Google's core algorithm priorities—relevance, authority, and user experience—haven't fundamentally changed. But how therapist practices rank for new patient queries has evolved in three concrete ways.
First: Local competition intensified. More therapy practices are now investing in Google Business Profile optimization. Where a practice could rank with a half-maintained profile two years ago, that no longer works. GBP consistency, category accuracy, and regular posting now separate first-page results from page-two relegation. In our experience working with therapy practices, the gap between a neglected GBP and an optimized one has widened from 2-3 ranking positions to 4-5 in competitive metros.
Second: E-E-A-T signals shifted toward practice specificity. Generic content about 'how to choose a therapist' no longer signals authority to Google. Practices demonstrating depth in a specific modality—dialectical behavior therapy, exposure therapy for OCD, somatic experiencing—rank above generalist competitors. This isn't new in principle, but the competitive gap has become measurable.
Third: Review authenticity matters more. Therapist practices with 15-20 verified patient reviews now outrank those with 40+ older, unverified reviews. Google's systems are better at distinguishing genuine patient feedback from bulk-generated content. HIPAA-compliant testimonials (anonymized, patient-initiated) signal legitimacy more effectively than they did 12 months ago.