Quick Answer
In 2026, therapy clients find providers through Google search (still #1 but with 65% zero-click results), AI search engines like ChatGPT (fastest-growing channel, 800M weekly users), insurance platforms (Alma, Headway, Rula), directories like Psychology Today (declining significantly), and word-of-mouth referrals. The biggest shift is the rapid rise of AI recommendations and the decline of traditional directory listings.
Something has changed
If your caseload feels lighter than it used to, you are not imagining it.
Across Reddit threads, Facebook groups, and supervision sessions, therapists are saying the same thing: "the well is drying up." Inquiries from Psychology Today have slowed to a trickle. Referral sources that used to be reliable have gone quiet. And for many therapists, especially those who opened their practice in the last five years, the playbook they were taught no longer works.
"I thought it was just me" is the most common reaction. It is not just you.
Three shifts are happening at the same time, and most "how to get therapy clients" articles still give advice from 2020. Here is what actually changed:
Psychology Today is collapsing as a referral source
Therapists report 77 to 94 percent drops in PT inquiries. Platform companies are crowding the listings. The $30/month directory that built many practices is no longer delivering.
AI search is becoming a primary referral channel
ChatGPT grew from 300 million to 800 million weekly users in 10 months. People are asking it "find me a therapist near me" and it is answering with specific names.
Platform companies are reshaping the market
Rula, Alma, Headway, and Grow Therapy are managing thousands of therapist profiles, absorbing insurance panels, and changing how clients discover providers.
Why this guide exists: Almost every article about getting therapy clients recycles the same advice: "optimize your Psychology Today profile, post on Instagram, ask for referrals." That advice is not wrong. It is just incomplete. Nobody is connecting the data about what has actually changed. This guide does.
Is Psychology Today still worth $30 a month?
Quick Answer
Psychology Today is still worth listing on, but it should no longer be your primary client acquisition strategy. Many therapists report 77 to 94 percent declines in PT inquiries since 2023. The platform is increasingly crowded by managed-care companies like Rula, and clients are shifting to Google search and AI tools to find providers.
The data here is striking. While Psychology Today does not publish its own referral metrics, therapists have been tracking their numbers. Here is what they are reporting:
| Therapist | Before (2022) | After (2025) | Decline |
|---|---|---|---|
| Therapist A (urban, CBT) | 15-20 inquiries/month | 1-3 inquiries/month | ~85% |
| Therapist B (suburban, couples) | 10-12 inquiries/month | 1-2 inquiries/month | ~86% |
| Therapist C (urban, trauma) | 8-10 inquiries/month | 0-2 inquiries/month | ~83% |
| Therapist D (rural, general) | 6-8 inquiries/month | 0-1 inquiries/month | ~90% |
| Therapist E (urban, anxiety) | 20+ inquiries/month | 2-5 inquiries/month | ~80% |
Source: Self-reported data from therapist forums and communities (2024-2025). Individual results vary by location and specialty.
What is causing the decline?
Several factors are compounding:
Platform companies are crowding the listings
Rula, Alma, Headway, and Grow Therapy manage thousands of therapist profiles on Psychology Today. Their profiles often have premium positioning and polished copy, making it harder for independent practitioners to stand out.
More therapists, same search volume
The number of licensed therapists in the US grew significantly post-pandemic, but search volume for "find a therapist" has plateaued. More profiles competing for the same eyeballs.
Clients are searching differently
Instead of browsing a directory, more clients go straight to Google, ask ChatGPT, or use their insurance company's portal. PT is no longer the default starting point for many people seeking therapy.
As one therapist put it on Reddit: "Almost every therapist I've spoken to in 2025 has said either that Psychology Today has never worked for them, or it used to but doesn't anymore."
The verdict: Keep your Psychology Today profile. It costs $30/month and still sends some referrals. But treat it as one channel among many, not your primary strategy. If PT is the only place you are listed, that is a problem.
Where clients are finding therapists (the 2026 data)
Quick Answer
Therapy clients search five main channels in 2026: Google search (550,000 monthly searches for 'therapist near me' alone), AI tools like ChatGPT (800M weekly users, fastest-growing), insurance portals and platforms (Alma, Headway, Rula), directories (Psychology Today declining, TherapyDen growing), and word-of-mouth referrals.
Here are the five channels ranked by current effectiveness, based on available data and therapist-reported results:
Google search (still #1, but changing)
"Therapist near me" gets 550,000 searches per month in the US alone. Add in specialty variations ("anxiety therapist near me," "couples counseling near me") and the total is well over 1 million monthly searches. Google remains where most therapy clients start.
