1. Executive summary
The account currently runs its entire paid budget through a single Performance Max campaign whose efficiency has declined for several months, while all keyword Search sits paused. This plan reallocates the same $30,000 monthly budget into a clearer, more measurable structure without increasing spend.
The recommended structure has three parts:
- Performance Max (60%, $18,000/mo): retained as the primary campaign but corrected — conversion goals locked to booked-revenue actions, brand traffic excluded, and creative refreshed to reverse the decline. Budget is held flat until efficiency recovers.
- Non-brand Search (30%, $9,000/mo): three new campaigns organised by clinical modality (EMDR & Trauma, Couples & Gottman, DBT), built only on terms with a proven conversion history.
- Brand Defense and Reserve (10%, $3,000/mo): a dedicated brand campaign to capture name searches efficiently, plus a held-back reserve for testing once the core is stable.
All work is designed around CCG's confirmed unit economics (cost per acquired client of approximately $631 against a client lifetime value of $1,768–$2,321) and remains within the practice's compliance requirements: self-pay / out-of-network positioning, no insurance messaging, no outcome guarantees, and no protected health information in any tag, audience, or feed.
2. Current account state
2.1 What is running
A live gax API pull for 1 January – 30 June 2026 shows the following delivery:
| Campaign group | Type | Status | Spend | Conversions | Cost / conv. |
|---|---|---|---|---|---|
[PMAX][STANDARD][ALL GEOs] |
Performance Max | Enabled | $180,987 | 557 | $325 |
| 8 × local Performance Max campaigns | Performance Max | Paused | ~$7.7K each | 96–246 each | $31–$81 (see note) |
| 7 × keyword Search campaigns | Search | Paused | $91,364 total | 162 total | $419–$968 |
Display \| DBT Child \| Parents |
Display | Paused | $0 | 0 | — |
The account holds 38 campaigns in total (25 Search, 12 Performance Max, 1 Display). Only the single Standard Performance Max campaign is currently live.
2.2 Key findings
-
Performance Max efficiency is declining. Return on ad spend fell from 2.86× to 1.26× between March and June on flat spend — the characteristic signature of creative fatigue. The campaign runs on one enabled asset group while 16 others sit paused.
-
The paused local campaigns are not a reusable asset. Their apparent $31–$81 cost-per-conversion is a measurement artefact: they were optimised toward a $0 ad-extension-tap goal rather than booked clients. This plan does not revive them.
-
Search is starved and structurally inefficient. When active, Search held only 10–12% impression share, with 33–45% of available impressions lost to budget. Approximately $23,000 of historical keyword spend produced zero booked clients.
-
Conversion tracking is diluted. The account carries six or more overlapping lead actions and ten or more call actions. A single inquiry can trigger several at once. Across the live campaign, 556 bidding conversions sit against 22,404 all-conversions — a 40× gap composed of micro-actions.
2.3 Unit economics (client-confirmed)
Drawn from CCG's own reporting (Therapy Notes, through January 2026):
| Metric | Value |
|---|---|
| Average revenue per session | $72.82 |
| Sessions per client | 24.28–31.87 |
| Client lifetime value | $1,768–$2,321 |
| Cost to acquire a client (CAC) | $631 |
| LTV : CAC ratio | 2.8× – 3.7× |
| Clinical intake capacity | ≈ 117 new clients / month |
The ratio is already at or above the 3:1 industry benchmark. The objective is therefore to hold CAC at or below $631 while increasing intake volume, trending toward a 3:1 ceiling of roughly $590.
3. Strategic framework
Six principles govern the rebuild:
- Make spend legible. Divide the single Performance Max campaign so each dollar maps to a readable intent tier rather than one opaque pool.
- Separate brand from non-brand. Capture brand searches through a dedicated, low-cost campaign so reporting reflects the true cost of new demand.
- Rebuild Search on proven terms only. Re-open non-brand Search exclusively against keywords with a conversion history, with the historical waste list applied as negatives from launch.
