Meet Dr Susan L. Miller
Each month we spotlight an ACA member in the ACA Monthly Bulletin, our monthly newsletter. The Member Spotlight is designed to showcase the work of our members to you! We hope their stories inspire or spark interest. Let’s share our experiences within our counselling community.
What motivated you to pursue a career in counselling?
Arriving in Australia in my early 20’s gave me the opportunity to pursue further study (not readily available in Northern Britain of the 80’s). I had a strong drive to find a career involving assisting others to pursue meaningful change in their lives. I chose psychology (and sociology), later specialising in counselling at post-graduate. After graduating, I secured a great job as a university counsellor in the Western suburbs of Melbourne. The role involved working with people from diverse cultural backgrounds who were facing challenges on individual, psycho-social and systemic levels.
For a time, I managed the University Counselling Centre. But, after a stint in senior management, realised I needed more flexibility and choice in terms of working hours. In 2000 I co-established private practice – The Melbourne Counselling & Psychology Centre. Working privately enabled me to combine clinical practice with teaching graduate counselling programs (including intensives for Monash Uni in Hong Kong and Singapore). Working across diverse populations and geographic locations led me to challenge the limitations of traditionally oriented approaches to counselling and psychological health. I looked into this further through doctorate research into the effectiveness of contemporary models of therapy (with an emphasis on hope, vision and constructivism) compared to traditional and psychoeducational approaches.
What specific areas do you primarily work within?
I like diversity in work. Within private practice I am engaged in counselling, training, teaching, supervision and clinical assessment. Shortly after setting up private practice in 2000, I was approached to undertake trauma training for train staff of the Victims of Crime Assistance Service within the Dept of Justice. This led private consulting to various departments within DoJ for more than two decades (while running my private clinical practice). I debriefed, trained and counselled staff across DoJ sectors including the City Morgue, the Victorian Police and Victim Support Agencies and the Victims of Crime Assistance Tribunal. I also co-ordinated the Jury’s Commissioner’s debriefing program for the State (debriefing jurors following stressful trials) while working clinically with staff from other (confidential) sectors within the Department. My connection with DoJ meant that my clinical work at the Centre consisted largely of survivors of acute, mass and historical crime. The work included sensitive (high media profile) cases including family members of homicide victims, family violence survivors and survivors of incidents of mass trauma and terrorism in Australia and overseas.
These days my clinical work involves assisting a diverse range of mainly adult clients. My background with DoJ means that I continue to receive referrals for trauma and traumatic loss. However, I also work with people with everyday relationship issues, mid-life change/adjustment, anxiety, grief and post-natal depression. I balance clinical work with other opportunities within the profession; group training, curriculum development and writing. I also continue to teach intensive programs at graduate level.
Can you share a recent success or achievement in your counselling work that you're proud of?
Working in a capacity in which people confide their deepest fears and hopes is deeply gratifying. The work with family members of homicide victims stands out, as does the work with survivors of family violence and humanitarian work (supporting asylum seekers with psychological assessment reports regarding the implications of returning to home country). Like most counsellors, I’ve had cases in which quick thinking was important. One that comes to mind was an assault survivor/refugee who was experiencing confusion/disorientation/dysfunction that seemed beyond the norm for PTSD referral. I referred him to a GP colleague who immediately sent him for a CAT scan. The scan showed a subdural hematoma (a result of the assault but apparently, overlooked at the hospital). He was rushed into neurosurgery and survived. The case raises the importance of a strong referral base, thinking outside of the box, realising some presentations require a team approach, all while staying in your lane (i.e. not suggesting diagnoses or giving physical health advice).
I’m also gratified to have assisted so many survivors of crime, and to have taught/supervised students who have gone on to do amazing things. I am pleased to have co-created a collegial workplace consisting of self-employed counsellors who are a pleasure to work with (whilst we enjoy a lovely workspace with views of the tree-tops of Collins Street). In terms of a particular success or achievement - developing a model of counselling that de-centralises pathology, respects the vision of the client, and aims to instill hope within the parameters of a positive, narrative psychology/re-storative framework. Employing this method with people who have faced unthinkable horror and witnessing the shift in agency and coping is deeply rewarding. A mother of a homicide victim recently returned after sixteen years. I first saw her immediately after the death of her child. She had been living interstate. She gave me heartfelt feedback and wanted to return to re-process her experience as her (deceased) child would have been turning 21. She said, ‘You were there for me that first night.’ I was reminded to never underestimate the impact of being present, even in the direst circumstances and/or when you think you have little to offer. The idea that people place trust in us at the darkest times is something for us all to be proud of.
