Integrative Therapy in San Rafael and Sebastopol, CA
Miriam Rubino, MA, LMFT 126411

Frequently Asked Questions

  • I work primarily with adults seeking trauma recovery, somatic healing, and deeper self-understanding so they can enjoy better relationships. I’m especially attuned to the needs of BIPOC clients, trauma survivors, sensitives, creatives, and anyone who feels stuck, overwhelmed, or disconnected from themselves or their environment.

  • Many people come to therapy unsure if what they’re experiencing “counts” as trauma. You don’t have to have a specific event or diagnosis to benefit from support. Trauma can show up in everyday symptoms that feel confusing or “just part of who I am.”

    You might notice:

    • anxiety or tension you can’t explain

    • overwhelm or shutdown during conflict

    • trouble setting boundaries

    • people-pleasing or caretaking patterns

    • chronic exhaustion

    • difficulty concentrating

    • feeling disconnected from yourself or your body

    • emotional numbness

    • repeating relational patterns, even when you don’t want to

    These are all common and valid signs of stress stored in the nervous system — often long before we consciously make the connection.

  • My style is warm, relational, culturally attuned, and deeply integrative. I weave together somatic healing, IFS/Parts Work, EMDR, expressive arts, and relational psychotherapy among other evidence based modalities and add elements of energy psychology, plant spirit, and ancestral work, if we see that work is suited for and welcomed by you.

    • My work is evidence-based AND woo-woo

    • Deep and practical

      Healing happens when the whole person — body, emotions, imagination, and spirit — is included, not just the mind. And healing is rooted in translating the important explorations transformations into the everyday, for a life that is fulfilling, connected and respectful.

    • One of my favorite phrases is “After enlightenment, chop wood and carry water”

  • Your first full session is a chance for us to get to know each other, engage in Assessment and Evaluation, explore what brings you in, what you’re hoping for, and what feels most urgent or important. Normally this session is slightly longer than a regular therapy session, to give us ample time, set the pace of how we will work together — nothing is forced or rushed.

  • I currently offer therapy in two locations:

    • San Rafael, CA (Marin County) — in-person

    • Sebastopol, CA (Sonoma County) — in-person

    • Statewide across California — online therapy

  • Yes — EMDR is one of my primary trauma-healing modalities.
    EMDR helps your brain reprocess overwhelming memories so they no longer feel charged, intrusive, or defining.
    Together, we work with:

    • Distressing memories

    • Trauma triggers

    • Negative beliefs formed during overwhelming experiences

    • Body sensations connected to past events

    EMDR supports:

    • Emotional regulation

    • Reduction in anxiety, panic, and overwhelm

    • Increased confidence and self-trust

    • Integration of past experiences so you can live more freely now

    I offer EMDR both in-person and online, depending on your preference and readiness.

    Learn more about EMDR and the 8 Phases of EMDR

  • Somatic therapy is an embodied approach that recognizes the profound ways trauma, stress, and emotion live in the body — not just in thoughts or memories.
    In our work together, we explore:

    • Body sensations

    • Breath, movement, and posture

    • Protective patterns held in the nervous system

    • Your unique rhythm for pacing and regulation

    • How your body signals boundaries, overwhelm, or readiness

    Somatic therapy helps you:

    • Release stored tension

    • Build capacity and resilience

    • Reconnect with intuition and inner wisdom

    • Shift long-standing patterns from the inside out

    This work is gentle, trauma-informed, and deeply collaborative. We follow your nervous system, at your speed.

  • I support clients exploring non-ordinary states of consciousness through:

    • Legal, prescriber-supported experiences (such as ketamine or cannabis-assisted work) for deep transformative healing

    • Non-substance pathways: expressive arts, imagery, movement, music journeys, breath, and dreamwork

    • Plant Spirit Dietas

    I do not provide or prescribe any illegal substances.
    I offer preparation, grounding, emotional processing, and integration to help you make meaning of these experiences and bring insights into daily life.

