This Clinician Embodies Mindfulness In Private Practice—With Powerful Results

Many people have an incomplete picture of what a mindfulness practice entails. Before she started a practice of her own, Nikki Rubin, PsyD was one of those people.  Eventually though, in her training as a therapist and a student of mindfulness, she started to realize that mindfulness can be useful in her work as a private practitioner. 

Now, Rubin specializes in mindfulness-based third-wave cognitive behavioral therapy (CBT), which represents an evolution of traditional cognitive behavioral treatment approaches. Balance, curiosity, and flexibility are all important themes in the clinical work Rubin provides—as is mindfulness. She has come to realize that these principles can also be applied to her business, and can help her sustain and grow her practice.

4 Ways to Bring Mindfulness into Private Practice

Rubin realized early on in her career that every private practice has two equally important sides—the clinical and the business side. Rubin naturally gravitated toward clinical work. What surprised her was just how much she embraced her entrepreneurial spirit as well.

“There’s a lot of problem-solving involved in clinical work,” says Rubin, who opened her private practice in New York in 2014 before moving to Los Angeles in 2018. “With business, it’s problem-solving in a different way. There’s also a creativity you can bring to it. For me, marketing creates a balance with my clinical work.”

There are four guiding lights that Rubin uses to honor mindfulness in private practice. 

1. Set parameters.
Like a mindfulness practice, setting and maintaining boundaries requires a conscious, intentional effort. It doesn’t just happen overnight, and part of Rubin’s effort to apply mindfulness in private practice is to set—and then honor—her parameters. 

What hours will you work, and what types of clients will you see? What are your fees or cancellation policy? How often will you pay yourself? When clinicians don’t take the time to think through the answers to these questions, they often end up feeling unhappy and burnt out, says Rubin. “This is a business. That doesn’t diminish or minimize the care that we provide to our clients,” she adds.

Sitting down and setting these parameters will force you to evaluate how much you can—and want—to work. Building in time for self-care and other things that make you happy is a crucial part of avoiding burnout and making sure you can provide the care your clients need. 

2. Be flexible—when necessary.
Especially as you’re growing your business, you may need to be flexible. For instance, some clinicians prefer not to see clients at 8AM. But, Rubin says, there may be times where you do need to open that 8 AM slot if you’re trying to grow. When and how you’re flexible comes back to the parameters you set for yourself. Be clear about what areas you’re willing to have flexibility in, and what areas are non-negotiable. 

Flexibility also relates to administrative tasks. “Mindfulness in private practice is about increasing your behavioral repertoire—being able to do things differently based on what the context dictates,” she says. For example, in the past, Rubin didn’t email clients because she didn’t want to be digitally connected 24/7 checking and responding to messages. She also feared that clients would use email for clinical conversations that are more appropriately addressed face-to-face. 

However, as technology evolved to include secure messaging through a client portal, Rubin decided to give it a try. “I decided to try it because I felt I could maintain boundaries,” she says. “I don’t use my personal email. Once I terminate with someone, they don’t have access to secure messaging. I also get the convenience of not having to play phone tag, which has been really nice.”

3. Plan for ups and downs.
“Being mindful is about being able to stay the course,” says Rubin. When their caseload is down, some therapists make the mistake of lowering their rates, working any day or time, or accepting patients who aren’t a good fit. “This inevitably leads to burnout,” she adds. “For me, it’s about planning for the dips and being able to ride them out without reacting impulsively and making decisions that don’t align with my values or mission for my business.”

Creating passive revenue streams helps Rubin compensate for times when she’s less busy. To build up those additional sources of revenue, Rubin teaches university courses, facilitates workshops, and teaches several online continuing education courses—including one about integrating mindfulness into clinical practice. She also sublets some of her office space to other clinicians, and provides supervision and consultation to licensed therapists. 

There are only so many hours in a day to see clients, and that’s not counting the behind-the-scenes admin work that you don’t get paid for. Building up additional sources of revenue allows you to worry less if your caseload is lighter than you would like. “With passive income, once the initial work is done, you can collect income without additional effort,” she says. 

“For me, it’s about planning for the dips and being able to ride them out without reacting impulsively and making decisions that don’t align with my values or mission for my business.”

4. Remain curious.
This includes being curious about new technologies that can enhance practice management, your overall efficiency, and client satisfaction. It also means being curious about building relationships with other providers who can provide referrals, professional support, and even friendship. 

For Rubin, those person-to-person connections make a huge difference. She makes professional connections through other colleagues, conferences, networking events, and even through her clients. “I don’t think there’s a marketing tool that can replace real human connection. I really enjoy building relationships with other clinicians,” says Rubin.

At the end of the day, honoring mindfulness in private practice has helped Rubin create and sustain a busy and balanced practice. “Some people are too rigidly attached to one way of doing things, so then they make choices based on how things should work as opposed to what actually works. Then they become really frustrated,” she says. “Mindfulness helps me shift things that aren’t working, and it helps me stay organized in moving forward.”

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