The popularity of non-mainstream cancer treatments raises complex issues for patients and medical practitioners and it is vital to scientifically evaluate effectiveness and investigate mechanisms of action of complementary treatments. This thesis describes sociodemographic, medical and psychological characteristics of participants in The Gawler Foundation program, which incorporates meditation, social support, positive thinking and a vegetarian diet. It describes program impact in terms of: Profile of Mood States (POMS), Mini-Mental Adjustment to Cancer (Mini-MAC), Functional Assessment of Chronic Illness Therapy (FACIT) and salivary cortisol levels. Compliance with program recommendations for up to 12-months and effects on adjustment were explored. This thesis also describes the development of a scale to assess the effects of meditation. Program participants (n=112) were predominantly female, well-educated, younger in age with good social support. Over 60% reported metastatic disease and 50% had been diagnosed for over a year. Improvements in all measures were found at program completion, with Spiritual wellbeing particularly linked to improvement in quality of life (QOL). Those with higher levels of mood disturbance and lower QOL at baseline benefited more than those who were less well adjusted. Analysis of three, six, and 12-month follow-up data showed high compliance with program recommendations. Improvements seen at program completion were mostly not maintained at follow-up, although improvements from baseline were. These results suggest that the program has significant beneficial effects on adjustment but that these may not be fully maintained at follow-up, possibly due to difficulty incorporating program recommendations into everyday life and increasing disease severity. Study limitations include self-selection, high drop-out rates and lack of a control group. Initial investigation suggested that quality of meditation experience was linked to improved adjustment and this thesis describes the initial development of a scale to assess the effects of meditation, which was divided into two sections: Experiences During Meditation and Effects of Meditation in Everyday Life, and trialled on 236 participants. Scale evaluation involved factor analysis, reliability and validity analysis. The Experiences During Meditation scale had five subscales: Cognitive effects, Emotional effects, Mystical experiences, Relaxation and Physical discomfort. The Effects of Meditation in Everyday Life scale had a single factor structure, with the final scale consisting of 30 items. Construct validity was explored by assessing correlations with the measures: Perceived Control of Internal States, Mindful Attention Awareness Scale, FACIT Spiritual wellbeing subscale, POMS-Short Form and Physical Symptoms Checklist. It is anticipated that the scale may be useful for clinicians and researchers and may contribute to improved understanding of the effects of meditation practices.

Yes

Musculoskeletal disorders are a considerable burden to the individual and the society at large. Therapeutic exercise and psychosocial interventions are longer-term therapies for relieving pain, improving function and outcomes after musculoskeletal disorders, and for enabling patients to manage their conditions. Healthcare professionals such as physiotherapists and occupational therapists widely use therapeutic exercise as part of a single or complex intervention. However, adherence to supervised or home exercise remains low among patients with musculoskeletal disorders. Understanding the barriers and facilitators of exercise adherence has the potential to improve the delivery of exercise programs and the design of interventions to improve adherence. Similarly, psychosocial interventions are recommended as a supplement to exercise therapy for the management of prolonged pain and disability after musculoskeletal disorders. Several psychosocial factors have been linked to prolonged pain and disability after hand injuries. However, while clinicians believe they have a role in managing psychosocial problems in hand therapy, barriers such as limited access and lack of knowledge pose a challenge to delivering psychosocial interventions. Current evidence shows that online-based coping skill programs provide cost-effective and accessible options for delivering psychosocial interventions in musculoskeletal care. However, there is a dearth of literature on the design, development, and implementation of online-based psychosocial interventions in hand therapy. This thesis includes four manuscripts with three overarching objectives. The first objective was to synthesize the qualitative evidence on barriers and facilitators of therapeutic exercise towards closing the gaps in adherence literature. The second objective was to understand the beliefs, attitude, knowledge and practice behavior of clinicians with regarding to managing psychosocial problems in hand therapy. The third objective was to provide a report on the design and development of a web-based coping skill training program for psychosocial problems specific to hand therapy. The fundamental aim is to provide toolkits that can be used to increase the knowledge and clinical practice behavior of physiotherapists and occupational therapists to optimize musculoskeletal health using therapeutic exercise and psychosocial interventions. The second and third manuscripts are a protocol and completed meta-synthesis of qualitative literature outlining the factors influencing adherence to therapeutic exercise in individuals with musculoskeletal disorders from the perspective of patients and healthcare professionals. We identified numerous factors influencing adherence to therapeutic exercise, which were organized according to the World Health Organization (WHO) multidimensional adherence framework. Based on the meta-ethnography line of argument, interpretation of identified themes: personal and lifestyle characteristics, health status and illness perception, nature of the program, health system, and social/environmental resources, showed that while some factors interact, others could be conceptualized as being on a continuum. These findings expanded the original model introduced by the WHO. The fourth manuscript presents a qualitative descriptive study designed to understand the knowledge, attitude, beliefs, and practice behavior of hand therapists practicing in Ontario