A Step-by-Step SEO Audit Framework Built for Therapy Practice Websites

This guide is written for licensed therapists, practice managers, and group practice owners who want to understand why their website isn't generating consistent patient inquiries — and what specifically needs to change.

You don't need a technical background to work through this framework. You do need honest access to your site, a willingness to look at uncomfortable gaps, and about two to three hours of focused time.

What this audit will tell you:

• Whether your site has technical problems that prevent Google from crawling or ranking it
• Whether your service pages are aligned with how prospective patients actually search
• Whether your local presence (Google Business Profile, citations) is consistent and complete
• Whether your site communicates the trust signals patients need before reaching out

What this audit won't tell you:

• How your site compares competitively to other therapists in your market — that requires crawl data and keyword gap analysis
• Why you're losing ranking for specific queries without access to Search Console and historic position data
• Whether your content strategy matches search demand in your specialty area — that's a separate research exercise

If you're reading this after already doing a checklist-style review and still can't identify the root cause of flat organic traffic, the diagnostic layers below are designed to help you move past surface-level symptoms and find the underlying issue.

Note: Where this guide touches on HIPAA-related content decisions or APA advertising ethics, it is providing general educational context — not legal or compliance advice. Verify current rules with your licensing authority and a qualified healthcare attorney.

Before any content or local work matters, Google has to be able to crawl, render, and index your pages. Many therapy practice websites have one or more technical issues that quietly suppress rankings regardless of how well-written the content is.

Indexation Check

Start by typing site:yourdomain.com into Google. The number of results shown gives you a rough sense of how many pages are indexed. If you have 20 pages on your site but only 4 appear, that's a crawl or indexation problem worth investigating immediately.

Then open Google Search Console (free) and check the Coverage report. Look for pages marked as "Excluded" or "Crawl anomaly" — these tell you exactly which URLs Google is ignoring and why.

Page Speed

Use Google's PageSpeed Insights to test your homepage and at least one service page. Pay attention to the mobile score — most therapy site visitors are on phones. In our experience working with healthcare practice websites, slow load times on mobile are among the most consistent technical drag factors found during audits.

Common causes include uncompressed images, render-blocking scripts from booking plugins, and themes built for visual appeal rather than performance.

Mobile Rendering

Open your site on an actual phone, not just a resized desktop browser. Check that:

• Navigation menus open and close correctly
• Contact and booking buttons are easy to tap
• Text is readable without zooming
• Forms work end-to-end on mobile

HTTPS and Core Signals

Confirm your site loads over HTTPS (the padlock icon). Check that www and non-www versions redirect to one canonical version. Duplicate home URLs are a small but real crawl inefficiency that compounds over time.

Score this layer: if you find two or more issues here, fix them before moving to content.

The most common content problem on therapy websites is not thin writing — it's misaligned writing. Pages describe what a therapist does from a clinical perspective rather than from the perspective of someone searching for help at 11pm wondering if their symptoms are treatable.

Service Page Audit

List every service page on your site. For each one, ask three questions:

1. Does the page title and H1 include a specific search term a patient would actually type — not just a clinical label?
2. Does the page describe who this service is right for, in plain language?
3. Does it explain what a patient can expect from the process?

A page titled "EMDR Therapy" that describes the history and mechanism of EMDR but never mentions trauma, PTSD, anxiety, or specific patient outcomes is missing the match signal Google uses to rank it for patient-intent queries.

Location Signals on Content Pages

If you see patients in person, your service pages should mention your city, neighborhood, or metro area — not just in the footer, but naturally within the page copy. A page about "anxiety therapy" that contains no geographic reference cannot rank in local searches, regardless of how thorough the content is.

Keyword Alignment Check

Open Google Search Console and go to the Performance report. Filter by page, then click on any service page. Look at the queries it's currently receiving impressions for. If you're a marriage and family therapist in Denver and your couples counseling page is getting impressions for terms you don't recognize — or nothing at all — the page has an alignment problem.

Missing Pages

Common pages therapy websites are missing entirely:

• Individual pages per specialty (e.g., depression, anxiety, trauma, grief) rather than one combined "issues I treat" page
• A dedicated page for each insurance panel or self-pay policy
• A FAQ page addressing common intake and session questions
• Location-specific pages for multi-location practices

Each missing page is a missed ranking opportunity for a specific patient query.

