Therapy ads get flagged more than almost any other category in Google Ads — not because you’re doing something wrong, but because you’re operating in one of the most sensitive, human‑centered spaces on the internet. If your campaigns keep getting hit with “Eligible (Limited)” labels, blocked audiences, or restricted targeting, you’re not alone. At SMX Boston last week, this was the number‑one complaint from agency owners.

A behavioral health client came to me convinced their agency could target Google Ads toward patients with better insurance. It can't, no targeting setting reveals what a search query never contained. Here's what I told them instead, and why most marketing advice for therapists skips the question that actually matters.

A generalist agency will run your therapy practice's Google Ads exactly like they'd run a plumbing company's, default settings, no HIPAA-safe tracking, no idea why "therapist near me" can trigger a policy flag. Here's the real Ohio math on what a client should actually cost you, and why the fix isn't a better agency, it's owning the account yourself. Excerpt (short): Your "all-in-one" agency is running your therapy practice's ads like a plumbing business.