- Repair Performance Max before scaling it. Lock conversion goals, refresh creative, and stabilise efficiency before introducing a target ROAS or additional budget.
- Weight toward what already works. Favour mobile devices and the strongest-performing geographies; place underperforming markets on a defined review period.
- Respect learning periods. Each goal, bid-strategy, or structural change resets machine learning for one to two weeks. Stage these changes; never apply two resets to the same campaign at once.
4. Budget allocation
Target steady-state allocation (reached at approximately Month 3):
| Campaign | Type | Bid strategy | Monthly budget | Share |
|---|---|---|---|---|
| Performance Max (refreshed) | Performance Max | Max Conv. Value → tROAS | $18,000 | 60% |
| Search — EMDR & Trauma | Search | Max Conv. → tCPA $400 | $4,500 | 15% |
| Search — Couples & Gottman | Search | Max Conv. → tCPA $425 | $2,700 | 9% |
| Search — DBT | Search | Max Conv. → tCPA $500 | $1,800 | 6% |
| Brand Defense | Search | Max Conv. → tImpr. Share | $1,500 | 5% |
| Reserve / Test | Search or Video | Max Conv. | $1,500 | 5% |
| Total | $30,000 | 100% |
This represents a reallocation of existing spend, not additional budget.
5. Performance Max — changes
Performance Max remains the largest line because it is the only campaign type delivering Google Maps presence, broad reach, and remarketing that keyword Search and organic listings cannot. It is corrected in place; no new Performance Max campaign is created, and the eight paused local campaigns are not revived.
Changes are grouped by function below and consolidated in §5.6. Items that reset the learning period are marked [L].
5.1 Measurement and read-accuracy (implement first)
These changes make the account's numbers trustworthy and should precede any bid or budget change.
| # | Change | Detail |
|---|---|---|
| 1 [L] | Lock the bidding conversion goal to deep-funnel actions only | Retain Won, Won Calls, and Stage: Consult Scheduled in the bidding column. Demote all page views, ad-extension taps, "Click Learn More," "Click Book Appointment," and local actions to secondary (tracked but not bid toward). |
| 2 | Report on primary conversions only | Remove all-conversions from dashboards and optimisation reads. |
| 3 | De-duplicate conversion actions | Define one primary lead action and one primary call action per funnel step; set all others to secondary. |
5.2 Brand isolation
| # | Change | Detail |
|---|---|---|
| 4 [L] | Apply a brand-exclusion list | Create and apply a CCG_BRAND exclusion. No exclusion exists today; over 1,699 brand clicks currently run through Performance Max at blended cost. |
| 5 [L] | Remove the counseling center group search-theme signal |
Feeding the brand as a signal directs the campaign toward existing brand searchers. Bundle with change 4 to share one learning reset. |
| 6 | Remove the where can i find free therapy signal |
CCG is premium self-pay; this term attracts non-qualifying demand. |
| 7 | Resolve the lifestance health arlington va signal |
Retain only if competitor conquesting is intentional; otherwise remove. |
Brand traffic is captured instead by the dedicated Brand Defense campaign (§6.3). After these changes, the campaign's true non-brand efficiency should be re-measured.
