Interview with Pamela Milam, LPC

Medium Logo 3 Sepia Headshots 7 4 2011 016Today, we interview Pamela Milam, LPC. She is a member of the New York Chapter of the WNBA, is a reader, author, and therapist living part-time in Dallas and New York.  Represented by Jim Levine at the Levine Greenberg Literary Agency, she is the author of a new book, What Your Therapist Really Thinks About You, which takes a closer look at what happens inside the therapy office and is the author of “Premarital Counseling for Gays & Lesbians: Case Studies and Helpful Questions.”

Can you describe what a normal day looks like for you as you do your job?

Yes, I live in Dallas and New York – live half-time in both cities, so my life is different depending on where I am.

When I’m in Dallas: I wake up, get ready for work, and leave for a ten-minute drive to my private practice counseling office. When I get there, I open my laptop and begin to review my charting from the sessions in the prior week.  I make a quick set of notes for the sessions on my calendar that day – reminding myself to ask….for instance….”John” how his dad’s surgery went or “Suzie” whether she completed her homework assignment or “Helen” what her mom said after she confessed that she was planning to marry a woman.  I get an overview of where each client is in his or her process and then wait for the first session.

After that, the first client arrives and I do counseling.  I see clients one after another, scheduling them – usually – twenty-five minutes apart.  I do not usher one person in immediately as the other is leaving.  I have a “Couch Cooling Period,” if you will.  I don’t like for one client to sit down on the couch and experience sitting in the warm spot left by the last client’s behind.  If that happens, then I’m running sessions too close together. I make time in between each appointment to think about what happened in session, to document it, and – if needed – to go to the bathroom or get a sip of club soda.

At the end of the day, I make sure I’ve done all of my charting and billing, and I go home.

When I’m in NYC:  It’s different.  I’ve been doing distance counseling with my clients in Texas, which means I schedule the occasional phone session, but now with the new HIPAA/HITECH rules, I’m implementing a new system using –and I’m not ready to use it yet.  Therefore, when I’m in NYC, I focus on my writing and teaching.  I write articles for and I create continuing education courses (CEU classes) on I enjoy doing all of this work immensely – counseling, writing, and teaching.

What theory (or theories) inform your practice and why?

I think of myself as an existential counselor.  I don’t use a fixed structure or set of absolute rules for how I conduct counseling, but I do rest on certain principles. I believe in both freedom and responsibility.

Existential counseling utilizes the uniqueness of the individual along with the universality of specific life problems. This approach reminds the client that freedom, choice, and responsibility play a large role in most conflicts. Through the use of existential thought and exploration, the client will discover areas of greater strength, control, and resolve.

However, our counseling sessions are guided by the client, not by my philosophies or ideologies. I ask questions to make the client think more deeply about his or her place in the world – We talk about the larger life questions, “Who am I?” “Why am I here?” “What is my purpose?” “What is happiness?” and from there we move toward the specifics and find ways to address the client’s presenting problem.

Reflect on how you determine when you need to seek consultation or supervision. Can you provide me with a specific example of each?

When I was still under ongoing supervision, I regularly called on my supervisor for guidance.  Now that I’m a seasoned professional, there’s a fair amount of give and take. Colleagues call on me for support and I call on them.  We always de-identify the case if we need to talk about a question regarding a client.

Recently, when I had a client who was having trouble making progress, I went to my peer group and sought consultation.  I have a group of 6-10 therapists who meet once or twice a month to provide each other with encouragement, consultation, and support.  It is very helpful in regard to getting constructive feedback, creative ideas, and it’s also great for networking.

What do you do to maintain self-care and wellness?

At the beginning of my career, I wasn’t so great at this part.  I worked long hours, skipped meals, and kept my phone on all of the time.  I was perpetually available, frequently working, and I got tired.  That’s when I realized that all of the training about self-care (during grad school) was no joke.  It was serious business.

I lightened my caseload, joined a peer group, took on a couple of new hobbies that recharged me, and I made more time for fun things like hiking, reading, theater-going, and spending time with my spouse.

My life is balanced and I feel like I’m offered a more centered approach to my counseling practice.

What are the most significant personal development issues you face as a counselor? How have you addressed personal and professional growth and development?