  • Ketamine-assisted Therapy (KAP) is a treatment modality that provides faster relief than traditional talk therapy. I offer both low dose and higher dose methods, which vary in delivery and treatment length.

    A common treatment may last anything between 4 and 8 dosing sessions (but it could be more).

    Preparation sessions precede the treatment, and Integration sessions follow each dosing session

    During Intake and Assessment, we will discuss the possibility of using KAP.

    Medical screening: After our initial discussion, I will refer you to one of my vetted collaborating prescribers for a full psychiatric assessment to verify there are no medical contraindications and you could benefit from this treatment.

    If you are eligible, the prescriber will send the medicine to you in the form of troches or lozenges (for sublingual use), which you will bring to the dosing sessions.

    During the session, you will swish the medicine as directed, then will recline and turn attention inward. A curated playlist will support the session (depending on modality) and the therapist will ensure your safety throughout the process. Depending on the KAP modality used and dosage, you may interact more with me through relational and somatic interventions, or you may be more reflective and inner directed.

    After the medicine effect starts wearing off, we will start the process of integration of insights, and I will support you to get ready to get back safely into the outside world.

    A very standard treatment may look like:

    2-3 Preparation sessions (50 min each)

    1 Dosing Session (3 hours)

    1 integration session (no farther than 3 days after dosing session) -50 min

    1 dosing session (3 hours)

    1 Integration session (50 min)

    We will continue this rotation until we deem symptoms decreased, and therapist, client and prescriber agree that treatment can continue with integrative therapy, or we prepare for termination.

    For your safety and maximum benefit, it is recommended that you have at least 1 follow up session with the prescriber every 2 or 3 months.

    Although the medicine will greatly help maximize your treatment results, it is important to remember the medicine will work with your inner wisdom, your intentions and capacities, so good Preparation and Integration are still the best ways to ensure the change you will notice is meaningful and lasting.

  • I understand this is a common and important question. I’m out-of-network by choice for several reasons that center on protecting your care, and preserving clinical flexibility:

    • Privacy & confidentiality. Using insurance typically requires submitting a diagnosis and may allow insurers access to treatment records. Working privately helps keep your therapy confidential.

    • Clinical autonomy and individualized care. Being out-of-network lets me tailor session length, pacing, and the specific tools we use (intensives, Psychedelic-assisted therapy, extended processing when needed) without being limited by insurer session rules or billing categories.

    • Fewer administrative hurdles for you and me. Many clients find that private practice reduces back-and-forth authorizations and paperwork that can slow or complicate care.

    That said, I want care to be accessible: I provide Superbills that clients can submit to many PPO plans for out-of-network reimbursement, and I hold a limited number of reduced fee spots for those with financial need.

  • Yes — As a bicultural, bilingual therapist, I offer therapy in English and Spanish.
    Sí, también ofrezco terapia en español. Soy una terapeuta bilingüe y bicultural.

  • My work is now more centered in supporting adults (and their inner child) to recover from difficult experiences, some of them that are a result of their childhood, relational and trauma experiences.

    I came to this work after working for many years as a Child Therapist (supporting children and their parents) for the Child Therapy Institute of Marin-where I am now a Clinical Supervisor- and after many years of trauma focused training.

    I truly love providing safe and protected healing space to children ages 5–10 using play therapy and expressive arts, so I reserve a few selected spots for Child Centered Play Therapy.

    Please note that Child Therapy is only offered at the San Rafael location.

    I do not work with couples at this time.

  • Yes, I offer a free 20-minute consultation to help you get a sense of whether we’re a good fit.
    You can ask questions, share your goals, and get a feel for my style.

    Contact me to schedule your consultation.

  • The best way to learn about my work is reading the different pages in the website.

    You can also find me on professional therapy directories, including:

    These profiles include my training, approach, specialties.

    Contact me for availability and to book a session.