5.3 Creative and audience
| # | Change | Detail |
|---|---|---|
| 8 [L] | Refresh creative and activate asset-group diversity | 17 asset groups exist; only General Brand is enabled, concentrating all spend in one ageing creative pool. Rebuild and enable modality groups for EMDR & Trauma, Couples, and DBT with fresh video and imagery. Do not build new IFS or CBT creative, which do not convert. This is the highest-leverage performance change. |
| 9 | Clean asset-group naming and hygiene | 14 asset groups carry "unknown" ad strength (unfinished) and several are mislabelled. Resolve before activation. |
| 10 | Strengthen audience signals | General Brand carries 50 search-theme signals but only one audience signal. Add remarketing lists, Customer Match (hashed email only), and in-market therapy / mental-health audiences. |
5.4 Bidding, budget, and geography
| # | Change | Detail |
|---|---|---|
| 11 | Hold budget flat at $18,000/mo | Do not scale into a declining return; allow the creative refresh to take effect first. |
| 12 [L] | Introduce a target ROAS only after efficiency stabilises | Set near the trailing achieved ratio (recently ~1.7–2.0×), not a hard target applied mid-decline. |
| 13 | Re-weight geography | Increase emphasis on Florida (2.69× value-to-spend); place Washington DC (1.02× on ~$21K over six months) on a defined review period. |
| 14 | Remove West Virginia targeting | If its current zero-spend presence is unintended. |
5.5 Account hygiene
| # | Change | Detail |
|---|---|---|
| 15 | Adopt a mobile-first landing-page standard | Mobile converts roughly four times more efficiently than desktop ($232 vs $933 per conversion). Performance Max offers no device bid control, so this is addressed through landing-page speed, message match, and tap-to-call placement. |
| 16 | Run a placement-exclusion pass | Exclude the low-quality display and website long tail (junk apps, made-for-advertising sites). |
| 17 | Verify Final URL Expansion | If enabled, add a page feed limited to modality and location pages and exclude non-converting blog URLs. |
| 18 | Extend negative keywords | Add informational and symptom-led terms (e.g. bipolar disorder symptoms, ocd symptoms, adhd symptoms in kids, how to deal with a narcissist, neurodivergent). |
5.6 Consolidated change register
| # | Change | Area | Learning reset |
|---|---|---|---|
| 1 | Lock bidding goal to Won / Won Calls / Consult Scheduled | Measurement | Yes |
| 2 | Report on primary conversions only | Measurement | — |
| 3 | De-duplicate conversion actions | Measurement | — |
| 4 | Apply CCG_BRAND brand-exclusion list |
Brand isolation | Yes |
| 5 | Remove counseling center group signal |
Brand isolation | Yes (with #4) |
| 6 | Remove where can i find free therapy signal |
Brand isolation | — |
| 7 | Resolve lifestance health arlington va signal |
Brand isolation | — |
| 8 | Refresh creative; activate EMDR / Couples / DBT groups | Creative | Yes |
| 9 | Clean asset-group naming and hygiene | Creative | — |
| 10 | Add audience signals | Audience | — |
| 11 | Hold budget flat at $18,000 | Budget | — |
| 12 | Introduce target ROAS after stabilisation | Bidding | Yes |
| 13 | Re-weight geography (Florida up; DC on review) | Geography | — |
| 14 | Remove West Virginia targeting | Geography | — |
| 15 | Mobile-first landing-page standard | Device | — |
| 16 | Placement-exclusion pass | Placements | — |
| 17 | Verify Final URL Expansion; add page feed | URLs | — |
| 18 | Extend negative keywords | Negatives | — |
5.7 Sequencing
Learning resets are spaced so that no single change blinds the campaign more than necessary:
| Week | Changes | Reset |
|---|---|---|
| 1 | 1, 2, 3, 4, 5, 6, 18 | One reset (changes 1 and 4/5 together) |
| 2–4 | 9, then 8, then 10 | One reset (change 8) |
| 5–6 | 17, 16, 13, 14, 15 | None |
| 7+ | 12 | One reset |
6. Search — new campaign build
All Search campaigns are built new. No legacy keyword campaign and no local Performance Max campaign is revived; historical data is used only to identify which terms have converted.
