As a clinical psychologist, and founder of The Couch Practice in South Africa, I have had the privilege of navigating the challenging yet rewarding intersection of clinical practice and entrepreneurial innovation for over a decade. My journey has been shaped by the trials and triumphs inherent to both spheres, fostering greater understanding of the critical balance between business acumen and compassionate care. In this article, I invite you to join me in thinking about mental health advocacy, effective leadership and the adaptability required to thrive in the ever-evolving healthcare landscape. My intention is to inspire you and share insights, to empower you to chart your own course of personal and professional growth.
Yumna Zubi, Clinical Psychologist and CEO of The Couch
How did your background lead you to a career in mental health?
Growing up in apartheid-era South Africa, I was exposed to stark inequalities and significant family challenges. My brother was diagnosed with cerebral palsy and hydrocephalus, conditions that profoundly impacted his ability to talk, eat, walk, and function normally. Hydrocephalus is characterized by an abnormal accumulation of cerebrospinal fluid in the brain's ventricles, leading to increased intracranial pressure and potential brain damage. Cerebral palsy refers to permanent movement disorders caused by abnormal brain development or damage to the parts of the brain that control movement, balance, and posture. My brother's cognitive abilities remained at the level of a five-year-old, adding further complexity to his care.
The bio-psycho-social causes of these conditions are complex, involving genetic, prenatal, and perinatal factors. During the 1980s, hydrocephalus was still being studied, and few medical treatments were available. Access to these limited treatments was further hindered by apartheid, exacerbating the challenges of obtaining proper care. My brother's life was a constant battle due to these limited resources, compounded by pervasive inequality and discrimination. Witnessing the daily discrimination and stigma he faced ignited a deep empathy within me and attuned me to the needs of vulnerable people, emphasizing the importance of advocating for those who are often overlooked or marginalized. This became the driving force behind my commitment to equality and fairness, especially in mental health care.
My brother's medical team said his prognosis was poor and, due to his complications, he had a high risk of mortality during childhood. Despite the odds, my mother was a beacon of resilience and unconditional love. She taught my brother to talk, walk, and eat. Even with a lack of resources and tailored medical support, she persisted in integrating him into society, treating us as normally as possible. My mother taught me to never give up and continually strived to give my brother the best quality of life. He underwent numerous surgeries due to fluid accumulation in his brain and spent much time in hospitals. At the age of 9, he eventually lost his vision following another surgery, and had to learn to function without sight. Surpassing initial expectations, he lived until the age of 31, cherishing people, music, nature, and food. His ability to love intensely and appreciate the beauties of life despite his struggles taught me to value the things we often take for granted. His love for life and ability to learn, combined with my mother's persistence, showed me the power of making a difference, no matter how small. This journey profoundly shaped my path into healthcare, emphasizing the importance of equality and fairness in providing care and support to those in need.
I carried these experiences into my professional life, initially volunteering at Golden Hours, a school for children with disabilities, and later being a voluntary counsellor at the South African Depression and Anxiety Group. In addition, I coordinated a practical Adult Basic Education and Training (ABET) course at the University of the Witwatersrand, intended to bridging the divide between inequality and advocating for fairness.
Such early experiences paved the way for pursuing a Master's Degree in Clinical Psychology. I gained invaluable clinical experience at the Tara H. Moross Centre, Chris Hani-Baragwanath Hospital, and Akeso Parktown. Working at Sizwe Tropical Disease Hospital with terminally ill, multi-drug resistant and extreme drug resistant tuberculosis (TB) patients had a profound impact on me. The experience drew my attention to the importance of being mindful of life’s fragility and the profound questions we face in confronting our mortality.
In 2013 I entered entrepreneurship as CEO of a private practice, The Couch. Over the past decade it became a space that embraces collaborative development of business courses, continuous professional development of workshops, volunteer programmes and innovative healthcare. The Couch’s precept "Heal. Learn. Grow" encapsulates our core values and vision for healthcare and business leadership. It represents commitment to facilitating the healing process, promoting continuous learning, and enabling personal and collective growth.
How do you integrate leadership principles into the healthcare space?
The integration of leadership principles into the healthcare space is a critical aspect of my approach. While corporate environments often employ a competitive model, at The Couch we prioritise a collaborative approach, with inclusivity paramount. Our leadership principles emphasise the active participation of all, challenging traditional top-down hierarchies. We believe that a work environment that encourages diverse perspectives empowers individuals to contribute more meaningfully to our collective goal of providing accessible, holistic treatment solutions.
Reflecting on our journey, I recognise that the growth of The Couch required the collective efforts of all team members. Through positive contributions and constructive feedback every individual played a vital role in shaping our practice. An inclusive approach fosters innovation, and creates a supportive environment where everyone feels valued and motivated to excel.
Furthermore, we developed a volunteer program, in which a team of aspiring psychologists collaborate to create psychoeducational content for various social media platforms and destigmatise mental health. We also coordinate community outreach efforts at the practice, emphasising multidisciplinary collaboration in addressing the mental health needs of our community.
We integrate leadership principles into the healthcare space at The Couch by offering continuous professional development and mentorship opportunities for healthcare professionals and business owners. Technical, clinical and business tools developed in 2017 through the Healthcare Accelerator program by GE and Standard Bank and the business acumen acquired in 2018 from the Harvard ManageMentor program, inspired me to develop and tailor "The Business of Private Practice" course for healthcare professionals looking to start or grow their private practice. The course addresses essentials of healthcare entrepreneurship, providing invaluable insights, strategies and practical advice to navigate daily challenges. Through such initiatives, we aim to support individual growth and broaden impact, striving to revolutionise mental health care.
How do you adapt your leadership style to meet the unique challenges of both healthcare and business environments?