But here is the catch: according to SparkToro, roughly 65% of Google searches now end without a click. Google increasingly answers queries directly with AI Overviews, featured snippets, and local pack results. This means your Google Business Profile and structured website content matter more than ever, because that is what Google pulls into these zero-click results.
AI search engines (fastest growing)
ChatGPT grew from 300 million to 800 million weekly active users between early 2025 and late 2025 (source: OpenAI). Perplexity, Claude, and Google Gemini are also growing rapidly. These are not niche tools anymore. They are how a significant and growing portion of the population finds information.
When someone asks ChatGPT "recommend a therapist for OCD in Austin," it does not show 10 blue links. It recommends 3 to 4 specific providers with reasoning. This is a fundamentally different discovery model, and most therapists are not optimized for it.
Insurance portals and platform companies
Alma, Headway, Rula, and Grow Therapy have become major referral sources for therapists who accept insurance. These platforms handle credentialing, billing, and increasingly, client matching. For insurance-based practices, they are now a primary channel.
The tradeoff: you give up some control over your practice identity, and the platforms take a percentage or set your rates. For private-pay therapists, these platforms are less relevant.
Directories (declining, but still useful)
Psychology Today is still the largest therapist directory, but as we covered above, its effectiveness has dropped significantly. TherapyDen is growing as an alternative, especially among LGBTQ+ affirming and social justice-oriented practices. GoodTherapy and Open Path Collective serve smaller but dedicated audiences.
The directory model itself is under pressure. When AI tools can recommend therapists directly, the value of scrolling through hundreds of identical profiles diminishes.
Word-of-mouth referrals (still strong)
Referrals from other therapists, physicians, and past clients remain valuable. They convert at higher rates than any other channel because trust is already established.
The challenge: referrals do not scale. You cannot control when or how many come in. They are a great supplement to an active strategy, not a strategy on their own.
Why ChatGPT is sending more referrals than Psychology Today
Quick Answer
Yes. ChatGPT and other AI tools are actively recommending specific therapists and practices when users ask for provider recommendations. One psychologist reported a deep decline in PT referrals alongside a much higher number of people who found them through ChatGPT. OpenAI is also building a formal therapist referral network.
This is the section where most therapists raise an eyebrow. AI recommending therapists? Sending actual referrals?
Yes. And it is already happening at scale.
"I have noticed a deep decline in referrals from Psychology Today and a much higher number of people who found me through ChatGPT."
Psychologist, reported on professional forum (2025)
How AI search differs from Google
When someone searches Google for "anxiety therapist near me," they see a list of links to navigate. When someone asks ChatGPT the same question, they get a curated list of 3 to 4 specific providers with explanations for each recommendation. The user does not browse. They follow the recommendation.
This matters because AI recommendations carry a different kind of trust. A Google result says "here are your options." A ChatGPT recommendation says "based on what you described, I recommend this person and here is why."
The numbers backing this up
800 million weekly users. ChatGPT alone has more weekly active users than Instagram had in 2021. These are not early adopters anymore.
527% growth in AI-referred traffic. Year-over-year growth in traffic from AI answer engines to websites, according to a 2025 Authoritas study.
28% of traffic from ChatGPT. One therapy-related tool (anonymized) receives 28% of its total traffic from ChatGPT referrals, making it the second-largest traffic source after Google organic.
OpenAI is building a therapist referral network. According to Behavioral Health Business, OpenAI is actively developing formal therapist referral capabilities within ChatGPT.
To be clear: This is not about AI replacing therapy. It is about AI becoming the new front door. The therapy still happens between two humans in a room. But how clients find that room is changing fast.
How to get your practice recommended by ChatGPT
Quick Answer
AI recommendations are influenced by list mentions across reputable sites (41% weight), reviews and ratings (16%), brand mentions on the web (11%), and specific customer examples (14%), according to research by Onely. The key: ChatGPT reads your website, not your Psychology Today profile. A well-structured site with clear specialties and FAQ sections is essential.
A 2025 study by Onely, a technical SEO agency, analyzed what factors influence AI answer engines when they make recommendations. Here is what they found, translated for therapists:
| Factor | Weight | What this means for therapists |
|---|---|---|
| List mentions | 41% | Be listed on multiple directories and "best therapists" lists. Consistent NAP across sites. |
| Reviews & ratings | 16% | Google reviews matter more than PT reviews for AI. Aim for 10+ with detailed text. |
| Customer examples | 14% | Case studies, anonymized client outcomes, or specific descriptions of who you help and how. |
| Brand mentions | 11% | Your practice name mentioned on other sites, blogs, podcasts, professional directories. |
| Other factors | 18% | Website structure, content quality, recency, and consistency of information. |
Source: Onely, "What influences AI recommendations" (2025). Weights are approximate and vary by query type.
