5 Questions: Erin Baurle Gets Real About Cancer Care

When someone is diagnosed with cancer, it can feel as if their entire world has been shattered. In the aftermath, patients and their families must deal with not only the physical demands of treatment but also the emotional and psychological consequences of uncertainty, loss and change.

That’s where Erin Baurle comes in. As Director of Oncology Counseling Services at the University of Colorado Anschutz Medical Campus, Baurle provides mental health care for people affected by cancer. In her current role, Baurle and her team offer individual, couples and group therapy tailored to every stage of the cancer journey.

Some patients are overwhelmed and need help forming questions for their doctors; others are in remission and struggling to redefine themselves. Even grief, she explains, can be approached with intention, through legacy planning, reflection and deep interpersonal connection.

In this week’s 5 Questions, we talk with Baurle about how she helps her clients hold on to hope, how she balances such emotionally demanding work with motherhood and why she believes confronting death can be just as sacred as celebrating birth.

You were in private practice for a time, helping individuals and families deal with the stresses of life. How is your work different now that you are helping people deal with the stresses of cancer? 

I love working in the field of psychosocial oncology, which has grown and developed over the last fifty years. My oncology colleagues are getting better at treating cancer; most people diagnosed with cancer will survive. Thus, we are becoming more aware of the long-term side effects of cancer treatment on identity, mental health and relationships. 

I previously practiced in Chicago, which had a larger psychosocial oncology presence. When I moved to Colorado, it was hard to find a role in psychosocial oncology, so I used my health psychology background to work in primary care and opened my own private practice. While both of these experiences were rewarding, when the opening for my current role at UCHealth and the University of Colorado Cancer Center became available, I knew it was the right fit for my interests and experiences. 

What do cancer patients need when they come to you and your team, and how do you provide it? 

Current research indicates up to 80 percent of cancer patients will have significant emotional distress, depression or anxiety at some point in their cancer experience. 

When people are first diagnosed, it is a time of great chaos and stress as they navigate the health system and learn their treatment plan. We help people hone their questions for appointments, consider their values as they make treatment decisions and communicate to their support system. 

During cancer treatment, patients tend to feel ill and are focused on healing. This is the time when their caregivers need more support, and we will see them manage the many stressors they are facing. 

After active treatment ends, the support system tends to think cancer is “done.” However, the person who had cancer is often coming to terms with their experience psychologically for the first time. We help people consolidate their experiences, navigate how they want life to look going forward and communicate their needs. 

We offer individual, couples and group therapy and bill to patient insurance. Notably, we are the only Oncology Counseling team in the state of Colorado. 

How do you help people stay hopeful and keep fighting during difficult treatments and diagnoses? What gives you hope at the end of the day? 

A big part of my job is actually helping people accept and voice the challenges they are facing during and after cancer treatment or into living with metastatic disease. The language we use in our society is we “fight” cancer, and people diagnosed are “warriors.” This description is uncomfortable for many cancer survivors, and we work to create space for their true experiences, rather than what our society tends to prescribe to survivorship. 

In general, we call people who have been diagnosed with cancer “survivors” starting from the time of diagnosis. Or we say “someone with cancer” rather than cancer patient, using person-first language. 

Cancer survivors’ loved ones often have the hardest time hearing the challenges the cancer patient is facing; they are already hurting and want the person to be okay. Thus, we practice how to effectively communicate the challenges they are facing and normalize that experience in our work together. 

In terms of hope, I review an individual’s values and priorities, and we consider how those have shifted since diagnosis. We consider what they want their future to look like, which is often different than the life they were living before cancer. This process of growth and renewal develops hope.

Hope for me is inherent in my worldview. In fact, I was nominated for Most Optimistic in my high school class. Learning to shift our perspective to what we can be hopeful about, even in dire circumstances, is a core component of therapy. If you’re interested in learning more, reading Viktor Frankl’s “Man’s Search for Meaning” and similar books can help.

The cancer journey doesn’t always end in a positive outcome. How do you help people prepare for a terminal diagnosis, and how do you prepare for the grief of loss? 

I often work with individuals facing end of life and greatly enjoy this part of my work. Think of the amount of time we spend preparing for a baby’s birth—there are announcements, showers, decorating the room and picking out the name. Just as we were each born, we will also each die. Accepting that and talking through the reality often helps. 

In therapy with someone facing end of life, I hold space for their challenging feelings of grief and loss at leaving life and their loved ones. We practice legacy planning, or how they want to be remembered when they are gone. For some, this is leaving personalized letters or having a tree planted in their name. It is hard to lose someone you have worked with intimately in this way. I manage this by having a balanced day-to-day life, which for me involves time with my family and friends, being outside, exercise and cooking. 

You are a wife and mother.  What have you learned about compartmentalizing so the intensity of your work doesn’t come home with you every day? Or does it?   

 I learned at an early age the importance of self-care. I know that sounds trite, but making sure my basic needs are met allows me to be my best for those I work with and my loved ones. I prioritize sleep, exercise and having fun with people who are meaningful to me. 

I don’t socialize with people in my field at this time in my career, and I think that also helps create a boundary. Our time outside of work is spent with other people who have kids, doing family things. It’s vibrant, busy, demanding and helps mitigate the heaviness of this work. 

It’s also true that there is a “muscle” you develop the more you do this kind of work. It was very challenging initially to keep life and work separate, but 15 years later, that has gotten much easier.