Adapting my leadership style to meet the unique challenges of healthcare and business environments is a balancing act that requires versatility. Sometimes I need to adopt the role of a psychologist, providing support and guidance to individuals with mental health challenges. At other times I need to assume the responsibilities of a CEO, making strategic decisions and ensuring the success of the business.
On the business side, strategic thinking and adaptability are key. We navigate socio-economic differences, market dynamics and regulatory changes whilst maintaining a commitment to quality care. It's about creating innovative solutions to enhance efficiency without compromising on high standards of service. What is critical for me in meeting both objectives is prioritising decisions aligned with our business goals, while never losing sight of the human element: respect, genuine care and well-being of people are non-negotiables. It is vital to strike a balance between the operational needs of the business and the compassion required in the healthcare space.
What are the biggest challenges you face as a clinical psychologist and leader in the current healthcare and business landscape? How do you address them?
One of the most pressing challenges is persistent disparities between those who can afford mental healthcare services and those who cannot. It is disheartening to see individuals who desperately need support and treatment but are unable to access them because of financial constraints. Addressing this issue requires a delicate balance between providing accessible services and ensuring the practice’s financial sustainability. While from a business perspective it is not always possible to provide free sessions extensively, we are committed to finding innovative ways to bridge the gap in healthcare access.
We tackle the issue through outreach initiatives and collaboration with non-profit organisations. Through partnership we extend our reach to underserved communities and provide affordable or discounted services to those in need. This approach enables us to prioritise accessibility while ensuring that the practice remains financially viable. We actively look for opportunities to give back to the community by organising mental health awareness campaigns, workshops and educational events, to destigmatise mental health and provide resources to individuals lacking access to formal treatment. By staying true to our core values and committing to community outreach, we can strive for positive impact while address the challenges of healthcare disparity.
In addition, we have implemented a sliding-fee scale for those facing financial hardship, making it possible to help individuals with limited financial resources, and ensuring that cost is not a barrier to accessing essential mental healthcare services. By tailoring our pricing structure to accommodate diverse community members, we enhance accessibility and inclusivity in our practice.
As a business leader in current healthcare, I notice the reluctance of many healthcare professionals to venture into the business sector. Mental healthcare requires a unique combination of clinical knowledge, empathy and deep understanding of the human mind. Nevertheless, professionals do not always possess the necessary business acumen to navigate the complexities of running a practice or making critical business decisions.
I try to foster a nurturing, collaborative environment to address such challenges. I actively encourage and support mental health professionals to develop business skills through mentorship, training programs and continuous professional development. By equipping them with necessary knowledge and resources, we can empower mental health professionals to make better business decisions.
Overall, my journey in private practice as CEO of The Couch involves continuous learning and growth. It has reinforced the importance of integrating leadership principles into compassionate care and highlighted the need for adaptability in the ever-evolving landscape of healthcare. Through collaboration, innovation and steadfast commitment to core values, we aspire to achieve a lasting impact on mental healthcare, ensuring a future where accessible, equitable and high-quality mental health services are within reach of all.
How do you stay adaptive and responsive to changes in business and healthcare?
Staying adaptive and responsive is a dynamic process. It requires balancing innovation with staying true to my vision and mission as a healthcare practitioner and business leader. One of the game-changers for us at the practice has been leveraging artificial intelligence (AI) for administrative tasks. AI reduces redundancy and frees up valuable time for team members to focus on learning and growth, drawing on their passion and expertise. The shift enables everyone to contribute to shaping our practice and the broader healthcare space.
Staying adaptive also involves nurturing team leadership. Each person brings unique insights and skills. Through harnessing AI, we create space for all to innovate and contribute in diverse ways. This is not only about efficiency; it also lays the foundation for transformative change in healthcare. By remaining adaptive and forward-thinking, we not only keep pace with change, but can also drive it, with a vision to revolutionise and enhance healthcare.
Another moment in healthcare that signifies change is the recent signing of the National Health Insurance (NHI) into law in South Africa. Universal health coverage (UHC) stands as a key policy goal for sustainable development in numerous nations, aiming to promote equitable access to healthcare services and alleviate health disparities. While health insurance is crucial for achieving broader healthcare objectives, it also necessitates careful considerations when making healthcare-related decisions. The effective implementation of NHI requires a significant shift in how healthcare services are delivered and managed. To meet these challenges, there is a pressing need to develop more integrative healthcare approaches that combine the strengths of various disciplines and sectors. Ensuring ethical responsibility, transparency, and accountability at every stage of the process is essential.
In ongoing efforts to evolve and integrate business advancement with healthcare while adapting to changing patient needs, we recognise the importance of remaining responsive to the global climate. Our commitment to online services has expanded significantly since the COVID pandemic, broadening our global client-base and satisfying the growing demand for accessible mental health care.
Looking ahead, we are thrilled to share our plans to enhance our capabilities to satisfy mental health needs. We are now poised to open a state-of-the-art, patient-centred, value-based healthcare hospital. The facility will be dedicated to revolutionising mental health care, implementing innovative business practices and evidence-based treatments. Our goal is to support patients and healthcare providers through future healthcare development.
What are your predictions for the future of leadership in healthcare, and how can current leaders prepare for these changes?
When I consider future leadership in healthcare, I anticipate a blend of clinical expertise and business acumen. The healthcare landscape is increasingly complex, and to navigate it successfully, leaders have to take on different roles. Healthcare providers should step up and take a more active role regarding business issues. It is no longer sufficient to understand patient care; we also need to comprehend the intricacies of the industry – remain proactive rather than reactive – and stay at the forefront of positive change and innovation. Current leaders should prioritise continuous education about healthcare dynamics. The industry evolves continuously through new research, technologies, treatments and regulations. We must stay informed and make decisions that support and improve patient care and drive the industry forward.
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