For most private practice therapists, local SEO is where the majority of new patient searches happen. Queries like "therapist near me," "anxiety therapist in [city]," and "couples counseling [neighborhood]" all trigger local results — the map pack and nearby organic listings. Your website's technical and content health influences these results, but so does a separate set of local signals.

Google Business Profile Audit

Search for your practice name in Google. Check that your Google Business Profile (GBP) appears and that the following are accurate and complete:

• Practice name (exactly as it appears on your website)
• Address and phone number (matching your website exactly — character for character)
• Primary and secondary categories ("Mental Health Service" and relevant specialty categories)
• Hours of operation
• Website URL pointing to the correct page
• At least one recent photo

Name-Address-Phone (NAP) inconsistencies between your GBP and website are a known local ranking suppressant. Even minor differences — "Suite 200" vs. "Ste. 200" — create citation conflicts that accumulate across directories.

Citation Consistency Check

Search your practice name in Google and scan the first two pages. Look for directory listings on Psychology Today, TherapyDen, Healthgrades, Yelp, and any local directories. Check that the NAP information matches your GBP and website exactly. Inconsistent listings across multiple directories compound the ranking suppression.

Review Signals

Count your current Google reviews and note the average rating. In our experience, practices with fewer than five reviews are effectively invisible in competitive local markets — not because of a hard threshold, but because review volume and recency are ranking signals that competitors with active review generation strategies consistently outperform on.

Important: Any response to a patient review must follow HIPAA guidelines. Never confirm a reviewer is a patient or reference any detail of their care in your response. This is educational context — consult a healthcare compliance attorney for guidance specific to your practice.

SEO gets a patient to your website. Trust signals determine whether they contact you. For a therapy practice, the trust bar is high — someone is considering sharing their most vulnerable experiences with a stranger. Your website has to close that gap before the first phone call.

About Page Audit

Your About page is typically one of the highest-traffic pages on a therapy website. Audit it against these criteria:

• Is there a professional photo? (Not a stock image — a real one)
• Does it explain your clinical background and training in plain language?
• Does it communicate who you work best with — not just credentials, but approach and fit?
• Is there a clear next step (contact form, scheduling link) at the bottom?

Social Proof

Check whether your site displays Google review excerpts, testimonials, or directory ratings. Note the APA Ethics Code (Standards 5.01–5.06) and your state licensing board rules before using testimonials — some states restrict or prohibit patient testimonials in therapy practice marketing. This is educational context, not legal advice; verify current rules with your licensing authority.

Content That Demonstrates Expertise

A blog post written at the depth of a Wikipedia summary does not build authority. Audit your existing content: does any of it demonstrate a point of view, a clinical framework, or a specific expertise that a prospective patient would find meaningful? If not, the content is unlikely to contribute to either rankings or trust.

Contact and Intake Friction

Go through your own contact process as if you were a new patient. Count the steps. Identify any points where the process is unclear, requires unnecessary information, or where a prospective patient might abandon. High intake friction is a conversion problem that no amount of additional SEO traffic will solve.

After working through all four layers, you'll have a list of identified issues. The question most therapists ask at this point is: where do I start?

Prioritization Framework

Use this sequencing logic:

1. Technical blockers first. If Google can't crawl or index your site correctly, no other work will produce results. Fix indexation and speed issues before anything else.
2. Local NAP consistency second. Citation conflicts suppress local rankings independently of your website quality. Clean these up before investing time in new content.
3. Service page alignment third. Updating existing pages to better match patient search intent produces faster results than creating new pages from scratch.
4. New content and trust signals last. These compound over time but require the technical and local foundation to be stable first.

Simple Scoring Rubric

Score each layer on a 1–3 scale:

• 1 — Significant issues: Multiple problems found, likely suppressing rankings now
• 2 — Moderate issues: Some gaps, not critical blockers but limiting growth
• 3 — Healthy: No major issues, minor optimizations possible

If two or more layers score a 1, you have a compounding problem — fixing one layer in isolation will produce limited results because the issues are interacting. This is typically the point where a professional audit with crawl data, competitive benchmarking, and Search Console history will surface root causes that a manual review misses.

When to Stop DIYing and Request a Professional Review

In our experience, DIY audits surface the visible issues well. What they miss is the interaction between issues and the competitive context — why a technically clean site still doesn't rank in a specific market. If you've addressed the obvious problems and organic traffic remains flat after 60–90 days, the remaining gap is almost always competitive or strategic rather than technical.

At that point, requesting a professional therapist SEO audit gives you the competitive benchmarking and prioritized roadmap that moves the needle rather than just identifying more things to fix.