Google Dominates Search Ads More Than Ever. It's Working Through That

If you’re a therapist—or any small-business owner, really— you live and die with Google. Regulators may step in

- Mark Bergen and Shelly Banjo

In March, Ellen Ross’s business came to a standstill. Ross is a psychotherapist, accustomed to sitting across from patients, helping them deal with their deepest traumas and fears. When the pandemic started shutting the economy down, Ross shut her San Jose office, too. She nixed plans to hire another therapist and began adjusting to video therapy, which meant, among other things, building breaks in between sessions.

“I can’t look at a screen as long as I can interact with human beings,” says Ross, who spent years counseling in hospitals before setting up her own practice in 2017. And then there was the Google problem. In the before time's, Ross spent about $20 a day on search ads to promote her practice. That worked well enough. People would search for things like “therapist near me” and she would bid for those terms at Google’s silent auction. If she won the auction, ads for her practice, True North Psychology, would appear at the top of search results. Google charged for each click. In 2019, she spent about $5,500.

Starting in April, Ross’s calculus changed. Americans were stuck at home, some juggling home-schooling and work, others newly jobless. They were anxious and searched the web for help, sometimes looking for video counseling. Ross noticed that the prices for her regular keywords jumped sharply. She was still finding patients, though they often arrived after trying one of the proliferating virtual therapy startups, such as BetterHelp and Talkspace, and it was becoming prohibitively expensive to buy the Google ads to attract them.