6.1 Structural approach: modality-led, geography as ad groups
Clinical modality is a far stronger predictor of cost-efficiency than geography. Across the historical data, cost per acquisition by modality spans roughly 14× (from $389 to over $5,400), while the geographic spread is only 1.7× ($454 to $786).
| Modality | Historical spend | Conversions | Cost / acq. | Decision |
|---|---|---|---|---|
| EMDR & Trauma | $25,498 | 65.5 | $389 | Primary investment |
| Couples & Gottman | $12,863 | 30.4 | $423 | Build |
| DBT | $6,939 | 13.5 | $514 | Build (on-brand) |
| IFS | $4,650 | 1.0 | $4,650 | Exclude |
| CBT | $3,420 | 1.0 | $3,420 | Exclude |
| Online / Virtual (generic) | $2,716 | 0.5 | $5,431 | Exclude |
Accordingly, the build uses three modality campaigns, each with one ad group per geography. This pools conversion signal at the campaign level so target-CPA bidding has sufficient data, while keeping per-geography performance visible for budget weighting and localised negatives.
Geographic cost per acquisition, for bid weighting: Virginia $454, New York $480, Maryland $533, Washington DC $556, Florida (Boca) $619, New Jersey $786.
A notable pattern: the same keyword can perform very differently by market. emdr therapy near me converted well in Virginia ($201) and New York ($109) but produced no conversions on $880 of spend in Washington DC. Geography-level ad groups allow such terms to be excluded only where they fail.
6.2 Settings shared by all Search campaigns
| Setting | Value |
|---|---|
| Networks | Search only; Search Partners off, Display Expansion off at launch |
| Location targeting | Presence ("people in") for inclusions and exclusions |
| Language | English |
| Devices | Mobile-first; confirm landing-page tap-to-call and booking above the fold |
| Ad rotation | Optimise |
| Brand safety | Brand terms added as campaign-level negatives on every non-brand campaign |
| URLs | Final URL set to the matching modality × location page; auto-tagging on; consistent UTM parameters |
| Ads per ad group | 2–3 responsive search ads, each with ≥10 headlines and 4 descriptions |
| Bid strategy ramp | Launch on Maximise Conversions, transition to target CPA per §6.10 |
6.3 Brand Defense — $1,500/mo
Purpose: capture brand-name searches efficiently. Performance Max currently absorbs these searches at its blended cost; a dedicated brand campaign captures them at low cost-per-click and high return, and allows Performance Max to focus on incremental non-brand demand. Brand demand is finite, so this campaign will not spend its full budget unless extended to competitor conquesting.
Bid strategy: Maximise Conversions, transitioning to Target Impression Share (90%+, top of page) once stable.
Ad groups and keywords:
| Ad group | Keywords (match type) |
|---|---|
| Core Brand | counseling center group, the counseling center group, ccg therapy, counseling center group [city] (exact + phrase) |
| Brand × State | counseling center of maryland / new york / virginia / florida / new jersey, bethesda counseling center (phrase) |
Negatives: jobs, careers, login, patient portal, free, competitor brand names.
Responsive search ad (pin headline 1 to position 1 for brand integrity):
Headlines: The Counseling Center Group · Official CCG Therapy Site · Book With CCG Directly · Evidence-Based Therapists · DBT, EMDR, Gottman & More · In-Person & Virtual Care · Specialist-Matched Therapy · Short-Term, Skills-Focused · Out-of-Network Practice · Book a Free 15-Min Consult · Find Your CCG Therapist · Therapy That Works for You · Trusted Local Therapists · Counseling Center of [State] · Start With a Free Consult
Descriptions: 1. Book directly with The Counseling Center Group. Evidence-based, specialist-matched care. 2. DBT, EMDR, Gottman and trauma therapy, in person or virtual. Free 15-minute consult. 3. Out-of-network practice with transparent self-pay rates. We submit OON paperwork. 4. Matched to the therapist whose expertise fits your needs. Book your consult today.
