Facebook and Instagram ads for a therapy practice
Why Meta restricts health targeting, the creative that books consultations, realistic budgets and cost per lead, and how to retarget without being creepy.
Meta ads and Google Ads solve different problems for a practice. Google captures a person already searching. Meta interrupts a person who has not started looking yet, which makes it slower, cheaper per lead, and better for two specific jobs: filling a specialty group or program, and building a pipeline for a practice whose calendar is not yet full.
If your only problem is that you have three openings this month, run Google first. The Google Ads guide covers that. If you are launching a couples intensive, a teen DBT group, a perinatal specialty, or opening a second office, Meta is usually the cheaper way in.
The targeting rules you cannot get around
Meta classifies mental health as a sensitive category. You cannot target people by interest in depression, anxiety, therapy, or any health condition, and detailed targeting options that once existed there have been removed. You also cannot imply in the ad that you know something about the viewer. "Struggling with anxiety?" pointed at an individual reads to Meta's reviewers as an assertion about personal health attributes, and it gets rejected or, worse, approved and then disapproved after it starts spending.
What you can do:
- Target by geography, tightly. A ten to twenty mile radius around the office, or the specific towns you serve.
- Target by age and, where genuinely relevant to the service, gender. A perinatal program targeting women 25 to 42 is fine.
- Target broadly and let the creative do the qualifying. This is now the better approach anyway, because Meta's delivery system finds the responsive audience faster than manual targeting does.
- Build lookalike audiences from your own website visitors and video viewers rather than from a client list. Never upload a client list to an ad platform. That is the line, and it is not a close call.
Write the ad in the third person and about the service, not about the viewer. "Our practice runs an eight-week group for new mothers in Boulder. Thursday evenings, starts October 6." That passes review and it converts better, because it is concrete.
The creative that works
Three formats carry almost all the performance in this category.
The clinician-to-camera video, 30 to 60 seconds, shot on a phone, vertical, no script read off a screen. The clinician says who the service is for, what happens in a session, what it costs, and how to start. This outperforms every polished production we have run. People are choosing a person, and a stiff corporate video hides the person.
The plain-text-on-color image with one specific line: "Couples counseling in Fort Collins. Openings Tuesday and Thursday evenings. $180 per 80-minute session." Boring, cheap to make, and consistently the second-best performer.
The carousel that answers the four questions one card at a time: what we treat, what it costs, do we take your insurance, how soon you can be seen. Good for cold audiences who have never heard of you.
Avoid: stock photos of a person with their head in their hands, quotes over sunsets, and anything that implies the viewer has a condition. Also avoid before-and-after framing entirely. It is a testimonial by another name and it is the fastest way into an ethics problem.
Offers that get a response
A cold Meta audience will not book a $180 session from a first ad. Give them a step that costs less.
- A free 15-minute consultation call, with a real calendar link. Highest intent, lowest volume.
- A group or workshop with a start date and a price. Deadlines create response.
- A short guide worth downloading: "What actually happens in the first three couples sessions", four pages, no email gymnastics. Cheapest leads, weakest intent, requires real follow-up.
- Waitlist registration for a specialty you are launching. Costs almost nothing and tells you whether the specialty has demand before you build it.
Never offer a discount off a session fee as the hook. It attracts price shoppers, it anchors your fee downward for everyone who sees it, and it does not increase show rate.
Budgets and what to expect
Start at $20 to $40 a day. Below $15 a day Meta cannot exit the learning phase on a lead campaign and results stay noisy. One campaign, one or two ad sets, three to five creatives. Let it run 10 to 14 days before judging.
Realistic numbers in most US metros: $8 to $35 per lead on a specialty offer, $30 to $90 per booked consultation once no-shows are counted, and a 30 to 50 percent show rate on free consultation calls unless you confirm them properly. That show rate is the number most practices ignore and it is the one that decides whether the channel pays.
Confirm every booked call twice: an immediate text with the time and the clinician's name, and a reminder two hours before. That alone typically moves show rate from the high thirties to the mid sixties.
Retargeting, carefully
Retargeting works here, but the sensitivity is real. Someone who visited your anxiety page does not want an ad following them around that says "still struggling with anxiety". Retarget with neutral, practice-level creative: the clinician introduction video, an openings announcement, a workshop. Cap frequency at two or three impressions per week, and exclude anyone who has already submitted a form.
Install the Meta pixel on the site but do not fire custom events that name a condition. An event called "viewed_trauma_page" sitting in an ad account is exactly the kind of data you should not be creating. Track page views and form submissions, nothing more granular.
How this fits with everything else
Meta produces awareness and cheap leads. It does not produce ready-to-book demand at the volume Google does. The practices that get the most out of it use Meta to build an audience and Google to convert one, and they run both against a website that answers the four questions. The website guide covers the page those clicks land on, and the benchmark report shows how little competition most local practices actually face.
Frequently asked
Will my ad get rejected? Some will, and rejection is normal rather than a mark against you. The usual causes are second-person health language, implied personal attributes, and the words "you" plus a condition in the same sentence. Rewrite in the third person and resubmit.
Should I use Instant Forms or send people to my site? Instant Forms produce two to four times the lead volume at a lower cost and a much lower show rate, because the friction is gone. Use them for waitlists and workshops. Send consultation requests to a real page.
Do I need to post organically for the ads to work? No, but an empty profile hurts. A visitor who clicks your name should find a headshot, an office photo, hours, and a handful of posts from this year. Ten posts is enough.
If you want the campaign built, written and monitored, Meta ads are one of the services in the free 14-day trial. Text or call (385) 832-6175.