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I would't recommend using black hat SEO because the short-term gains often lead to ranking later. I would focus on strong content, technical SEO, and building authority for results that last.

I'm not in therapy myself, but I know it helps many people when they find the right therapist. Like any service, the experience depends a lot in the person you're working with.

I usually find broken backlinks with Google Search Console or Ahrefs, then fix them by adding a 301 redirect the missing page. If the links has no value. I simple ignore it instead or trying to remove it.

I think karma still helps, especially for joining some communities, but it's not the main factor anymore. Good content, being active, and posting in the right subreddit seem to matter much more now.

For me, the biggest change came from publishing helpful content consistently and targeting low-competition keywords. Once few posts started ranking. the traffic grew much faster.