with regards to psychosocial problems. The findings informed by the Theoretical Domains Framework provide insights into factors influencing the decision of clinicians to assess and manage psychosocial interventions in hand therapy. Addressing factors such as knowledge, attitudes, and beliefs about psychosocial factors at the individual and organizational level has the potential to increase the capacity of clinicians to adopt a clinical practice behavior that promotes the assessment and management of psychosocial problems in hand therapy. The fifth manuscript is a mixed-methods study describing the design, development, and usability testing of Hand Therapy Online COping Skills (HOCOS) training online program to support hand therapists in the management of psychosocial problems. Using a three-step process that involved needs assessment, heuristic testing, and user testing, we sought feedback from Information and Communication Technology experts and clinicians in hand therapy to develop the HOCOS prototype using iterative cycles. The results revealed heuristic violations and usability related to task performance, navigation, design aesthetics, content, functionality, and features and desire for future use. All violations were corrected in the final prototype, and participants expressed a high degree of satisfaction with using the final prototype in practice. The next phase of HOCOS design would require user testing by patients with hand injuries. / Thesis / Doctor of Philosophy (PhD) / Bone and joint injuries are very common in orthopedic practice and massive burden to individuals and society at large. Many patients are given exercises as part of their treatment to reduce pain and improve function. Unfortunately, many individuals continue to struggle with attending therapy sessions and doing exercises by themselves. Starting and continuing exercises are required to maximize the benefits from exercise recommendations. However, many barriers continue to make exercising a challenge. Research is needed to identify the challenges of starting and continuing exercises from the perspectives of both patients and healthcare professionals. In some situations, some patients with bone and joint injuries such as hand injuries continue to have pain and reduced function even after the original injury has healed. The weak relationship between the initial injury and present experience of pain and reduced function means other reasons like the mental, emotional, and social factors need to be considered in clinical practice. Healthcare professionals have reported several difficulties when dealing with psychosocial problems and want to learn strategies and skills for dealing with the mental, emotional, and social challenges affecting recovery after injuries to bones and joints. The use of the web-based coping skills training for managing psychosocial problems in individuals with bone and joint conditions has shown positive results. However, these strategies are yet to be explored in individuals with injuries to the hand and upper limb. This thesis includes four papers with the first two papers aimed at examining the literature on adherence to therapeutic exercise. Findings from these papers showed the interactions among the five factors influencing adherence to exercise according to the World Health Organization’s model: patient, health condition, treatment plan, health system, and socioeconomic factors. The third paper sought to understand the opinion of clinicians working in hand therapy about the mental, emotional, and social issues of patients. The result showed that participant’s beliefs, attitudes, knowledge and behavior concerning the assessment and management of psychosocial issues are shaped by several factors organized into six themes. The final paper reports on the steps involved in the making of a new internet coping skill program developed for use in individuals with hand and upper limb conditions. Review of the website by technology experts and clinicians showed areas for improvement which were subsequently amended until the participants reported satisfaction with the system. The clinicians expressed interest in using the online coping skill program in their hand therapy practice.

Yes / Most people living with dementia want to remain in their own homes, supported by family and paid carers. Care at home often breaks down, necessitating transition to a care home and existing interventions are limited. To inform the development of psychosocial interventions to enable people with dementia to live well for longer at home, we qualitatively explored the views of people living with dementia, family carers and health and social care professionals, on how to achieve and maintain independence at home and what impedes this. METHODS: We conducted an inductive thematic analysis of qualitative interviews with 11 people living with dementia, 19 professionals and 22 family carers in England. RESULTS: We identified four overarching themes: being in a safe and familiar environment, enabling not disabling care, maintaining relationships and community connectedness, and getting the right support. For people living with dementia, the realities of staying active were complex: there was a tension between accepting support that enabled independence and a feeling that in doing so they were accepting dependency. Their and professionals' accounts prioritised autonomy and 'living well with dementia', while family carers prioritised avoiding harm. Professionals promoted positive risk-taking and facilitating independence, whereas family carers often felt they were left holding this risk. DISCUSSION: Psychosocial interventions must accommodate tensions between positive risk-taking and avoiding harm, facilitating autonomy and providing support. They should be adaptive and collaborative, combining self-management with flexible support. Compassionate implementation of rights-based dementia care must consider the emotional burden for family carers of supporting someone to live positively with risk. / This work was supported by the Alzheimer’s Society (UK) and was carried out within the UCL Alzheimer’s Society Centre of Excellence for Independence at home, NIDUS (New Interventions in Dementia Study) programme (Alzheimer’s Society Centre of Excellence grant 330). This project is also part-funded funded by The National Institute for Health Research Applied Research Collaboration North West Coast (ARC NWC).