One of the ways I have grown is by realizing that I cannot help every client. I remember being cavalier and thinking that I could shoot from the hip and figure things out as I went.  Not true.  Training is important.  There is a reason for those required continuing education classes. It was a relief, in a way, when it hit me that there really some clients with issues outside my area of expertise.

I can grow by taking classes and training programs to gain those skills, or I can grow by knowing my own limits and being willing to refer clients to the appropriate counselor.

I have grown personally and professionally by trying new things.  I wrote a book, taught a class, traveled to Russia and Estonia, and recently, I attended a theatre workshop just to learn more about the inner workings of the acting and directing community.  If I have clients who are performers, I’ll be ahead of the game, understanding more about what they experience.

It’s important not to stagnate – not to sit inside the counseling office only listening to stories of how other people live their lives and neglecting to live my own life.  I want to live and experience life and to hear more about the lives of other people of all kinds. Curiosity is the best way to cure inertia and spark ongoing growth.

There are so many aspects of beginning a counseling career that can feel confusing and overwhelming. What would you say should be the top 3 priorities for a beginning counselor?

  • Get a system in place for handling billing and tracking your income.  (you don’t want to get your taxes into a mess)
  • Find a network of colleagues for support, encouragement and guidance
  • Know your specialty areas – do not stray into doing counseling without proper training.

What are your thoughts and feelings regarding the difficulty we (young professionals) have with job placement, the flooded counselor market, and underpaid positions.  This job is wonderful and difficult and it feels like we cannot get paid well or find positive supportive working conditions.

I’m not sure what the answer is.  It is tough.  I’ve made the comment before that the social services profession tends to be highly rewarding in many ways, but less so in regard to financial security.

With that said, I believe that counselors who are motivated and determined can find good jobs and establish financial security.  Networking helps immensely.  Professional friendships make all the difference.

What resource (book, person, website, and or blog) helped you the most when establishing your private practice?

I don’t remember reading a book to help with that.  What helped the most for me back then was that I made a decision to build a private practice and I pressed forward to make it happen.  I was surprised at how easy it was to get help building a website.  Then, I took phone calls from potential clients and set up appointments. There was that “Field of Dreams” feeling about it back then.  “If you build it, they will come…” and they did.  I was delighted by that.  My practice built to the point that I had too many clients and started referring them out to my colleagues.  I don’t know if that’s how it works these days.

From what source do you receive the majority of your referrals? 

First, my website.  Second, “word of mouth” –former clients who tell people about my practice.

What led you to the decision to create a premarital CEU course? 

I thought it was only fair for lesbian and gay couples to have premarital counseling too – and I wanted to customize the sessions in particular for the LGB community.  I’m leaving off the “T,” because I believe there’s an entire book waiting to be written for the Transgendered Community.  They will have issues particular to their lives and there should be a book to address those issues.

Tell us about your books… 

ASD Publishing guided me through the process of publishing my book Premarital Counseling for Gays & Lesbians: Case Studies and Helpful Questions. It’s a simple handbook for couples and for counselors – a quick 100 pages looking at issues specific to gay couples and issues common to all couples. The link is here:

I have a second book represented by the Levine Greenberg Agency.  It’s called What Your Therapist Really Thinks About You.  It explores the therapeutic relationship between counselor and client, common pitfalls, and thorny situations, offering an inside look at what happens in therapy.  The literary agency is here:

My e-article is on Amazon:  Ten Rules for Successful Coping During the Divorce Process. It provides tips and insight for managing life before, during, and after a divorce.  The link is here:

Where can we purchase your books?

My book and e-article are both available on or you can buy them through my publisher’s website:


Networking Event-Chronic Pain Presentation Success

We had another successful presentation/networking event! Thanks to everyone who attended today’s event and a big thanks to Desirae Ysasi for her insightful presentation on chronic pain. Her presentation taught us how to address resistance with clients as well as helpful relaxation techniques and interventions used to assist clients with chronic pain.

Today’s proceeds were given to Desirae whom decided to donate the proceeds to the Out of Darkness Walk. This walk is dedicated to suicide awareness and prevention.

If you were unable to make this event, we hope to see you at our next event.

Tiffany, Tracy & Virginia