Now, if you own a therapy practice in the United States, there has been a time when someone from Yelp has tried selling something to you by telling you that "your clients are searching for you on Yelp right now".

Well, it does happen because Yelp profiles are ranked high on Google and many millions of people access Yelp every month.

Whether you should spend money on advertising on Yelp or not is another issue altogether. This is how it is; cost, confidentiality issues, and what you need to be wary of before entering into any contract.

Yelp ads work on a cost-per-click model, similar in spirit to Google Ads which we've covered in detail in our guide to whether Google Ads are worth it for therapists. A few essentials: 

• There is a monthly budget limit set, and you pay per click, at prices that can differ significantly depending on the category and market. Use the estimates provided in your Yelp account rather than average industry-wide estimates, which are inaccurate.

• Be careful when looking over the details of the contract. Self-serve advertising is usually cancellable, but the packages offered by the telesales team from Yelp always had term commitments. Look over what you're going to sign before the sales team pressure you into anything.

• Yelp is very US-focused. Its users are predominantly Americans, thus its marketing value is low for a UK-based practice — something we will discuss again later. No matter the numbers, testing requires budgeting for a few months and calculating calls and bookings per click, but not clicks themselves, let alone impressions.

The big difference with Google: On Yelp, you pay for clicks that come from individuals browsing the directory, while with search ads, you get individuals searching for help.

People browsing convert at a lower rate, hence the reason why business owners have mixed feelings regarding Yelp ads: Some love them while others eventually give up on them after a few months of disappointment.

For therapists the maths is manageable only because you need so little. As we worked out in How Many New Clients Does a Therapy Practice Actually Need Per Month?, a set solo business requires merely two or three customers per month. Had Yelp brought you just one or two of these, it would have justified itself to a great extent.

Whether this is true about you and your town is precisely the kind of study to carry out.

Yelp's most controversial feature is its automated recommendation filter. Reviews the algorithm deems insufficiently trustworthy are hidden behind a "not currently recommended" link and business owners have complained about this for years.

The FTC has acknowledged receiving over 2,000 complaints about Yelp since 2008, many centring on filtered reviews, and lawsuits alleging review suppression have repeatedly made headlines (though courts have consistently rejected the strongest claims, and Yelp maintains — with some supporting research — that its filter catches fake reviews that competitors' platforms leave up).

Yelp insists advertising plays no role in filtering, and no court has found otherwise. But the practical reality for therapists is this: you cannot ethically solicit client reviews. 

Soliciting reviews violates Yelp's own guidelines, and more importantly, a client publicly reviewing their therapist inherently discloses they're in therapy — something professional ethics make inappropriate to encourage. So your Yelp presence will grow slowly and unpredictably, if at all. Don't build a marketing plan on a review pipeline you can't cultivate.

One absolute rule: never be tempted by services selling fake reviews. As of 2026, buying fake reviews is a federal offence in the US, with fines exceeding $50,000 per violation — and for a licensed clinician, the reputational damage would dwarf the fine.

But here’s the catch that Yelp doesn’t tell you when trying to sell their services: every penny spent on directory advertising goes straight to rent. The minute you stop paying – your listing stops being visible. Having your own website through therapy SEO is the complete opposite approach – it’s an asset you own that works on its own month after month without paying per click cost.

It certainly takes time: rankings take months, not days. However, every click coming from organic searches costs you nothing while with Yelp and Google Ads you are charged for every single visit. Moreover, a website built through proper SEO uses exactly those keywords that your potential clients use “CBT for panic attacks Leeds”, “EMDR therapist close to me” etc.

Our guide to the best EMDR and CBT keywords shows how to structure that content, one problem per page, and our walkthrough on outranking Therapy Today on Google proves a small practice site can beat the big directories at their own game.

The practical sequencing for most therapists is therefore: claim the free listings everywhere (Yelp included), invest the real budget in therapy SEO, and only then consider paid channels — Yelp included — as a measured experiment rather than a standing expense.