The main aim of this thesis is to analyze how the general public and registered churches are informed about the Psychosocial intervention team of the Czech Republic. In addition, the thesis focuses on the analysis of available sources of information about psychosocial intervention (aid) and crisis intervention in emergency situations. The churches were asked by using interviews with their representatives. These were mainly personal interviews, telephone communications, and e-mail correspondence. The awareness of the general public was identified by using a questionnaire. The questionnaire was based on the general information about the Psychosocial Intervention Team of the Czech Republic and emergency situations, in the second part of the questionnaire the questions were whether the respondents met with this team and in what case it was. This thesis is the first one that deals with the awareness about the Czech Psychosocial Intervention Team. It can therefore be used as a basis for further research on this topic. It has been found that the general public has some awareness of the Psychosocial Intervention Team, but it is at a very low level and only one of the 105 respondents has personally met with this team. As far as the churches are concerned, the awareness was higher, but only a few churches closely cooperate with this team. It should be noted that it would be desirable to deepen the awareness about this team by general public and to ensure better cooperation between this team and churches.

In children, life-threatening illnesses (LTIs) present with both physical and psychosocial side effects, which seem to contribute to the perpetuation of hopelessness and fear among the children and their families. Children with LTIs often experience regular and painful treatment routines. A LTI not only impacts on the child but also on the family. LTIs put families in a critical and vulnerable situation, evoking emotions such as shock, disbelief and fear. Hope and coping strategies appear to be crucial for both children and their families when facing the effects of a LTI on a child. While medical intervention strategies are used to alleviate physical side effects, psychosocial intervention strategies (as referred to in this research study) that are focused on improving the well-being of the child and family, appear to be limited. Psychosocial interventions are defined as any intervention that emphasizes psychological or social factors, rather than biological factors. Psychosocial intervention strategies, such as „dream-come-true‟ projects, appear to ameliorate distress, offer respite, decrease isolation, empower individuals, increase self-confidence and give the children unique opportunities to connect with their families in a positive, normal way. Such a psychosocial intervention strategy is offered by the Reach For A Dream Foundation (RFAD) in South Africa. The experiences of the recipients of RFAD „dream-come-true‟ projects were the focus of this study. The goal of this research study was to study the „dream-come-true‟ psychosocial experiences of children/adolescents and their families, by means of a narrative enquiry design. This design allowed participants to tell their stories truthfully, giving the researcher the opportunity to immerse herself in the personal experience of each participant. Participants were purposively, and then randomly, selected from an RFAD client list. A total of six children/adolescents, between the ages of 8 and 18 years, were randomly selected from Johannesburg and the surrounding areas. The children/adolescents and both parents were interviewed, except for one father who was not present (17 participants in total). Child/adolescent interviews included the use of fun, tactile emotive cushions to assist the participants to recognize emotions they had felt „pre-dream‟, during the „dream‟, and „postdream‟. Semi-structured, individual in-depth interviews were used to interview parent participants. The parent‟s story was not interrupted, thereby providing the opportunity for a fluid narrative. In addition to interviews, the researcher made field notes of the participant‟s reactions, body language and emotions after each interview. All interviews were recorded and transcribed. Tesch‟s (1990) approach was used to identify, analyse and report patterns within the data. The findings of this study suggest that intervention strategies improve emotional health and overall wellness in participants. „Pre-dream‟ feelings of fear, sadness, loneliness and a lack of normality in everyday life, were prominent themes. Participating parents expressed anger, helplessness and guilt about being unable to help their children. During the „dream-come-true‟ experience, the predominant themes that emerged were excitement, amazement and gratitude. The theme of disbelief in the reality and experience of the „dream‟ was also prominent. „Post-dream‟, the participants reported a more positive, confident and hopeful outlook. This research appeared to yield some important information on the possible benefits of psychosocial intervention strategies, as they seemed helpful in addressing the challenges presented by LTIs in children/adolescents. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