What does NOT matter for AI recommendations
Paid advertising. You cannot buy your way into ChatGPT recommendations (yet).
Keyword stuffing. AI tools understand context. Repeating "anxiety therapist" 50 times hurts, not helps.
Social media posting. AI tools pull from your website and web mentions, not your Instagram feed.
The key insight: ChatGPT does not read your Psychology Today profile. It reads your website. If your entire online presence is a PT profile and an Instagram account, you are invisible to AI search. A therapist with a well-structured website, Google reviews, and consistent directory listings will get recommended. A therapist with only a PT profile will not.
Free: 2026 Practice Visibility Checklist
The 15-point checklist we use to audit therapy practice visibility. Covers Google, AI search, directories, and local SEO. Takes 30 minutes to complete.
Free download. No spam. Unsubscribe anytime.
What to do about it (the 5-step audit)
You do not need to hire a marketing agency to get started. These five steps are specific, doable in a weekend, and address the biggest visibility gaps most therapists have.
Google yourself (and ask ChatGPT about yourself)
Open an incognito browser window and search for your name, your practice name, and "[your specialty] therapist [your city]." Note what shows up on page one. Is your website there? Your PT profile? Nothing?
Then open ChatGPT and ask: "Recommend a therapist for [your specialty] in [your city]." See if you are mentioned. If not, that tells you exactly where the gap is.
Time: 15 minutes
Claim and complete your Google Business Profile
If you have not done this yet, do it today. It is free and it is the single highest-impact action for local visibility. Complete every field: practice name, address, phone, hours, specialties, insurance accepted, and a detailed description written in natural language (not keywords).
If you already have a GBP, check that it is complete. Most therapists have claimed it but left half the fields empty.
Time: 30 to 60 minutes
Build a real website with structured content
A one-page Wix site with your photo and a paragraph about your practice is not enough in 2026. AI tools need content they can parse. That means:
A dedicated page for each specialty (anxiety, depression, couples, etc.)
An about page with your credentials, approach, and who you help
An FAQ page answering common questions in clear, direct language
A contact page with your full address, phone, and hours
Content written in your own voice, not copied from a template
Time: 1 to 2 days (or hire this out)
If you want personalized client materials for your site, we built a free worksheet generator that creates therapy worksheets using your client's own words. Nothing is stored on our servers.
Get at least 5 Google reviews
Google reviews now carry more weight than Psychology Today reviews for both search rankings and AI recommendations. Five is the minimum to appear credible. Ten or more puts you ahead of most therapists in your area.
Be mindful of confidentiality. A simple "If you found our work together helpful, a Google review helps other people find us" at an appropriate termination point is sufficient. Most clients are glad to help when asked respectfully.
Time: Ongoing (1 new review per month is a good pace)
Make your website AI-readable
AI tools extract information from websites that are structured clearly. This is not technical wizardry. It means:
Use FAQ sections with clear questions as headings and direct answers
Write in complete sentences (AI struggles with bullet-only pages)
Include your full name, credentials, and location on every page
Keep your Name, Address, and Phone (NAP) identical across all listings
Add schema markup if your platform supports it (WordPress, Squarespace)
Time: 2 to 4 hours
What will not work anymore
These are not bad strategies. They are just insufficient on their own in 2026. If any of these is your entire marketing plan, it is time to add more channels.
Relying solely on Psychology Today
We covered the data above. PT is one channel, not a strategy. If your only online presence is a PT profile, you are invisible to Google Maps, AI tools, and anyone who does not specifically browse that directory.
Running Google Ads without a website that converts
Paying for clicks to a one-page site with no clear call to action is burning money. Fix the website first, then consider ads. The average cost per click for therapy keywords is $5 to $15. That adds up fast if your site does not convert.
Posting on Instagram expecting client inquiries
Social media is great for brand awareness and community. It is not great for client acquisition. Therapy clients search with intent ("I need a therapist now"). They do not scroll Instagram looking for one. Your time is better spent on SEO and Google Business Profile.
"Just wait, it takes time" (without a strategy)
Patience is a virtue. But patience without a plan is just hoping. If you have been waiting 6 months with no active strategy beyond a PT profile and occasional referrals, waiting longer will not change the result.
Hiring a generic marketing agency
A marketing agency that serves restaurants, dentists, and lawyers will not understand the nuances of therapy practice marketing. The language is different. The ethics are different. The client journey is different. Look for someone who specializes in therapists or healthcare.
None of this is meant to make you feel guilty. You went to grad school to help people, not to learn SEO. "I didn't go to grad school to learn marketing" is probably the most common sentiment in therapist communities right now. Fair enough. But the landscape has changed, and the therapists who acknowledge that change will have fuller caseloads than those who do not.
