The "Big Therapy" Problem: Why Ohio Practitioners are Being Priced Out of Their Own Communities
I’m a fan of capitalism when it rewards the builders and the helpers in a community.
I love seeing an Ohio therapist take the leap to open a private practice in Clintonville or a group clinic in Dublin, invest in their own expertise, and grow a business that actually serves our neighbors.
That version of the work is about opportunity and human connection.
But let’s be honest: what you’re up against today doesn’t feel like a fair market. It feels like a monopoly with better branding.
This is exactly what I help my Google Ads Therapy clients navigate on a daily basis.
You can explore my full library of specialized strategies on my Google Ads for Therapists Hub.
While you’re busy in session helping someone through a crisis, multi-billion-dollar aggregators are buying up the digital ad real estate around you.
They aren't local builders; they are massive platforms that treat mental health like a volume game. They outbid you on every Google search and create a world where it’s easier to find a "matched provider" in a call center than a dedicated therapist in your own zip code.
The worst part is they sell the leads back to you.
The Cost of Therapy Care in Columbus, Cincinnati, and Cleveland
In cities like Columbus (from the Short North to Westerville), Cincinnati, and Cleveland, "Big Therapy" is driving up the cost-per-click to a point where local practices feel they can't compete. They aren't necessarily better than you at therapy, but they do have deeper pockets, and Google Ads is currently designed to reward the highest bidder, not the best clinician.
The Illusion of Choice
Ohio families are being funneled into "fast-food" therapy models. They think they’re choosing convenience, but they’re often losing the depth of care that only a local practitioner can provide.
This is why if you’ve ever Googled your own specialty and felt invisible, you aren't just imagining it. The system currently favors the "estates" of mental health which again are just national platforms with bottomless budgets.
For an independent therapist in Ohio, the stakes are uniquely high:
The Saturated Auction: In cities like Columbus, Cincinnati, and Cleveland, "Big Therapy" is driving up the cost-per-click to a point where local practices feel they can't compete. They aren't necessarily better than you—they just have deeper pockets and Google Ads and ad platforms reward more money.
Hyper-Local Precision: Working with me we don’t try to outspend the giants on "general" terms like therapy. We win by being specific to the neighborhoods you serve—whether that’s Powell, Dublin, Clintonville, Upper Arlington, or New Albany. This specificity reduces waste and ensures your ads show up for the neighbors most likely to walk through your door.
Top-Tier Expertise, Local Heart: You get the same strategy I’ve shared on global stages, applied specifically to your practice. As the President of the Paid Search Association, a top 100 PPCer worldwide, I see the national trends, but I apply them with the context of an Ohio neighbor to therapists.
From Nationwide to Powell: My Story
I believe marketing has a moral threshold.
It should be used to safeguard opportunity for the experts—not just the few at the top.
I write about ethics in my content on my blog in an effort to stop the snake oil in the industry: Are There Any Good Marketing Agencies? The Truth Business Owners Deserve.
I grew up right here in Powell, Ohio. I love this community, and I love seeing the people in it thrive.
My journey in this industry started at Nationwide here in Columbus, and for years, I worked nationally—managing massive budgets from Indiana to California and traveling the world to speak at the biggest stages in my industry.
I’ve been recognized as a Top 100 PPC specialist in the world, but for a long time, I was doing that work remotely for giant corporations. Then I realized: there are local therapists in my own backyard who didn't even know they had access to world-class expertise right here in Central Ohio.
Working with therapists has become deeply personal for me. It feels like I'm finally giving back to the community that raised me. I’m not just a specialist; I’m a neighbor who knows how to use the "big tech" tools to help the local builders win.
The "Aggregator Tax" in the Ohio Auction
In the 2026 landscape, the ad auction in Columbus, Cincinnati, and Cleveland isn't just crowded; it’s being manipulated by "Big Therapy" platforms that can afford to lose money on a click just to starve out local competition. When you bid on a general term like "anxiety therapist," you aren't just paying for a lead but you're paying an "aggregator tax."