6.4 EMDR & Trauma — $4,500/mo, target CPA $400
| Ad group | Geography | Seed keywords (match) — historical cost/acq. |
|---|---|---|
| EMDR — VA | Virginia | emdr therapy near me (broad, $201) · emdr treatment center (phrase, $474) · trauma therapist [city] va (phrase) |
| EMDR — NY | New York City | emdr therapy near me (broad, $109) · trauma counseling nyc (broad, $272) · emdr therapy nyc (exact, $438) · emdr trauma specialist (phrase, $336) |
| EMDR — MD | Maryland | trauma therapist maryland (phrase, $106) · emdr therapist maryland (exact, $226) |
| EMDR — DC (review period) | Washington DC | trauma therapist dc (phrase, $98) · emdr therapy dc (exact, $232). Add emdr therapy near me as a geo-negative. |
| EMDR — FL (expansion) | Boca Raton / Miami | EMDR boca raton (broad, $177) · emdr therapy [city] fl (phrase). Start with a low cap. |
Excluded as negatives (≥$300 historical spend, zero conversions): trauma therapy emdr (exact), emdr treatment center new york, emdr therapist washington dc, ptsd therapy emdr (DC), emdr therapy maryland (exact), emdr therapy nj (exact).
Responsive search ad (substitute [City] / [State] per ad group):
Headlines: EMDR Therapy in [City] · Evidence-Based EMDR Care · Trauma Therapy in [State] · EMDR for Trauma & PTSD · Specialist-Matched EMDR · Trauma-Informed Therapists · Short-Term, Skills-Focused · In-Person & Virtual EMDR · Licensed EMDR Therapists · Book a Free 15-Min Consult · Heal at Your Own Pace · Care That Meets You · Out-of-Network Practice · Transparent Self-Pay Rates · Matched to an EMDR Specialist
Descriptions: 1. Evidence-based EMDR with a therapist matched to you. In person in [City] or virtual. 2. Process trauma with structured, short-term EMDR care. Book a free 15-minute consult. 3. Out-of-network practice with transparent self-pay rates. We submit OON paperwork. 4. Trauma-informed specialists across [State]. Start with a free consultation today.
6.5 Couples & Gottman — $2,700/mo, target CPA $425
| Ad group | Geography | Seed keywords (match) — historical cost/acq. |
|---|---|---|
| Couples — VA | Arlington / N. Virginia | couples therapy arlington va (broad, $76 — the account's strongest converter) · gottman marriage counseling (phrase, $185) · relationship therapy virginia (broad, $290) |
| Couples — NY | New York City | marriage counseling nyc (broad, $266) |
| Couples — DC | Washington DC | washington dc couples therapy (exact, $445) |
| Couples — NJ (monitor) | New Jersey | relationship therapy new jersey (broad, $852) — low cap; review closely |
Excluded as negatives: couples therapy maryland (phrase), gottman couples counseling (NY, phrase).
Copy for this campaign must remain warm and free of clinical jargon, and must never imply a guaranteed outcome or reconciliation.
Responsive search ad:
Headlines: Couples Therapy in [City] · Gottman-Method Therapists · Marriage Counseling [City] · Reconnect With Your Partner · Evidence-Based Couples Care · Specialist-Matched Therapy · Therapy for Couples [State] · In-Person & Virtual Sessions · Short-Term, Skills-Focused · Book a Free 15-Min Consult · Communicate Better Together · Out-of-Network Practice · Transparent Self-Pay Rates · Matched to a Couples Expert · Strengthen Your Relationship
Descriptions: 1. Gottman-informed couples therapy with a specialist matched to you. In person or virtual. 2. Evidence-based tools to communicate and reconnect. Book a free 15-minute consult. 3. Out-of-network practice with transparent self-pay rates. We submit OON paperwork. 4. Couples and marriage therapists across [State]. Start with a free consultation today.
6.6 DBT — $1,800/mo, target CPA $500
DBT is an on-brand strength: CCG's DBT-Linehan Board Certification is a verifiable credential and should lead the messaging.
| Ad group | Geography | Seed keywords (match) — historical cost/acq. |
|---|---|---|
| DBT — NY | New York City | dbt therapy near me (broad, $230) |
| DBT — NJ | New Jersey | dbt counseling (phrase, $335) |
Excluded as negatives: dbt treatment program (VA), dbt therapy near me (DC, geo-negative), dbt skills group dc, dbt program virginia, DBT Skills Group Online (NY). "Skills group," "program," and "online" variants convert poorly; retain only "dbt therapy / counselling near me / [city]."
