May 24, 2025 • 8 mins
Wondering why it’s suddenly so much harder to fill your practice? In this week’s Ask Allison, I’m breaking down the massive shift in the therapy landscape—and what Big Therapy Tech has to do with it. From skyrocketing competition on directories to the rise of agency-style tech companies dominating Google Ads, I’ll help you understand the forces at play and what it means for your marketing. More importantly, I’ll walk you through how to adapt—by getting hyper-intentional, building real relationships, and leaning into the human connection Big Tech can’t replicate. If you want a full practice in 2025, this one’s a must-listen.
Prefer video? This episode is also available to stream on our YouTube channel!
Sponsored by TherapyNotes®: Use promo code Abundant for 2 months free
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:07):
(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.) Welcome to Ask Allison.
Y'all ask the questions about having a
fun and thriving practice and I answer them.
We have a worksheet for you today so
you can bring this answer into your life.
You can access that at abundancepracticebuilding.com slash
links, where you'll also be able to ask
any questions you have for Ask Allison.
If you want more support, we've got some
free trainings in there too.
(00:28):
If you can't get enough Ask Allison, check
out our YouTube channel for our entire Ask
Allison library.
Welcome back to Ask Allison.
Here's today's question.
In today's market, are therapists having to do
more to get clients?
Super juicy question.
I'm going to answer it juicily, but first
I want to thank TherapyNotes for sponsoring Ask
Allison.
(00:49):
I have talked about them for years and
years.
You probably know their features by heart, but
what really sets them apart is that they
genuinely care about your experience.
It's not just about troubleshooting.
They actively implement user-suggested features like their
new AI notes and their automated client payments.
Everyone at TherapyNotes believes in the product and
they really want you to love it too.
(01:10):
Plus, they're independently owned, which means no venture
capital, no pressure to prioritize their investors over
you.
This independence allows them to keep their prices
fair, to focus on innovation, to prioritize customer
experience.
With over 100,000 therapists already on board,
they've proven you don't have to compromise success
for quality.
If you're ready to see for yourself, try
(01:31):
TherapyNotes free for two months.
Use the code ABUNDANT at TherapyNotes.com.
So to answer the question, in today's market,
are therapists having to do more to get
clients?
Absolutely.
Absolutely.
If you started a practice even two years
ago, it was a totally different experience.
The economy is definitely playing a role, but
(01:51):
the bigger impact is due to big therapy
techs' influence.
And I want y'all to understand this
on a deeper level than you might currently,
so I'm going to go on a bit
of a rant about it.
I promise it is answering the question, but
there's some education first.
I'm also not going to name any names
of these companies because they are extremely litigious,
(02:12):
and I'm not interested in a legal battle
with people with endless cash.
So think of the companies that are advertising
on the huge podcasts you listen to.
Also think about the companies that help you
take insurance but pay you better per session
than being paneled on the same insurance.
Hopefully a few companies are coming to mind.
Let's break down what's happening.
(02:34):
Pre-COVID, the mental health world was comprised
of agencies, group practices, and solo practices.
I'm lumping things like the VA, University Counseling
Centers, those kinds of things.
Those are all agencies.
So we all had our lanes for marketing.
Community Mental Health didn't have Psychology Today profiles
(02:54):
for their therapists, nor did the VA or
the University Counseling Centers.
That'd be super weird, right?
So these tech companies, they hire therapists, and
they are basically huge agencies.
They provide some more autonomy, and in some
cases, some more money than other agencies, but
overall, they function like an agency.
(03:16):
And many are creating Psychology Today profiles for
their therapists.
So if you have your own practice and
you work for one of these tech agencies
part-time, you may have two profiles, one
of which was created by a marketing team
and is more likely to get referrals.
We all know by now that tech companies
continuously breach client confidentiality, and they share client
(03:37):
info to social media so they can retarget
with ads, and they just pay a fine
for that.
These aren't run by people who can lose
their license in the same way that if
we did the same thing, we would be
in hot water.
If you're using Google Ads, for instance, to
fill your practice, that's become really, really difficult.
Google Ads work by each company or practice
(03:59):
sets a price for what they're willing to
pay to have someone click on their ad.
That doesn't mean a client just to click
on the ad that takes them to their
website.
And then Google gives the spots to any
search, gives the spots at the top and
on the sides.
Those go to whoever's willing to pay most.
So if you're willing to pay $50 for
(04:20):
every person that clicks on your ad, you'd
think that'd be shown to a fair amount
of potential clients.
But big therapy tech has really deep pockets,
and they're going to be happy to pay
far more.
So your ads are going to be shown
to way fewer people.
Insurance companies, this is another aside, a different
(04:40):
kind of these big therapy tech companies.
Insurance companies are only allowed to profit 15
to 20% from what we pay them
for our premiums.
And the 80 to 85% that remains
is supposed to go to medical expenses.
If not, they have to pay back money
to the people who've paid premiums.
This is called the medical loss ratio.
(05:03):
However, as expected, the insurance companies find these
loopholes.
So they found that they can buy group
practices.
They can start other companies.
