Most therapists didn't go to school to learn marketing. You trained for years to be a great clinician, and then someone handed you a website, a Psychology Today profile, and a quiet inbox. Our Full Caseload virtual summit was four hours built around one question: what fills a caseload. Here's what came out of it.

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We opened with Heard's own data, moved into a search and SEO deep dive with Dr. Marie Fang, sat down for a fireside chat with three practice owners, and closed with a therapist who filled her caseload on social media after swearing she never would. Four sessions, one throughline: a few intentional moves beat a pile of random ones.

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If you missed it, or want a refresher, this is the recap. 

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What 500 therapists' marketing spend tells us

Melanie Hahn, Heard's VP of Marketing, and Leah Judge, who leads brand and content, opened with numbers from Heard's anonymized data: about 500 therapists, roughly a million dollars in categorized marketing spend across 2024 and 2025. Median revenue across the sample slipped from about $98,000 to about $96,000 year over year, a baseline of -0.83%. The question for every channel: did it beat that baseline?

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Four buckets capture about 90% of what therapists spend on: directories (42%), SEO and marketing agencies (about 18%), paid ads (about 18%), and website tools (about 13%). Directories lead by a wide margin, and 81% of the group paid for Psychology Today. The surprise is what that spend does. Psychology Today on its own sits almost exactly at the sample baseline. It doesn't sink you, and it doesn't grow you. As Melanie put it, it's a baseline rather than a tiebreaker.

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The signal that kept showing up was stacking. Therapists who combined a few channels saw the real movement. SEO agencies correlated with a 19% lift in median year-over-year revenue. The 12 therapists who ran both Google and Meta ads saw a 28% lift. Three or more directories trended positive. The crossover point landed around three to four channels working together. These are directional signals from a sample, some of them small, so treat them as a starting point rather than a promise.

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"When we think about marketing, you can do a lot of random acts of marketing. That doesn't typically work, though," Melanie said. "Marketing is kind of this machine where if you have a few building blocks stacking on each other, that's when you start to see a lot of efficiency and a lot of impact on what you're doing and on your revenue."

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A few more takeaways worth holding onto. Pulling out of marketing entirely tended to hurt revenue, so a steady minimum of time or money beats stopping and starting. Email paired with a website outperformed email alone. Search is shifting under everyone: paid ads and free organic results now share the page with AI overviews and tools like ChatGPT, which is why you'll hear terms like AEO (AI engine optimization). 

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And owned channels keep winning. "An owned channel tends to have the best ROI," Melanie noted, because once someone is on your email list, reaching them again costs you nothing. The most important point came back to the audience, not the tactics: "Marketing is about your audience and resonating with them."

Ready to dig in? Here’s our marketing checklist for therapists. 

SEO and AIO without the burnout

Dr. Marie Fang, a licensed psychologist in San Diego and founder of Private Practice Skills, took the search conversation deeper. Her first move was to take pressure off. "You do not need to post daily. You do not have to be on TikTok," she said. Most of what she covered is one-and-done work you revisit once or twice a year.

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She started with niching, because specificity is what gets a solo practice found. "The more specific that you can get in what your focus is, what your emphasis is in your practice, the less competition you have, and the more trust you build immediately with potential clients who relate." Her analogy stuck: search "food near me" and you compete with the whole neighborhood. Search "gluten-free Ethiopian food near me" and the map zooms out, because someone will drive ten miles for the specific thing.

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On your website, the highest-value real estate is your specialties pages. If three specialties live on one page, split them into three, each with its own page, so Google and AI can surface the exact one a client is searching for. Name your credentials clearly so AI can see you're qualified. Fill in the SEO basics your site builder already offers (page titles, meta descriptions, image alt text), check your load speed and mobile view, and keep one clear, consistent call to action everywhere, like booking a free consultation call.

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Two points drew the most interest. FAQ pages punch above their weight: "AI loves FAQ pages so much. It's really fascinating how much AI loves FAQ pages," Marie said, so list the questions you hear on intake calls and answer them plainly. And a Google Business Profile is close to as powerful as your website for showing up in AI recommendations and maps, though Google requires an in-person location to keep one. Across every platform, keep your NAP (name, address, phone number) identical.

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On reviews, Marie was direct about the ethical bind therapists face and said she avoids them entirely while still ranking. SEO also takes patience: expect one to three months before changes show up, and use a free Google Search Console account to track whether traffic moves. If you do only three things, she said, optimize your specialties and FAQ pages, claim and fill out your Google Business Profile, and make your name, address, and phone number consistent everywhere.