Responsive search ad:
Headlines: DBT Therapy in [City] · DBT-Linehan Board Certified · Evidence-Based DBT Care · DBT Skills for Daily Life · Specialist-Matched DBT · In-Person & Virtual DBT · Short-Term, Skills-Focused · Licensed DBT Therapists · Book a Free 15-Min Consult · DBT for Emotion Regulation · Out-of-Network Practice · Transparent Self-Pay Rates · Matched to a DBT Specialist · Tools You Can Use Every Day · DBT Counseling in [State]
Descriptions: 1. Evidence-based DBT from DBT-Linehan Board Certified therapists. In person or virtual. 2. Build skills for emotion regulation and daily life. Book a free 15-minute consult. 3. Out-of-network practice with transparent self-pay rates. We submit OON paperwork. 4. Specialist-matched DBT care across [State]. Start with a free consultation today.
6.7 Match-type policy
Historical performance favours broader match types because the exact-match set skewed toward generic, high-cost head terms: broad match averaged $477 per acquisition, phrase $596, and exact $698.
- Default to broad and phrase on local-intent terms (
[modality] near me,[modality] [city/state]). This is safe only because the negative-keyword footprint below is substantial and Smart Bidding governs delivery. - Use exact match only for proven city-modality combinations (e.g.
trauma therapist dc,emdr therapy dc,washington dc couples therapy). - Never run broad or phrase match on a generic single-modality head term (
emdr,cbt,therapy) without the negative list applied.
6.8 Shared negative-keyword list
Applied to all three non-brand campaigns, alongside the ad-group geo-negatives noted above:
| Category | Terms |
|---|---|
| Non-converting modalities | ifs, internal family systems, ifs therapist near me, cbt, cbt sessions, cbt counseling, cbt treatment, accelerated resolution therapy |
| Generic low-intent | online therapy near me, online therapist near me, online therapy, teletherapy, bare family therapy / family counseling services (retain only parent therapy) |
| Self-pay protection | free, free therapy, low cost, sliding scale, medicaid, medicare, insurance, in network, takes insurance, aetna, cigna, bcbs, united healthcare |
| Wrong service / safety | psychiatrist, medication, meds, crisis, hotline, suicide, emergency, 988 |
| Non-commercial / wrong persona | child, kids, teen, adolescent (unless a paediatric line is intended), jobs, careers, salary, degree, course, certification, training, how to become, definition, symptoms, quotes, worksheet |
| Geo-specific | emdr therapy near me and dbt therapy near me in the Washington DC ad groups |
6.9 Extensions and assets
Applied across the Search and Brand campaigns:
- Sitelinks: Book a Consult · Our Therapists · [Modality] Page · Locations · Pricing & Insurance FAQ · How It Works
- Callouts: Evidence-Based Care · Short-Term Focus · In-Person & Virtual · Specialist Matching · Out-of-Network · Free 15-Min Consult
- Structured snippets: Services — DBT, EMDR, Gottman, Trauma Therapy, Couples Therapy, Individual Therapy
- Call asset: CallRail tracking number, mapped to the primary call conversion action
- Location assets: the 16 Google Business Profile locations
- Lead-form asset: omitted, to preserve a single deduplicated conversion path and avoid protected health information in Google's form
6.10 Bidding ramp
Per campaign:
- Launch on Maximise Conversions with no cap and allow approximately two weeks, or 15–30 conversions, to accumulate signal.
- Transition to target CPA at the modality target ($400 EMDR, $425 Couples, $500 DBT). This resets the learning period.
- After three to four weeks at target, tighten toward the blended ceiling (~$590, with a stretch goal near $450) if volume holds.
- At six to eight weeks, decide whether the Washington DC ad groups have cleared their target; reallocate to Virginia or New York if not.