They can pay those practices and companies more
per session for the same 90834, 90837s that
you might be doing over in your own
(05:24):
private practice.
They can pay them more per session, which
is paying themselves more per session, and then
pocket the excess because it's going to a
medical expense.
So that's a way that they're getting around
the medical loss ratio so that they can
pad their own pockets.
And they can market each of the therapists
in these group practices and these other businesses
(05:46):
in the same exact way that you market
your practice.
So if we use the Psychology Today example,
two years ago in your medium-sized city,
you might have had 300 therapists listed.
Well, now there are 3,000.
So the chances of being found among 300
therapists is much greater than being found amongst
(06:07):
3,000.
And these companies are huge.
They're impersonal.
They don't market niches.
They don't have any sort of like, I
see you, I hear you, I know you
kind of a feel.
But solo and small group practices have that
in spades.
So here's what I recommend to get clients
in this economy, in this mental health care
(06:27):
environment.
You have to be so much more intentional
with your marketing.
You cannot half-ass it.
That means you need a solid niche.
You need consistent messaging of that niche in
whatever marketing strategies you choose.
You need to capitalize on what big therapy
tech doesn't have, which is relationships.
So for 10 years, I've been saying networking
(06:47):
is as important as having a website.
It matters more now than it ever has.
As a culture, we're techier than we've ever
been, but we're not going to beat Silicon
Valley at its own game.
So here's the plan.
Have a niche.
Choose up to five marketing strategies.
One of them needs to be a great
website that's super niched.
(07:08):
Another has to be networking.
Not just meeting with someone once and checking
that box.
Creating an actual relationship with referral partners.
The other three marketing strategies to make up
your five are at your discretion.
We talk about a ton of options in
the abundance party if you need help.
Once you've selected your marketing strategies, you then
(07:29):
have to do them consistently and you have
to do them right.
Again, you cannot half-ass it in 2025.
Not if you want a full practice.
My students are getting clients in this tough
market because they are implementing the best practices
that I teach.
If you need help with that, DM me
the word party on social, or you can
hit the show notes to join if you're
(07:49):
listening to the podcast.
Today's free worksheet is how to not hate
networking.
In it, I teach you the steps to
networking without the awkwardness or the salesiness.
I take you through it step-by-step.
You've got to know how to network in
this market.
So I'm going to step off my soapbox.
Thank you so much for hanging out with
me today.
And I will talk with you later.
(08:13):
If you're ready for a much easier practice,
Therapy Notes is the way to go.
Go to therapynotes.com and use the promo
code abundant for two months free.
I hope that helped.
If you have questions for Ask Allison, or
you want to get your hands on the
worksheet for this episode, go to abundancepracticebuilding.com
slash links.
(08:37):
If you're listening, you probably need some support
building your practice.
If you're a super newbie, grab our free
checklist using the link in the show notes.
I'd love for you to follow rate and
review, but I really want you to share
this episode with a therapist friend.
Let's help all our colleagues build what they
want.
(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.) Welcome to Ask Allison.
Y'all ask the questions about having a
fun and thriving practice and I answer them.
We have a worksheet for you today so
you can bring this answer into your life.
You can access that at abundancepracticebuilding.com slash
links, where you'll also be able to ask
any questions you have for Ask Allison.
If you want more support, we've got some
free trainings in there too.
(00:28):
If you can't get enough Ask Allison, check
out our YouTube channel for our entire Ask
Allison library.
Welcome back to Ask Allison.
Here's today's question.
In today's market, are therapists having to do
more to get clients?
Super juicy question.
I'm going to answer it juicily, but first
I want to thank TherapyNotes for sponsoring Ask
Allison.
(00:49):
I have talked about them for years and
years.
You probably know their features by heart, but
what really sets them apart is that they
genuinely care about your experience.
It's not just about troubleshooting.
They actively implement user-suggested features like their
new AI notes and their automated client payments.
Everyone at TherapyNotes believes in the product and
they really want you to love it too.
(01:10):
Plus, they're independently owned, which means no venture
capital, no pressure to prioritize their investors over
you.
This independence allows them to keep their prices
fair, to focus on innovation, to prioritize customer
experience.
With over 100,000 therapists already on board,
they've proven you don't have to compromise success
for quality.
If you're ready to see for yourself, try
(01:31):
TherapyNotes free for two months.
Use the code ABUNDANT at TherapyNotes.com.
So to answer the question, in today's market,
are therapists having to do more to get
clients?
Absolutely.
Absolutely.
If you started a practice even two years
ago, it was a totally different experience.
The economy is definitely playing a role, but
(01:51):
the bigger impact is due to big therapy
techs' influence.
And I want y'all to understand this
on a deeper level than you might currently,
so I'm going to go on a bit
of a rant about it.
I promise it is answering the question, but
there's some education first.
I'm also not going to name any names
of these companies because they are extremely litigious,
(02:12):
and I'm not interested in a legal battle
with people with endless cash.
So think of the companies that are advertising
on the huge podcasts you listen to.
Also think about the companies that help you
take insurance but pay you better per session
than being paneled on the same insurance.
Hopefully a few companies are coming to mind.
