From Psychologist to Patient Advocate — An Interview with Dr. Trisha Miller

Updated: Feb 23

Dr. Trisha Miller is a Patient Advocate at a hospital in St. Louis, MO and a Life Coach to clients in various parts of the country. Her decades of past experience as a PhD Clinical Psychologist informs her current work. Having worked as a psychologist with individuals of all ages and with almost all challenges, she is able to quickly understand the needs of the patients and clients she now works with. As a Patient Advocate, she assists patients who are going through major medical issues, such as those related to Covid, as they struggle to win their personal battles with illness and injury. She is a Certified Patient Experience Professional. As a Life Coach, Dr. Miller works with individuals looking to face personal and/or professional challenges and growth with the support and advantage of experienced, expert guidance.

Trisha Miller

Tell us a little about your background, where you grew up, etc.

I grew up in small towns in Kansas and Missouri, moving several times until my parents settled in a town on the outskirts of St. Louis. I spent my youth in libraries, in the woods, reading, writing poetry, and, for a period, lip-sinking to John Denver albums in my parents’ living room. My parents were self-sufficient, gardened, and my mom made my clothes. Midwest values of hard work were a staple in my family that I vacillated in my resonance with. I valued watching Saturday cartoons and laying beneath the pine trees just as much as I valued hard work.

How did you get from small-town mid-America to a Ph.D. in Clinical Psychology?

That was an unexpected twist. In high school, I thought I was headed toward a college degree in business. That was… until I took a psychology class my senior year and fell in love. In college, I majored in both business and psychology until psychology quickly won out. Psychology was the path I saw to seek an understanding of how and why humans behave and grow the way we do. I decided that a Ph.D. in Clinical Psychology would give me the fullest advantage in that pursuit. I specialized in developmental psychology, trauma-related issues, and family systems.

What professional pursuits ensued?

I worked in psychiatric inpatient settings and outpatient mental health clinics, supervised doctoral students and therapists pursuing licensure, did psychoeducational features on radio and tv, presented workshops of many kinds to various audiences, and eventually achieved that pre-conceived ideal of having my own private practice, collaborating with other professionals in my own business setting, in a space that I designed and had built.

Is that where your professional pursuits remain?

No. Another twist sent me in a quite different direction.

What was that?

In 2017, my father had quadruple by-pass surgery. I lived four states and an 11-hour drive away. When I stayed with him during and after his surgery, I saw the difference his nurses made in his recovery. They also supported my mom, my brother, and me in such a way as to help us navigate the stressful situation and remain a positive support to my dad. I saw the psychology in this; I wanted to be a part of that aspect of recovery and healing for others. It was a life-altering experience.

Specifically, how did this alter your life?

I realized that I needed to return home to St. Louis to help care for my aging parents, and I also realized that I wanted to “pay it forward.” I wanted to help others through extremely stressful medical situations in the way that my family had been helped during my father’s surgery and recovery. I closed my private practice, moved back to St. Louis from North Carolina, taught online college-level psychology classes, and began working in a hospital as a Patient Advocate. I spent time with my dad before he died a year later and have been an ongoing support to my mom since. The change in my career path, from psychologist to patient advocate, brought me great opportunities to learn about medical care of seriously ill patients, end of life dynamics and processes, and how to support patients and families through these challenges effectively. Using my education, training, and experience in this new setting has been very satisfying. I have also remained committed to my avocation of one-on-one therapeutic support through my part-time practice as a life coach.

What type of patients do you work with in your hospital as a patient advocate?

I work in a long-term acute care hospital that specializes in ventilator weaning and complex wound care. For the last eight months, we have been primarily caring for post-COVID patients. These patients come to us struggling in their fight to survive COVID, having been unable to wean off a ventilator or wean down from high levels of oxygen through a nasal cannula.

What is your role with these patients?

As a Patient Advocate, I help patients and families navigate through their medical care while they are with us. I also provide them with emotional support and coach them in managing the anxiety that comes with weaning from a ventilator. I also support the patient’s family, who are likely exhausted, scared, traumatized, confused, and need compassion, information, and hope. Our length of stay averages 28 days yet is often longer. In that time, I develop a relationship with these people during a time of high stress and vulnerability. The connection I develop with them is, therefore, very personal.

What is the hardest aspect of your job?

Every day, my co-workers and I say, “That is so sad,” two or three times. There are many incredibly sad stories about the consequences of COVID on individuals and families. For example, more than once, we have had a patient struggling to wean off a ventilator after almost dying from COVID, who has been in the hospital for weeks or months and has lost a spouse to COVID during that time. They were unable to say good-bye or to attend a funeral. Their intense grief is in our hands to help heal while trying to help heal their COVID-ravaged bodies. What these patients are facing physically, emotionally, and spiritually is so overwhelming to them. In my job, I bring my background as a psychologist and therapist to these challenges, these people. In other situations, I sit with a patient and his family while he is taken off the ventilator in what we call a compassionate wean, or a termination of life support, when it has become clear that he will be unable to wean off the ventilator due to the damage COVID has caused to his body. I have helped families make this extremely difficult decision. Several times, I have been present while someone dies. It is a very intimate experience.

It sounds like your job is filled with sadness. How do you deal with that?

Yes, there is certainly a lot of sadness, especially during this horrific pandemic. Yet, there are so many silver linings in the dark clouds. One of our patients battled the physical weakness and lung damage from COVID for weeks with us. Every time he worked with physical therapy, walking, his blood oxygen level dropped and his need for oxygen increased. His need for oxygen remained too high for him to go home on oxygen and too high for him to go to an acute rehab facility. He was with us longer than our usual length of stay. We cheered him on, and he gradually got stronger. He found out he had remarkable strength of will and spirit. And he left our hospital completely committed to continuing to take particularly good care of himself, much better than he ever had before COVID. Amid so much sadness at my hospital, we are privileged to see miracles and silver linings regularly. We also observe how our compassion and intentional care positively affect our patients and their families. This is a gift to be grateful for: the gift of the feeling of purpose and meaning in what we do.

What type of clients do you work with as a Life Coach?

I work with clients who need support and guidance through life changes, such as ending a relationship, taking care of an aging parent, or grieving and adjusting to the death of a loved one. I help individuals understand the source of their anxiety and make the changes necessary to shift perspectives. Often, that involves gaining self-insight and integrity. Sometimes it involves making terrifying choices. I also help parents who want to be the best parents they can be, yet know they lack good role models and an understanding of child development. I help people seeking assistance with a wide range of challenges, including ADHD, poor relationships, health/medical issues, feelings of low self-worth, and many types of personal/professional dilemmas. I look at a person from the perspective of developmental psychology. We are always growing. I understand that growth. I know what nurtures that growth in all domains of human functioning. I help empower others to become experts in their own self-nurturance.

How do you feel about your recent invitation to being an Executive Contributor for Brainz Magazine?

I feel extremely fortunate and excited for this opportunity to reach out to your readers. Sometimes, a person wants help with something yet is unwilling to seek therapy or life coaching. Reading books and magazines, such as Brainz, is a safe way to learn about oneself and gain ideas for making helpful changes. In addition, being an Executive Contributor for Brainz places me in the company of many wise professionals that I look forward to learning from. I will grow in many more ways and help many more people due to my affiliation with Brainz.

For more information, follow Trisha on Facebook & LinkedIn!



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