6.11 Reserve / Test — $1,500/mo
Held at launch and deployed once Performance Max has stabilised and the three Search campaigns are at target CPA. One of the following:
- Competitor conquest Search: competitor brand terms paired with "alternative," "reviews," or "vs" in CCG's strongest markets, with honest comparative copy and no competitor trademarks in ad text.
- YouTube remarketing: warm audiences only (site visitors, inquiries not yet booked, blog readers), reusing the refreshed Performance Max video. No cold prospecting at this stage.
7. Conversion tracking — recommendation
This section is a recommendation rather than a build prerequisite. The new Search campaigns can launch on the current setup; however, the cleaner the tracking, the more reliable every cost and efficiency figure in this plan becomes. We recommend completing it in parallel with the Week 1 work.
The account currently carries six or more overlapping lead actions and ten or more call actions, and a single inquiry can trigger several. Recommended cleanup, in priority order:
- Define one primary lead action and one primary call action per funnel step. Promote the deep-funnel actions —
Stage: Consult Scheduled,Won, andWon Calls— to the bidding column, and demote page views, ad-extension taps, and local actions to secondary. - Bid on the consultation or booking action; report on Won. Search bids toward the action with sufficient volume to learn, while results are reported as blended cost-per-Won against the $631 CAC benchmark.
- Build all reporting on primary conversions only, never all-conversions.
- Confirm CallRail and the single deduplicated call action are the sole source for phone leads.
- Re-audit monthly for newly created duplicate actions.
Until the deduplication is complete, reported cost-per-acquisition will read more favourably than reality. Treat early figures as directional and re-baseline once the cleanup is in place. No protected health information should appear in any conversion action, audience, Customer Match upload (hashed email only), or report.
8. Launch sequence
A 90-day phased rollout, ordered to produce attributable wins early given the account's recovery posture.
| Phase | Weeks | Actions |
|---|---|---|
| Stabilise | 1–2 | Apply Performance Max measurement and brand-isolation changes (§5.1–5.2). Launch Brand Defense. Build, but do not launch, the three Search campaigns and the shared negative list. |
| Re-open capture | 3–6 | Launch EMDR & Trauma and Couples & Gottman on Maximise Conversions. Begin the Performance Max creative refresh (§5.3). Hold Performance Max budget flat. |
| Introduce control | 7–10 | Launch DBT. Move stable Search campaigns to target CPA. Introduce a Performance Max target ROAS once efficiency has stabilised. |
| Optimise and test | 11–13 | Deploy the Reserve line. Decide on the Washington DC ad groups. Shift budget toward the strongest ad groups within the $30,000 envelope. |
9. Key performance indicators
| Indicator | Target |
|---|---|
| Blended cost per booked intake (Won) | ≤ $631; trending toward ≤ $590 (3:1 LTV:CAC) |
| Non-brand Search cost per booked intake | Below the $556 historical blend |
| Performance Max return on ad spend | Arrest the decline; recover toward ≥ 2.0× before scaling |
| Search budget-lost impression share | From 33–45% to below 15% on funded campaigns |
| Brand vs. non-brand reporting | Fully separated and reported independently |
| Mobile share of spend | Majority, with mobile-optimised landing pages |
| Washington DC efficiency | Clear target band within 6–8 weeks, or trim |
10. Compliance guardrails
Applied to every asset and setting:
- Self-pay / out-of-network positioning only; no insurance or in-network messaging.
- No outcome or cure guarantees.
- No crisis or urgency framing; crisis terms are routed to appropriate services (988).
- HIPAA-first: no protected health information in any tag, audience, Customer Match upload (hashed email only), feed, or report; a Business Associate Agreement is in place with every vendor.
- Brand self-claims are attributed, not asserted as independent fact.
- All monetary figures are directional planning ranges, not forecasts. Every historical metric is drawn from the live
gaxdata pull and the supporting audits; none is estimated.