Pamela Miller ’09 has spent her career working at the intersection of fields that have not always understood or talked to each other. She earned simultaneous degrees in law from the University of Cincinnati College of Law and a Master of Social Work from the University of Cincinnati School of Social Work. Today, she’s a practicing psychotherapist specializing in complex trauma, an expert witness and forensic consultant in child abuse cases, and a senior law and policy analyst. She has shaped the national conversation on what she helped define as Intrafamilial Child Torture (ICT)—a concept whose reach now extends to professionals in 83 countries. We asked her how those two educations and the sea of experience that followed became one practice. We also asked what courts still get wrong about children, and why the most harrowing work she can imagine is also the most rewarding.

1. You hold both a law degree and a Master of Social Work. How did those two educations shape the career you actually ended up building?

When I graduated, I had a sense that I wanted to be a lawyer with a social worker perspective who functioned within the court system. But working at Legal Aid in California really clarified things for me. I was up against private attorneys, constrained by caseload and hours, and I kept feeling like I couldn’t give my clients the same quality of representation their opponents were getting. I wanted to change the playing field somehow.

When I started doing expert witness work, something shifted. Judges would sit up, take notes, and ask me questions. Jurors would nod. I started seeing positive outcomes directly connected to my testimony—and it felt very right in a way that pure advocacy had not. The dual background turned out to be the thing: I could bring clinical and developmental expertise into legal settings in a way that neither a lawyer alone nor a social worker alone typically can.

2. What do courts and judges most consistently misunderstand about children—and what does that misunderstanding cost?

Courts tend to view children as little adults. A judge or attorney thinks: if that happened to me, I would react this way. But they’re applying their adult selves to a preschooler’s experience. Little kids who have been abused still run toward the parent who abused them—because children love their parents even when they’re being harmed. Courts that don’t understand that may read normal child behavior as evidence that abuse didn’t occur.

There’s also a standard-of-proof problem that I see constantly. Family court operates on a civil standard, a preponderance of the evidence. I’ve watched judges act as though they need proof beyond a reasonable doubt before they’ll take any protective action for a child. Part of my job is helping the court understand that they are empowered to protect kids well short of that threshold, and that waiting for certainty often means waiting too long.

3. You helped develop the concept of Intrafamilial Child Torture (ICT). What is it, and why does it need its own category?

Most physical abuse of children is committed by parents under extreme stress who lose control, didn’t intend the harm, and are genuinely remorseful—and statistically, that’s the majority of cases. Those families can often be helped and reunified safely.

ICT is categorically different. It’s child abuse that is severe and egregious, prolonged, and, critically, intentional and deliberate. The parent has a system of abusive behaviors designed to control, break down, and harm the child in order to meet the parent’s own psychopathological needs. That level of pathology is not rehabilitatable. Our position is that children who have been tortured by a parent should not be reunified with that parent. That’s a different clinical and legal conclusion than we reach in most abuse cases—and courts need a framework to recognize it.

The work has gotten traction. My foundational paper has been downloaded in 83 countries. We’ve since published case studies, victim impact analyses, a validity study, and a statistical analysis of over 100 ICT cases drawn from the media. We’re learning things like what types of harm were used, how long abuse continued before intervention, what the long-term outcomes for children were, and what motivated both the abusive and non-offending parent. That data matters. It changes how professionals recognize and respond to the most severe cases.

4. How do you sustain yourself emotionally doing this work over the long run?

Graduate school supervisors and mentors taught me early how to build what I’d call an outer armor—a way of engaging with devastating material without being destroyed by it. The distinction I return to most is between empathy and compassion. If empathy means I feel what you’re feeling, then unlimited empathy is incapacitating—I absorb the suffering and become unable to function. Compassion is different: my heart goes out to you, I want to help, but I am not experiencing your trauma with you. That’s actually how I can be most useful.

I think of it a bit like a surgeon or a trauma unit healthcare worker. There has to be a certain distance just to function. I teach that concept explicitly when I mentor graduate students, because I think a lot of people entering this field don’t learn it until they burn out—if they learn it at all.

5. Looking back, what do you value most about your legal education—and what would you tell current law students about where a JD can actually take them?

The elective courses. I took poverty law, child welfare law, capital punishment law, education law, and international human rights—and I use the content from those classes constantly, to this day. I’ve done asylum evaluations for refugees. I’ve done expert witness work on immigration-related matters. UC Law gave me a genuinely comprehensive education, not just vocational training for one job.

What I’ve noticed watching my graduating class over the years is that a lot of people who set out to practice law found their way into something adjacent—university administration, policy work, non-traditional professional roles—and I think that’s actually fine. When we were in school, we thought of law as vocational training for one specific job. What I believe now, about 15 years out, is that a legal education is part of a liberal education. It teaches you to analyze, argue, research, and write at a high level. Those skills travel.

For students who want to go where I went: find your mentors early, and take the work seriously even when it’s heartbreaking. This field needs people who are in it for the long haul.

Pamela Miller ’09 is an attorney, licensed clinical and forensic social worker, expert witness, and Senior Law & Policy Analyst at the Child Maltreatment Policy Resource Center. She is a 2023 Distinguished Alumni Award recipient from the University of Cincinnati. Learn more at pamelajmiller.org.