to nine months for a fine-tune session at $150–$250. If she’s scaling her ad spend past $1,000/month and wants active monthly management, she can add it on for $450/month, and only if she actually needs it.
In year one, Amanda’s most likely total with us lands between $2,500 and $3,500. With RevKey, she’s closer to $10,800. That’s a real difference, and it’s the kind of difference that lets a solo practitioner actually afford to run ads at all.
The 90-Day Fine-Tune Isn’t “Set It and Forget It”
The article also suggests that we hand you a finished campaign after 90 days and disappear, leaving your account to drift through the summer slump and seasonal changes on its own.
That’s not how it works.
After the 90-day fine-tune, we offer two ongoing options: periodic fine-tune sessions for stable campaigns ($150–$250 per session, every six to nine months or whenever something shifts), and monthly management ($450/month and up) for practices spending more than $1,000/month on clicks or running ads across many specialties.
The difference between our model and RevKey’s is not whether ongoing optimization is available. It’s whether you should be required to pay $900/month indefinitely for a campaign that, for most solo and small group practices, doesn’t need that level of touch every single week.
Once a campaign is built right and the data has stabilized, it hums. Negative keywords are in place. Bid strategies have settled. Specialty pages are converting. The optimization work that still needs to happen is real, but for most practices it’s measured in hours per quarter, not hours per week. Charging a $900 retainer for that is like paying a contractor a monthly fee to keep checking your roof when it isn’t leaking.
We’d rather charge you for what we actually do.
Why We Cap Our Basic Packages at a Few Specialties
RevKey calls our per-specialty pricing structure a “mistake:” that we’re forcing you to choose which specialties to advertise based on an “arbitrary cap.”
It’s not arbitrary at all.
Here’s what we’ve learned from running ads for therapy practices over almost two decades: the practices that try to advertise everything at once almost always do worse than the practices that focus.
A solo therapist with five specialties spread thin across a $500 monthly ad budget usually gets fewer real leads than the same therapist running tighter, better-converting ads on her two strongest specialties. Spreading a small budget across too many ad groups means none of them ever gather enough data for Google’s algorithm to optimize, you just slowly bleed money.
Our Silver Campaign covers up to four specialties, which is more than enough for almost every solo and small group practice we work with. For larger group practices with many clinicians and many niches, we scope a custom campaign, we don’t push you into a one-size-fits-all package.
The “cap” isn’t a limit we made up to charge more. It’s a guardrail to keep your budget from getting so thin that nothing converts.
Where We Actually Agree
To be fair, RevKey makes some points we genuinely agree with:
- Google Ads for therapy is a specialized, high-stakes platform with strict healthcare advertising rules. You shouldn’t hand it to a generalist.
- You should own your own Google Ads account and your data. (We’ve always done it that way: we build campaigns directly in your account.)
- You shouldn’t be locked into anyone’s proprietary CRM or software platform in order to run your ads.
- Continuous optimization matters — especially through seasonal changes like the summer slump or the New Year bump.
We’re aligned on all of that. The disagreement is about price, packaging, and whether you should be told to pick between SEO and Ads.
The Bottom Line
If you only do one thing after reading this, do the math on your own situation. Ask any agency you’re considering: What will I have spent in twelve months, setup, management, fine-tuning, everything, assuming my campaign is running smoothly?
Then compare that number to what one or two new long-term clients earn you. That’s the real ROI conversation.
And don’t let anyone talk you into choosing between SEO and Google Ads. The therapists with the fullest practices are doing both, quietly, dependably, and without overpaying for either.
If you’d like us to walk through what a combined SEO + Ads strategy looks like for your specific practice and budget, we’re happy to. Schedule a call and we’ll talk through whether a Basic Campaign, a Silver Campaign, or full monthly management is the right fit for where you are right now.
