Ranked Teletherapy Services Across 12 Cities in 8 Months Case Study
In 2025, a teletherapy brand partnered with Goforaeo to rank teletherapy services across 12 target cities and turn that visibility into steady consultation inquiries. The brand name is anonymized due to an NDA, and the metrics below come from GA4, Google Search Console, rank tracking, call or booking tracking, and Google Business Profile insights (where city level listings existed) for the dates listed.
Snapshot of Results
Timeframe: January 22, 2025 to September 22, 2025
Location: 12 target cities (multi city expansion)
Before vs after results:
- Cities with consistent page 1 visibility: 2 to 12
- Tracked keywords on page 1 (city + teletherapy): 18 to 96
- Top 3 placements (tracked): 3 to 24
- Non branded clicks (GSC): 820 to 2,980 per month
- Organic users: 3,100 to 9,400 per month
- Consultation requests (forms + schedule clicks): 74 to 235 per month
- Completed bookings: 48 to 142 per month
Context and Starting Point
Ranking teletherapy in multiple cities is not about making 12 copy paste pages. It requires correct city intent targeting, clean service differentiation, strong internal linking, and trust signals that reduce hesitation for online mental health care. At the start, the brand had decent national visibility, but city level rankings were inconsistent. Some cities had pages, but they were thin or overlapping. Others had no clear landing page at all, so the brand couldn’t rank reliably.
The goal was to build a scalable city system that ranks without cannibalization, while keeping content compliant and patient friendly.
Measurement Setup and City Level Reporting
Before scaling, we fixed tracking and created city segmented reporting so performance could be measured per city, per service type, and per device.
What we set up
- GA4 events for schedule clicks, booking completions, form submissions
- Cross domain tracking if scheduling tool used a separate domain
- Search Console regex filters for city page sets and city queries
- Rank tracking for each city across core teletherapy terms
- Looker Studio dashboard with city filters and weekly notes
- Call tracking where phone support existed
Diagnosis: Why City Rankings Were Unstable
We audited existing city pages, internal linking, and SERPs. The biggest issue was not lack of content volume, it was unclear page targeting and thin city relevance.
Key issues found
- City pages were too similar, creating duplication risk and weak differentiation
- Services were bundled, so Google didn’t know which page should rank
- Weak internal linking meant authority didn’t flow into new city pages
- Trust signals were not prominent enough for teletherapy conversion
- Titles and meta didn’t clearly communicate city + teletherapy intent
- FAQ content didn’t reflect the way people search locally
- Some city pages didn’t highlight therapist availability and process clearly
Strategy Overview
We built a repeatable system that scales across cities while staying unique. The plan had four layers: city hubs, service level pages, supporting content clusters, and trust plus conversion improvements.
Workstreams
- City landing pages built with unique local value sections
- Service differentiation across therapy types and issues supported
- Internal linking system connecting city hubs and service pages
- Supporting content clusters to build topical authority per service
- Snippet and CTR improvements for city intent searches
- Conversion flow improvements for booking completion
- E E A T improvements and compliance focused trust cues
City Page Framework That Ranked
We created a standard structure but wrote unique content per city based on demographics, query patterns, and what competitors emphasized. Each page was designed as a decision page.
What each city page included
- City specific intro with real locality context, not filler
- Clear teletherapy service overview and how sessions work
- Who the service is for and common reasons people book
- Therapist availability approach and what happens after booking
- Insurance or payment notes where applicable
- City relevant FAQs based on Search Console query patterns
- Prominent CTAs: schedule, request consultation, call support
- Trust blocks: credentials, privacy messaging, crisis guidance, support options
Unique city differentiation approach
To avoid duplication, we rotated focus per city based on real search behavior, such as:
- Anxiety therapy focus in some cities
- Couples therapy emphasis in others
- Stress and burnout framing in large metro areas
- Therapy for teens emphasis where demand showed up
- Multilingual support or flexible scheduling where applicable
Service Pages That Supported City Rankings
City pages rank better when there is a strong service layer behind them. We built and improved service pages so Google saw depth, and city pages could link into them without stuffing keywords.
Service pages built or expanded
- Teletherapy for anxiety
- Depression support therapy
- Couples therapy online
- Trauma informed therapy online
- Teen therapy and family support
- Therapy for stress and burnout
- Therapy for ADHD support (where applicable)
Each city page linked into the relevant service pages, and those service pages linked back to city pages via “available in these cities” sections.
Internal Linking and Architecture System
Internal linking made the multi city expansion stable. Without it, new city pages struggle to rank because they have no authority.