In children, life-threatening illnesses (LTIs) present with both physical and psychosocial side effects, which seem to contribute to the perpetuation of hopelessness and fear among the children and their families. Children with LTIs often experience regular and painful treatment routines. A LTI not only impacts on the child but also on the family. LTIs put families in a critical and vulnerable situation, evoking emotions such as shock, disbelief and fear. Hope and coping strategies appear to be crucial for both children and their families when facing the effects of a LTI on a child. While medical intervention strategies are used to alleviate physical side effects, psychosocial intervention strategies (as referred to in this research study) that are focused on improving the well-being of the child and family, appear to be limited. Psychosocial interventions are defined as any intervention that emphasizes psychological or social factors, rather than biological factors. Psychosocial intervention strategies, such as „dream-come-true‟ projects, appear to ameliorate distress, offer respite, decrease isolation, empower individuals, increase self-confidence and give the children unique opportunities to connect with their families in a positive, normal way. Such a psychosocial intervention strategy is offered by the Reach For A Dream Foundation (RFAD) in South Africa. The experiences of the recipients of RFAD „dream-come-true‟ projects were the focus of this study. The goal of this research study was to study the „dream-come-true‟ psychosocial experiences of children/adolescents and their families, by means of a narrative enquiry design. This design allowed participants to tell their stories truthfully, giving the researcher the opportunity to immerse herself in the personal experience of each participant. Participants were purposively, and then randomly, selected from an RFAD client list. A total of six children/adolescents, between the ages of 8 and 18 years, were randomly selected from Johannesburg and the surrounding areas. The children/adolescents and both parents were interviewed, except for one father who was not present (17 participants in total). Child/adolescent interviews included the use of fun, tactile emotive cushions to assist the participants to recognize emotions they had felt „pre-dream‟, during the „dream‟, and „postdream‟. Semi-structured, individual in-depth interviews were used to interview parent participants. The parent‟s story was not interrupted, thereby providing the opportunity for a fluid narrative. In addition to interviews, the researcher made field notes of the participant‟s reactions, body language and emotions after each interview. All interviews were recorded and transcribed. Tesch‟s (1990) approach was used to identify, analyse and report patterns within the data. The findings of this study suggest that intervention strategies improve emotional health and overall wellness in participants. „Pre-dream‟ feelings of fear, sadness, loneliness and a lack of normality in everyday life, were prominent themes. Participating parents expressed anger, helplessness and guilt about being unable to help their children. During the „dream-come-true‟ experience, the predominant themes that emerged were excitement, amazement and gratitude. The theme of disbelief in the reality and experience of the „dream‟ was also prominent. „Post-dream‟, the participants reported a more positive, confident and hopeful outlook. This research appeared to yield some important information on the possible benefits of psychosocial intervention strategies, as they seemed helpful in addressing the challenges presented by LTIs in children/adolescents. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-06-20T14:41:56Z No. of bitstreams: 1 HeronFloresNogueiraTeseParcial2017.pdf: 1090458 bytes, checksum: 7fb58690cffa20a016340355c25897be (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-06-20T14:42:15Z (GMT) No. of bitstreams: 1 HeronFloresNogueiraTeseParcial2017.pdf: 1090458 bytes, checksum: 7fb58690cffa20a016340355c25897be (MD5) / Made available in DSpace on 2018-06-20T14:42:15Z (GMT). No. of bitstreams: 1 HeronFloresNogueiraTeseParcial2017.pdf: 1090458 bytes, checksum: 7fb58690cffa20a016340355c25897be (MD5) Previous issue date: 2017-07-26 / Childhood obesity has reached levels never seen in our history. The family environment is one of the factors that can contribute to the emergence and maintenance of obesity, on the other hand, the participation of families is also considered as fundamental in prevention and treatment. In the literature there is notably a shortage of studies that focus on this issue. The present research has as general objective to perform a psychosocial intervention with families of obese children and to investigate their experiences and perceptions about possible changes in family dynamics, eating habits and lifestyle. This is a qualitative research through action research from the perspective of the Systemic Approach to the Family. Three families with children diagnosed with obesity participated in this study, living in different administrative regions of the Federal District and having an average family income of two minimum wages. The instruments used for the collection were: family life cycle interview script, genogram, scripts for the Multifamily Group (MG), follow-up interview script, HAT-Helpful Aspects of Therapy and the CCI-Client Change Interview. After the signing of the Informed Consent Term, the families were interviewed separately and the genogram was built, with an average duration of two hours, at the UCB Applied Psychology Training Center (CEFPA). After a few weeks, in the same place, the families participated in the GM, which happened in five meetings, with biweekly intervals, each with