Let's break down what's happening.
(02:34):
Pre-COVID, the mental health world was comprised
of agencies, group practices, and solo practices.
I'm lumping things like the VA, University Counseling
Centers, those kinds of things.
Those are all agencies.
So we all had our lanes for marketing.
Community Mental Health didn't have Psychology Today profiles
(02:54):
for their therapists, nor did the VA or
the University Counseling Centers.
That'd be super weird, right?
So these tech companies, they hire therapists, and
they are basically huge agencies.
They provide some more autonomy, and in some
cases, some more money than other agencies, but
overall, they function like an agency.
(03:16):
And many are creating Psychology Today profiles for
their therapists.
So if you have your own practice and
you work for one of these tech agencies
part-time, you may have two profiles, one
of which was created by a marketing team
and is more likely to get referrals.
We all know by now that tech companies
continuously breach client confidentiality, and they share client
(03:37):
info to social media so they can retarget
with ads, and they just pay a fine
for that.
These aren't run by people who can lose
their license in the same way that if
we did the same thing, we would be
in hot water.
If you're using Google Ads, for instance, to
fill your practice, that's become really, really difficult.
Google Ads work by each company or practice
(03:59):
sets a price for what they're willing to
pay to have someone click on their ad.
That doesn't mean a client just to click
on the ad that takes them to their
website.
And then Google gives the spots to any
search, gives the spots at the top and
on the sides.
Those go to whoever's willing to pay most.
So if you're willing to pay $50 for
(04:20):
every person that clicks on your ad, you'd
think that'd be shown to a fair amount
of potential clients.
But big therapy tech has really deep pockets,
and they're going to be happy to pay
far more.
So your ads are going to be shown
to way fewer people.
Insurance companies, this is another aside, a different
(04:40):
kind of these big therapy tech companies.
Insurance companies are only allowed to profit 15
to 20% from what we pay them
for our premiums.
And the 80 to 85% that remains
is supposed to go to medical expenses.
If not, they have to pay back money
to the people who've paid premiums.
This is called the medical loss ratio.
(05:03):
However, as expected, the insurance companies find these
loopholes.
So they found that they can buy group
practices.
They can start other companies.
They can pay those practices and companies more
per session for the same 90834, 90837s that
you might be doing over in your own
(05:24):
private practice.
They can pay them more per session, which
is paying themselves more per session, and then
pocket the excess because it's going to a
medical expense.
So that's a way that they're getting around
the medical loss ratio so that they can
pad their own pockets.
And they can market each of the therapists
in these group practices and these other businesses
(05:46):
in the same exact way that you market
your practice.
So if we use the Psychology Today example,
two years ago in your medium-sized city,
you might have had 300 therapists listed.
Well, now there are 3,000.
So the chances of being found among 300
therapists is much greater than being found amongst
(06:07):
3,000.
And these companies are huge.
They're impersonal.
They don't market niches.
They don't have any sort of like, I
see you, I hear you, I know you
kind of a feel.
But solo and small group practices have that
in spades.
So here's what I recommend to get clients
in this economy, in this mental health care
(06:27):
environment.
You have to be so much more intentional
with your marketing.
You cannot half-ass it.
That means you need a solid niche.
You need consistent messaging of that niche in
whatever marketing strategies you choose.
You need to capitalize on what big therapy
tech doesn't have, which is relationships.
So for 10 years, I've been saying networking
(06:47):
is as important as having a website.
It matters more now than it ever has.
As a culture, we're techier than we've ever
been, but we're not going to beat Silicon
Valley at its own game.
So here's the plan.
Have a niche.
Choose up to five marketing strategies.
One of them needs to be a great
website that's super niched.
(07:08):
Another has to be networking.
Not just meeting with someone once and checking
that box.
Creating an actual relationship with referral partners.
The other three marketing strategies to make up
your five are at your discretion.
We talk about a ton of options in
the abundance party if you need help.
Once you've selected your marketing strategies, you then
(07:29):
have to do them consistently and you have
to do them right.
Again, you cannot half-ass it in 2025.
Not if you want a full practice.
My students are getting clients in this tough
market because they are implementing the best practices
that I teach.
If you need help with that, DM me
the word party on social, or you can
hit the show notes to join if you're
(07:49):
listening to the podcast.
Today's free worksheet is how to not hate
networking.
In it, I teach you the steps to
networking without the awkwardness or the salesiness.
I take you through it step-by-step.
You've got to know how to network in
this market.
So I'm going to step off my soapbox.
Thank you so much for hanging out with
me today.
And I will talk with you later.
(08:13):
If you're ready for a much easier practice,
Therapy Notes is the way to go.
Go to therapynotes.com and use the promo
code abundant for two months free.
I hope that helped.
If you have questions for Ask Allison, or
you want to get your hands on the
worksheet for this episode, go to abundancepracticebuilding.com
slash links.
(08:37):
If you're listening, you probably need some support
building your practice.
If you're a super newbie, grab our free
checklist using the link in the show notes.
I'd love for you to follow rate and
review, but I really want you to share
this episode with a therapist friend.
Let's help all our colleagues build what they
want.
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