What it actually costs to get a therapy client in 2026
Quick Answer
Client acquisition costs vary by channel: Psychology Today ($30/month, declining ROI), Google Ads ($100 to $300 per new client), SEO ($300 to $800/month, compounds over time), and AI search optimization ($0 DIY or included with SEO services). The average therapy client generates $3,000 to $8,000 in annual revenue, making most marketing investments worthwhile if they bring even 2 to 3 new clients per month.
Nobody talks about this honestly. Here is a realistic cost comparison:
| Channel | Monthly Cost | Est. Cost Per Client | Trend |
|---|---|---|---|
| Psychology Today | $30/month | $15-$30 (was $3-$5) | Rising (fewer referrals) |
| Google Ads | $500-$2,000 | $100-$300 | Stable but expensive |
| SEO (professional) | $300-$800 | $50-$150 (compounds) | Improving (compounds) |
| AI search optimization | $0 (DIY) or included | Near $0 (early mover) | Growing fast |
| Social media | $0 (your time) | Difficult to measure | Low direct ROI |
The ROI math
The average therapy client is worth $3,000 to $8,000 in annual revenue (based on $150 to $200/session, seen weekly for 20 to 40 sessions). Even at the low end, one new client per month more than covers any marketing investment on this list.
The math: If SEO costs $500/month and brings 2 new clients monthly, that is $250 per client acquired. Those 2 clients generate $6,000 to $16,000 in annual revenue. That is a 12x to 32x return. The question is not whether marketing is worth it. It is which channels give you the best return for your situation.
Frequently asked questions
How do new therapists get their first clients?
+
New therapists typically get first clients through insurance panel acceptance, directory listings (Psychology Today, TherapyDen), Google Business Profile optimization, and networking with other providers. In 2026, optimizing for AI search engines is also increasingly important, as tools like ChatGPT recommend specific providers when asked.
How long does it take to build a full caseload?
+
Most private practice therapists take 6 to 18 months to build a full caseload, depending on location, specialties, insurance acceptance, and marketing effort. Therapists who actively manage their online presence tend to fill faster than those relying solely on Psychology Today or word of mouth.
Why am I not getting referrals from Psychology Today?
+
Psychology Today referrals have declined 77 to 94 percent for many therapists since 2023. Contributing factors include platform companies managing bulk profiles, increased competition, and the rise of AI search engines that bypass directories. PT is still worth listing on, but it should not be your only strategy.
Does social media work for getting therapy clients?
+
Social media can build brand awareness but rarely drives direct client inquiries. Therapy clients search with intent ("I need a therapist now"). They do not scroll Instagram looking for one. Your time is better spent on Google Business Profile, SEO, and AI search optimization.
How much should I spend on marketing my practice?
+
A reasonable budget is 5 to 10 percent of revenue. For a new practice, expect to invest $200 to $800 per month across directory listings, website hosting, and SEO. The key metric: cost per client versus lifetime client value ($3,000 to $8,000 per year).
What is Answer Engine Optimization (in plain English)?
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AEO is making your website easy for AI tools to read and recommend. It means writing clear question-and-answer content, keeping your information consistent across the web, and having a well-structured website. Think of it as SEO for ChatGPT instead of Google.
How do I get my practice recommended by ChatGPT?
+
Build a real website with clear specialty pages and FAQ sections. Get Google reviews. Be listed on multiple directories with consistent information. Write helpful content in your area of expertise. ChatGPT reads your website, not your Psychology Today profile.
Is it worth hiring an SEO agency for my therapy practice?
+
It depends on your market and time. In competitive cities, professional SEO ($300 to $800/month) can pay for itself with 2 to 3 new clients monthly. Look for someone who specializes in therapists. Avoid anyone who guarantees rankings or locks you into long contracts.
What are the best alternatives to Psychology Today?
+
The most effective alternatives in 2026 are Google Business Profile (free, high impact), your own SEO-optimized website, TherapyDen (growing), insurance platforms (Alma, Headway), and AI search optimization. Most successful therapists use 3 to 4 channels, not just one.
How can I stand out from other therapists in my area?
+
Build a real website with your unique voice. Create pages for each specialty. Earn Google reviews. Optimize for AI search. Most therapists in your area rely solely on Psychology Today. A well-structured website and 10+ Google reviews will make you more visible than 90% of your competitors.
Related guides
Research
ChatGPT Therapist Recommendations in 10 Cities
What AI recommends and why
Guide
What Clients See When They Google You
The 3-second judgment clients make from page 1
Analysis
The Real Cost of Psychology Today in 2026
The ROI math most therapists have not done
Guide
Psychology Today Stopped Working
The data behind the PT decline