an average duration of three hours. For these steps the researcher counted on scholarship students of Scientific Initiation of the course of Psychology. After two years, the families were interviewed by the researcher in their homes (follow-up) and each interview lasted an average of two hours. All stages of the research were recorded in audios, whose contents were later transcribed in full. The analysis of the information was made in the light of the Qualitative Epistemology in which the researcher realizes a constructive-interpretative production, and discussed based on the contribution of the systemic theory. The main aspects observed and discussed were organized in three stages: 1) the interview of the family life cycle: knowing the family and its history - the information collected showed the gestation of the babies without planning; Interaction pattern with conflicts, absence of parental authority and diffuse internal borders; Inadequate food pattern and difficulties in adhering to treatments. 2) The GM: interaction, learning and growth - transgenerational influences on the current food pattern and extensive family interferences; Difficulties in exercising the parental role and promoting adequate nutrition; Meanings of feeding and expression of intrafamilial affections; Attempts to make changes, and 3) the follow-up interview: revisiting families - jobs and activities remembered with ease; The changes made possible after the interventions; Current family dynamics with the presence of limits, authority and health care; Family contributions to the intervention model and expectations for the future. The present study, therefore, analyzed the families' experience in the psychosocial intervention, providing an in-depth and complex reading of the different factors related to childhood obesity and the family. This study can contribute to preventive actions and treatment of obesity, as well as help in the promotion of new research on the disease. / A obesidade infantil atingiu índices nunca vistos na nossa história. O ambiente familiar é um dos fatores que podem contribuir para o surgimento e manutenção da obesidade, por outro lado, a participação das famílias é apontada também como fundamental na prevenção e no tratamento. Na literatura há notadamente uma escassez de estudos que enfoquem essa questão. A presente pesquisa tem como objetivo geral realizar uma intervenção psicossocial com famílias de crianças obesas e investigar suas vivências e percepções sobre possíveis mudanças na dinâmica familiar, nos hábitos alimentares e no estilo de vida. Trata-se de uma pesquisa qualitativa por meio de pesquisa-ação numa perspectiva da Abordagem Sistêmica da Família. Participaram deste estudo três famílias com crianças diagnosticadas com obesidade, moradoras de diferentes regiões administrativas do Distrito Federal e possuem renda familiar média de dois salários mínimos. Os instrumentos utilizados para a coleta foram: roteiro de entrevista do ciclo de vida familiar, genograma, roteiros para o Grupo Multifamiliar (GM), roteiro de entrevista de follow-up, HAT-Helpful Aspects of Therapy e o CCI-Client Change Interview. Após a assinatura do Termo de Consentimento Livre e Esclarecido, as famílias foram entrevistadas separadamente e foi construído o genograma, com duração média de duas horas, no Centro de Formação em Psicologia Aplicada (CEFPA) da UCB. Após algumas semanas, no mesmo local, as famílias participaram do GM, que aconteceu em cinco encontros, com intervalos quinzenais, cada um com duração média de três horas. Para essas etapas o pesquisador contou com alunos bolsistas de Iniciação Científica do curso de Psicologia. Após dois anos, as famílias foram entrevistadas pelo pesquisador em suas residências (follow-up) e cada entrevista teve duração média de duas horas. Todas as etapas da pesquisa foram registradas em áudios, cujo conteúdo foi posteriormente transcrito na íntegra. A análise das informações foi feita à luz da Epistemologia Qualitativa em que o pesquisador realiza uma produção construtivo-interpretativa, e discutidas com base no aporte da teoria sistêmica. Os principais aspectos observados e discutidos foram organizados em três etapas: 1) a entrevista do ciclo de vida familiar: conhecendo a família e sua história – as informações levantadas mostraram a gestação dos bebês sem planejamento; padrão interacional com conflitos, ausência de autoridade parental e fronteiras internas difusas; padrão alimentar inadequado e dificuldades em aderir aos tratamentos. 2) O GM: interação, aprendizado e crescimento – influências transgeracionais no padrão alimentar atual e interferências das famílias extensas; dificuldades de exercer o papel parental e promover alimentação adequada; significados da alimentação e expressão dos afetos intrafamiliares; tentativas de realizar mudanças e 3) a entrevista de follow-up: revisitando as famílias - os trabalhos e as atividades lembrados com facilidade; as mudanças possibilitadas após as intervenções; dinâmicas familiares atuais com presença de limites, autoridade e cuidados com a saúde; contribuições das famílias para o modelo de intervenção e expectativas para o futuro. O presente trabalho, portanto, analisou a vivência das famílias na intervenção psicossocial proporcionando uma leitura aprofundada e complexa dos diferentes fatores relacionados à obesidade infantil e à família. Este estudo pode contribuir para ações preventivas e de tratamento da obesidade, assim como auxiliar no fomento de novas investigações sobre a doença.