What is the most rewarding aspect of being a counsellor for you?
Well, all of the above. Each day I remind myself of the privilege involved in doing meaningful work. To ‘walk’ with people through their most difficult times and end the day thinking you have helped people create agency in their lives. I think of myself as an expert facilitator rather than expert per se (the client determines their vision and pathway). I’ve had many moments that were moving. One that stands out involved an asylum seeker facing deportation who I supported with a psychological assessment report (for a residency decision-making Tribunal). She had lived in Australia (in hiding) since infancy, supported by the underground grape vine of health and education providers. She was also the carer for two other abandoned migrant children both of whom eventually obtained asylum. After she was granted asylum, they all turned up in the waiting room. Their tears of happiness at finally being safe and registered reminded me I’d chosen the right path.
I love that we never stop learning the craft. It’s a life-long process. The skill set has many applications (apart from counselling). A wonderful friend and colleague recently retired from clinical practice at 80. When I spoke to her she was on her way to volunteer to help asylum seekers with life skills in country Victoria. She’s an inspiration!
How do you contribute to the betterment of the profession and your community?
In my opinion, this job contributes to the betterment of the community. In terms of the profession itself, I have been on various committees at the Australian Psychological Society and the College of Counselling Psychologists. I’ve provided supervision, taught trainee counsellors for more than twenty-five years, spoken at conferences (including for the ACA) in Australia, Europe and the UK, and worked across government, community and corporate sectors. Assisting members of the community following mass trauma and terrorism feels notable. I’ve also enjoyed being part of working parties advocating for the betterment of services for survivors of crime. I hope my up-coming practical book on contemporary models of therapy will contribute further.
Are there any projects or initiatives you're currently involved in?
A practical case guide de-mystifying contemporary approaches that pulls together years of practice and incorporates evidence-based change principles and techniques in counselling practice. Watch this space! I also have a keen interest in the application of psychological based technology for use with certain under-resourced cohorts, e.g. the elderly, and in incorporating current research regarding the association of creativity and meaning (specifically creative writing) on neurological health and well-being into my work.
What advice would you give to someone considering a career in counselling/psychotherapy?
I need a lot of space for this one. Firstly, get to know yourself and be prepared to challenge yourself. If you haven’t had therapy – do it. The best training is sitting in the other chair. Keep healthy. It’s a demanding job, physically and emotionally. It’s critical to pace, take breaks, place boundaries, don’t see too many people in a day, and please make time for well-being.
I view my expertise in terms of engagement and facilitation into previously untapped resources and possibilities in the client. So, my best advice is to ‘resist giving advice’ (even when you are asked). I believe the job of the counsellor is to facilitate awareness so the client gains and develops confidence in their own agency.
Reflect critically on the socially constructed nature of mental health trends and the potential impact of restrictive concepts and new (and old) diagnostic categories (keeping in mind; these are constructs not truth). I ask students to think about how a construct or idea is useful to the client. In terms of therapeutic outcome what does the client want/hope for (in contrast to traditional ideas of what might be wrong/causal etc). As counsellors, we have a great opportunity to help but it’s important to be alert to the power involved in the counselling process and how (mis) belief and advice can lead to inadvertent harm.
Maintain professional boundaries at ALL times. Related to this; limit self-disclosure – it’s a difficult skill to apply effectively. Engage in supervision to reflect on areas of countertransference. Be clear about of the clients/issues you want to work with and those you should refer.
Most importantly, as a counsellor your presence and intuition is your most vital ‘tool’.
Lastly, read fiction as well as nonfiction. Good literature can teach us a lot about t the human psyche.
Is there a quote or philosophy that inspires your work?
- There is always gold - Michael White
- There are two ways of spreading light: to be the candle or the mirror that reflects it - Edith Wharton.
- Courage is found in unlikely places - J. R. Tolkien