Linking system implemented
- A main locations hub page linking to the 12 cities
- City pages linking to relevant service pages and booking pages
- Service pages linking back to city pages where service is available
- Supporting content linking into service pages and city pages
- Clean breadcrumbs and navigation so pages were reachable within 2 to 3 clicks
Supporting Content Clusters for Local Query Coverage
We created supporting content that captured early stage intent and routed users into the correct city and service page. This increased long tail reach and made rankings more stable.
Content types created
- “Is teletherapy right for me” pages
- What to expect in the first session
- Insurance and payment FAQ pages
- Privacy and session setup guidance
- Therapist matching process explainers
- Symptom and issue pages that link into service pages
Trust and Compliance Improvements
Teletherapy conversions depend on trust. We improved credibility elements and ensured content stayed compliant and patient safe.
Trust and safety work
- Clear clinician oversight, credentials, and licensing messaging
- Privacy and data handling explanation without over claims
- Crisis and emergency guidance placement on relevant pages
- Transparent scheduling, cancellation, and support flow
- Author bios and medical review notes where applicable
- Review snippets and proof points where allowed
Conversion Improvements That Increased Bookings
We improved booking flow to increase completion rate. Many users don’t convert because scheduling feels like a commitment. We reduced friction and clarified steps.
CRO updates
- Sticky schedule button on mobile
- Reduced steps between page and scheduling tool
- Shorter forms and fewer required fields
- Clear “what happens next” confirmation messaging
- Added support chat or call option for hesitant users
- Improved page speed and removed distractions on city templates
Tools Used
GA4, Google Search Console, Looker Studio, rank tracking via Semrush/Ahrefs, Screaming Frog, PageSpeed Insights and Lighthouse, Microsoft Clarity or Hotjar, Google Tag Manager, call tracking, booking platform reports, schema testing tools.
Timeline With Dates, Monthly Numbers, and Natural Notes
January 22 to January 31, 2025
We audited existing city pages, fixed tracking for booking events, built the city keyword map, and designed a scalable city page framework that avoided duplication.
Month end metrics:
- Cities with page 1 visibility: ~2
- Non branded clicks: ~820
- Consult requests: ~74
- Completed bookings: ~48
February 2025
We launched the locations hub, rebuilt the first set of city pages, and improved titles and meta descriptions for CTR. Internal linking began flowing into city pages.
Month end metrics:
- Cities on page 1: ~4
- Non branded clicks: ~1,060
- Consult requests: ~92
- Completed bookings: ~61
March 2025
We expanded to more cities, improved service pages that city pages linked into, and added city specific FAQs based on real query patterns.
Month end metrics:
- Cities on page 1: ~6
- Non branded clicks: ~1,380
- Consult requests: ~118
- Completed bookings: ~76
April 2025
We published supporting content clusters, strengthened internal linking between cities and services, and improved trust sections across city templates.
Month end metrics:
- Cities on page 1: ~8
- Non branded clicks: ~1,820
- Consult requests: ~152
- Completed bookings: ~97
May 2025
We refined city pages based on ranking movement, reduced cannibalization between similar pages, and improved mobile conversion flow for scheduling.
Month end metrics:
- Cities on page 1: ~9
- Non branded clicks: ~2,140
- Consult requests: ~176
- Completed bookings: ~110
June 2025
We scaled the remaining cities, added more service support pages, and improved snippet clarity on high impression city queries to increase qualified clicks.
Month end metrics:
- Cities on page 1: ~10
- Non branded clicks: ~2,420
- Consult requests: ~198
- Completed bookings: ~124
July 2025
We doubled down on cities sitting between positions 4 to 10, improved internal linking depth, and strengthened E E A T elements to build trust for conversion.
Month end metrics:
- Cities on page 1: ~11
- Non branded clicks: ~2,710
- Consult requests: ~218
- Completed bookings: ~134
August 22 to September 22, 2025
We focused on stability, refreshed underperformers, maintained publishing cadence, and improved booking flow to increase completion rate. All 12 cities reached consistent page 1 coverage.
Month end metrics:
- Cities with page 1 visibility: ~12
- Non branded clicks: ~2,980
- Consult requests: ~235
- Completed bookings: ~142
Before and After Proof Summary
City rankings improved because pages were unique, internally connected, and backed by strong service depth. Supporting content expanded long tail coverage, and trust plus conversion improvements turned city traffic into bookings.
- Cities with page 1 visibility: 2 to 12
- Page 1 city keywords: 18 to 96
- Non branded clicks: 820 to 2,980 per month
- Completed bookings: 48 to 142 per month
What Made It Work
The biggest driver was building a scalable structure without duplication. City pages were unique, service pages provided depth, and internal linking distributed authority evenly. Trust signals reduced hesitation, and booking flow improvements increased completion rate.