Palliative Care-Informed Counseling
Supporting the Person Beyond the Medical Crisis
Serious illness and medical crisis can change far more than a person's physical health. They may alter identity, relationships, independence, expectations for the future, and the experience of living in one's own body.
My counseling practice focuses particularly on the long middle – when the immediate medical urgency has diminished, but the personal consequences of illness or injury are still unfolding.
Informed by my background in oncology, mindfulness, grief and loss, and palliative care social work, I provide individual counseling that helps people explore these changes and consider how they want to live within their new reality.
My work offers a place to address the psychological, relational, and existential dimensions of serious illness that may not have had sufficient room during initial medical care.
For healthcare professionals: This page explains when a referral may be helpful, what counseling can address, and how to introduce these services to patients and families.
The Long Middle: When the Crisis Has Passed, But Its Impacts Are Still Emerging
Medical stability and psychological stability occur on different timeframes.
During diagnosis, treatment, hospitalization or acute recovery, much of a person's attention is directed toward immediate medical needs.
As those demands change, other questions may become more apparent:
Can I trust my body again?
Who am I now that my abilities or circumstances have changed?
How do I live with uncertainty about what comes next?
What do I do with the fear, anger, or grief that remains?
How do I reconnect with relationships, responsibilities, and parts of life that matter to me?
These questions often become more apparent after discharge, during cancer survivorship, or in periods of relative stability following serious illness or injury. Importantly, they often emerge when the support systems of medical and psycho-social teams are no longer available.
Counseling provides dedicated time to explore a life-altering health crisis after the immediate demands of medical care have subsided.
Who Might Benefit From a Referral?
My practice is particularly suited to adults whose lives have been significantly affected by serious illness, injury, or medical crisis and who have capacity and interest in reflecting on their experience.
Cancer Survivors After Treatment
People in remission, surveillance, or maintenance who are discovering that life after treatment brings questions about identity, bodily trust, uncertainty, and the future.
People Adapting to a Changed Medical Reality
Individuals living with lasting health changes or medically-stable ongoing conditions who are reconsidering independence, identity, relationships, and what living well means now.
People Living After a Major Medical Crisis
Adults following hospitalization, transplant, cardiac events, serious injury, or other life-altering medical experiences whose immediate crisis has passed but whose lives remain changed.
Family Members and Caregivers
People who have lived alongside someone else's medical crisis and are beginning to explore its effects on their own lives, relationships, responsibilities, and sense of self.
When Is Someone Ready for This Work?
The right time for counseling is as unique as each person’s health story.
My counseling practice is particularly suited to people who have moved beyond the most immediate demands of medical crisis and have some room to reflect on how the experience has affected their lives.
A referral may be especially appropriate when someone:
Has reached a period of relative medical stability, even if ongoing treatment, surveillance, or health limitations remain.
Is beginning to ask questions about identity, relationships, purpose, or what comes next.
Feels their life has changed in ways that medical recovery alone doesn't address.
Is experiencing uncertainty, grief, anger, or difficulty trusting their body.
Has some capacity and interest in exploring their experience beyond immediate medical problem-solving.
Wants to consider how to live meaningfully within circumstances they didn’t choose.
This work can be particularly beneficial well before a person is medically recovered, emotionally settled, or free of uncertainty.
However, when someone is primarily occupied with acute medical instability, intensive symptom management, or immediate crisis needs, other forms of support may be more appropriate initially.
My counseling is not designed to replace acute psychiatric care, crisis intervention, medical case management, or interdisciplinary palliative care. Individuals requiring these services may need additional or alternative support.
Why a Palliative Care Perspective?
Palliative care recognizes that serious illness affects the whole person – not only their physical health, but their emotional experience, relationships, identity, and what gives their life meaning.
My years working in oncology and palliative care have given me familiarity with the medical experiences that often accompany questions people bring to counseling.
I understand the urgency of diagnosis and treatment, the uncertainty of medical decisions, and the ways illness can change a person's relationship with their body, their family, and their future.
My counseling practice focuses particularly on what happens when there is finally room to consider these changes.
Rather than providing medical palliative care or crisis-oriented support, I bring a palliative care perspective into reflective counseling for people navigating life after medical disruption.
The goal of my work is to explore with individuals how their health crisis has impacted their lives, and how they might live with greater awareness, connection, and choice in the life they have today.
Cierra McNamara, MSW, LSW, IPCC
What Can Counseling Address?
My approach considers the whole person across four interconnected territories:
Body
The lived experience of physical changes, bodily trust, vigilance, vulnerability, and the relationship between the nervous system and emotional experience.
Mind
Fear, uncertainty, grief, anger, conflicting emotions, and the meanings a person has made of what happened.
Relationships
Changes in roles, independence, intimacy, family expectations, communication, belonging, and boundaries.
Meaning
Identity, values, purpose, mortality, continuity, and questions about how a person wants to live within changed circumstances.
Across these areas, my work supports the development of greater awareness, emotional capacity, and freedom to respond with choice, even when circumstances themselves cannot be controlled.
What Can I Say to My Patient?
A referral is often most helpful when counseling is presented as an additional layer of support for a person’s evolving recovery.
For someone after a medical crisis
“I know a counselor who specializes in helping people make sense of what they've been through medically and how it has affected their lives. Her work goes beyond managing stress and includes the changes people experience in their identity, relationships, and sense of the future.”
For someone navigating cancer survivorship
“Even when treatment is finished or things are medically stable, people can find that life feels very different. There's a counselor who works specifically with that part of the experience.”
For a family member or caregiver
“Your experience matters, too. I know a counselor who works with people affected by a loved one's serious illness, including the responsibilities, uncertainty, and changes in relationships that can come with it.”
For a patient unfamiliar with palliative care
“Her background is in palliative care, which focuses on quality of life through the continuum of serious illness, not just at the end of life. She brings that whole-person perspective into individual counseling.”
Referral Information
Center for Wisdom and Wellness
Individual counseling informed by oncology, mindfulness, grief and loss, and palliative care.
Location: In-person counseling in Centennial, Colorado, and telehealth throughout Colorado.
Services: Individual counseling for adults navigating life after cancer treatment, serious illness, or medical crisis, as well as family members and caregivers affected by these experiences. My work focuses particularly on periods of relative medical stability when there is room to explore the personal consequences of what has happened.
Fees: Sliding scale of $100–$140 per session. Private pay.
Initial contact: Free 15-minute phone consultation to discuss a person's needs and whether the practice may be an appropriate fit.
Patients and family members are welcome to contact me directly.
Explore more detailed service pages.