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What grew their practices, in their words

The fireside chat, moderated by Heard co-founder and CEO Andrew Reason, brought together three practice owners who built very differently: Anim Aweh, an LCSW who coaches therapists on money mindset and grew a large following on YouTube and social; Karyn Noel, who runs a group practice of five associates with a niche in eating disorders and body image; and Dr. Brent Metcalf, who built TriStar Counseling in Northeast Tennessee into a group of twelve clinicians.

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Andrew set the frame. Almost everyone in the room trained for years to be a great clinician, "but I don't think anybody in here decided that they wanted to become like a marketer or a salesperson or like a business person coming into this role." Then he asked what each of them thought would fill their caseload and got completely wrong.

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The answers rhymed. Google Ads disappointed all three early on. Brent didn't have the budget for them and leaned into networking instead: "Networking was probably the biggest advice that I had, which was a fun time because I got to make friends and drink lots of coffee and build up a referral source that way." Karyn tried a bare-minimum ad and landed an associate rather than clients. "Glad I tried it, would not go back because I'm so happy to have this person on my team, but it just didn't do what I was hoping it would do."

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What worked was relationships, reframed as community. Karyn described how she approaches it now: "I just want to make a new friend, and I want to be a new friend to you. Virtual therapy can be really lonely and so I have no agenda and I want to just get to know you." The panel's most reliable source of referrals was therapy-adjacent providers: dietitians, OBGYNs, doulas, midwives, and primary care offices. Brent's tactic for winning over a PCP office was memorable. "The key to success in PCP office is treats," he said, describing cookies cut in the shape of his logo dropped off for the nurses and front-desk referral coordinators. They also got practical about insurance: employee assistance programs like Modern Health as a steady referral stream, and teaching clients to ask their insurer about out-of-network benefits, which Karyn said covers her full fee about half the time.

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On rejection, both Anim and Karyn had a reframe worth keeping. Anim treats a no as misalignment, not failure. Karyn put it plainly: the people who are meant to find her will find her, and "no is a fine answer to have." And for therapists wary of social media, Anim offered a reason to reconsider: "It's like a free equalizer," a way to reach beyond the people you already know. Their homework for attendees: get clear on who you serve (Anim), put together a short talk and pitch yourself as a speaker (Karyn), and pick the marketing that feels authentic to you and do that (Brent).

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Authentic marketing: how one therapist filled her caseload on social

Jennifer of Jennifer Ann Counseling, a licensed professional counselor in Colorado Springs, closed the day with the most unlikely story. In March 2025 she told her own therapist she would never market herself on social media. About fifteen months later she has roughly 300,000 followers across Instagram, TikTok, and Facebook, a full caseload, two new associate therapists, and a course hundreds of people have taken. Social is now her number one lead generator.

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She spent real time on why marketing feels so hard for therapists, because the barrier is rarely strategy. It's perfectionism, imposter syndrome, comparison, and the fear of being visible. Her answer to all of it: start before you feel ready. "You start and the voice shows up. The first ten posts don't have to be good. They just have to exist," she said. The content that filled her practice wasn't polished or clinical. A silly reel of her tackling a trash can in her front yard brought in inquiries. A skit about a therapist who forgot to clock out on vacation got her ten client leads in a day and forty in a month, after months of tidy "ten tips for anxiety" posts went nowhere. Her read on it: "Authenticity converts. Marketing done right is just connection, and connection is literally what we were trained to do."

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The tactical parts were just as useful. Make booking effortless by putting a consultation link right in your bio. Don't try to beat the algorithm: "You don't really beat it. You just get to outlast it." Stay consistent through a system, not motivation. She plans content one day a week, batch-films another, drafts everything, and posts through the week, pulling from an idea bank she adds to whenever a thought strikes. On how much of yourself to share, her line landed with the room: "Share from the scar, not the open wound." And on ethics, she runs every post through three gut checks: could this identify a client, am I giving individualized clinical advice in comments or DMs, and would I be fine with my licensing board and a client both seeing it. She also keeps a social media policy in her informed consent and avoids soliciting reviews from clients.

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The throughline

Four speakers, four very different practices, and one shared pattern. Get specific about who you serve. Stack a few channels instead of chasing twenty. Build things you own, like an email list and a website, alongside anything you rent. Let people see the real person behind the credentials. And choose consistency over intensity, because the work compounds.

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Marketing is one hat. The financial side of your practice is another, and it's the one that tends to keep therapists up at night. That's where Heard comes in. We handle bookkeeping, taxes, and the business finances so you can put your energy back into clients and into the marketing that grows your practice. If you want to see what that looks like for your numbers, you can book a free consultation any time.

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