This thesis focuses on psychosocial interventions for psychosis. It consists of two parts: a systematic review on quality of life in forensic settings and an empirical study on negative symptoms. The systematic review follows the publication guidelines of the journal International Journal of Forensic Mental Health whilst the empirical study follows the publication guidelines of the journal Clinical Psychology and Psychotherapy. Reasonable adjustments have been made to the formatting of this thesis to enhance readability. Purpose: The systematic literature review aimed to summarise and critically appraise studies that have evaluated the effects of psychosocial interventions for psychotic disorders in forensic settings on quality of life. The empirical study aimed to evaluate the feasibility of Metacognitive Training (MCT) for negative symptoms and to identify mechanisms of change. Methods: The literature was systematically searched (using four databases) for research that included any quantitative measure of quality of life (i.e. self-esteem, quality of life, life satisfaction, and/or self-efficacy in relation to life-goals). In the empirical study, a new intervention was developed by modifying MCT for negative symptoms and four aspects of feasibility were evaluated: acceptability, practicality, demand and limited efficacy. The quantitative approach was supplemented with qualitative interviews on participants' views of the intervention. In addition, potential mechanisms of change were evaluated using a promising new method for analysing data from case-series: multilevel modeling. Results: In total, 10 papers met the inclusion criteria in the systematic review. Significant improvements in quality of life were found in five studies. The modified version of MCT showed good feasibility as demonstrated by the attendance rate, the positive oral feedback from participants and the multidisciplinary team, and the improvements on negative symptoms that were found following the intervention. Multilevel modeling proved useful in explaining the variance attributable to three different predictors: depression, internalised stigma, and reflective functioning. Conclusions: It was found that quality of life can be improved in forensic settings using psychosocial interventions. The pilot study indicated that MCT for negative symptoms has high feasibility and that changes in negative symptoms can partially be explained by depression, stigma, and reflective functioning.

This study investigated the experience of posttraumatic growth for breast cancer survivors who volunteered to complete a survey (N = 277). A number of participants also provided narrative responses containing their personal experiences of breast cancer (N = 100). Demographic characteristics, breast cancer variables, optimism, coping strategies, and participation in psychosocial interventions were examined in relation to posttraumatic growth as measured by the Posttraumatic Growth Inventory. Differences between those who participated in psychosocial interventions versus those who did not were examined. The relation of coping strategies utilized and optimism level to interventions accessed was also of interest. Predictors of posttraumatic growth were examined via generalized linear modeling. Finally, the narrative responses were investigated by means of content analysis. The results provided evidence that demographic characteristics (i.e., affiliation with religion and lower levels of education) and one breast cancer variable (i.e., increased number of years since diagnosis) were related to experiences of posttraumatic growth for breast cancer survivors. Use of active forms of coping, optimism level, and participation in recreational interventions were also related to posttraumatic growth. Those who participated in psychosocial interventions were more likely to be employed and have higher levels of education than those who did not access interventions. Use of several active coping strategies and one passive coping strategy increased the likelihood of accessing a number of different psychosocial interventions. Posttraumatic growth was predicated by affiliation with religion, lower levels of education, increased number of years since diagnosis, knowledge of breast cancer stage, higher levels of optimism, and use of one passive and two active coping strategies. Many of these findings support previous research, however some conflict with prior results. The narrative responses contained information regarding diagnosis and treatment, impact of breast cancer, coping with breast cancer, and support accessed. Although the negative impact of breast cancer was discussed in terms of short and long-term, positive long-term changes were also reported. A variety of coping strategies and supports were utilized by the participants as well.