How Protective PPC™ Flips the Script: Instead of entering a bidding war we can't win, we pivot to Intent-Based Pockets.
Precision over Power: We target the specific clinical niches and neighborhoods where aggregators are too "broad" to be relevant.
Quality over Volume: We optimize for the therapist-seeker in Westerville or Upper Arlington who is specifically looking for a local face, not a 1-800 number.
Budget Stewardship: We stop the "leakage" by excluding the junk traffic that Big Therapy platforms happily swallow up.
We have the tools to compete. We just need to stop letting the big platforms write the rules for Ohio’s mental health care. If you want to read more about my frameworks I talk about them here: How the 2026 PPC Landscape Has Changed: Introducing Protective PPC™
From Nationwide to Powell: My Story
I believe marketing has a moral threshold. It should be used to safeguard opportunity for the experts—not just the few at the top.
My journey in this industry started right here in Columbus at Nationwide Insurance. That’s where I learned the "big engine" of PPC—managing massive, high-stakes budgets where every decimal point matters. From there, I moved into global consulting, managing campaigns for companies across the U.S. and Canada, working out of Indiana, and traveling to speak on the biggest stages in the industry from Indy to California and beyond.
I’ve been recognized as a Top 100 PPC specialist in the world, but after years of doing this work for giant corporations, I looked at my own backyard in Powell, Ohio. I realized that local therapists—the people actually building our community in Clintonville, Dublin, and Upper Arlington—didn't have access to this level of expertise. They were being out-muscled by the very platforms I knew how to navigate.
Working with therapists has become deeply personal for me. It feels like I'm finally giving back to the community that raised me. I’m not just a global specialist; I’m a neighbor who knows how to use the "big tech" tools to help the local builders win.
Final Thoughts
Independent therapists in Ohio deserve more than a Google Ads dominated by national platforms.
The future of mental health care in our state depends on whether local practitioners can stay visible, competitive, and accessible to the people who actually live here.
That’s why the next era of therapist marketing isn’t about spending more—it’s about using smarter, hyper‑local strategies that reflect how Ohioans search for care today.
In 2026 search engines now reward specificity, authority, and real‑world expertise.
When your practice shows up with clear geographic relevance, strong service‑based intent, and trustworthy signals, you can outperform national brands even in crowded markets like Columbus, Cincinnati, and Cleveland. That’s the foundation of Protective PPC™—a model built to help therapists reduce wasted ad spend, strengthen local visibility, and protect their practices from the volatility of “Big Therapy” bidding wars.
Ohio families want real clinicians, not call‑center matching systems. And when your practice is optimized with the right keywords, the right targeting, and the right conversion pathways, you become the obvious choice for people searching for help in their own community.
If you’re ready to build a marketing strategy that reflects your values, protects your margins, and keeps care local, explore the frameworks inside Protective PPC™.
It’s built for independent therapists who want to grow sustainably—and stay in control of their own visibility.
Ohio Therapist PPC: Frequently Asked Questions
Why is Google Ads so expensive for therapists in Columbus and Cincinnati?
National aggregators (the "estates" of therapy) have multi-billion dollar budgets. They bid aggressively on general terms like "therapist near me," driving the cost-per-click (CPC) up for everyone. In cities like Columbus and Cincinnati, these giants often treat the auction as a volume game, making it hard for local clinicians to stay visible without a hyper-local strategy.
How can a local practice in Dublin or Clintonville compete with "Big Therapy"?
We don't try to outspend them; we out-maneuver them. By targeting specific neighborhoods (like Powell, New Albany, or Upper Arlington) and clinical niches, we find "Intent-Based Pockets" that aggregators ignore. This "Protective PPC™" approach ensures your budget is spent on neighbors who want a local, human connection, not a call center.
Does a therapist need a massive budget to see results in Ohio?
No. You don't need a Silicon Valley budget to fill your caseload. What you need is precision. By focusing your spend on 1-5 mile radiuses around your office and excluding "junk" traffic that big platforms typically waste money on, even a modest budget can yield a high-quality local client base.
