NARRATIVES OF PERCEIVED SOCIAL SUPPORT AS A MEDIATOR FOR INCREASED COPING RESOURCES AND OPTIMISM AMONG CANCER PATIENTS AND SURVIVORS by TAVARI TAYLOR BROWN A Dissertation Submitted to the Faculty in the Counselor duration and Supervision Program of Penfield College at Mercer University in Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY Atlanta, GA 2014 COPYRIGHT 2015 UMI Number: 3662748 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. Di!ss0?t&Ciori Publishing UMI 3662748 Published by ProQuest LLC 2015. Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 COPYRIGHT 2015 TAVARI TAYLOR BROWN ALL RIGHTS RESERVED ACKNOWLEDGEMENTS Thank you, Terrence Dominic Brown for nearly five years of evenings alone, waking up at 2:00 a.m. wondering why your wife is in another room reading or typing under dim light, and for a commitment to our marriage. Thank you, Talia G. Brown for being the best fetus, neonate, and daughter in the history of the world ever known to mankind! To “Dee,” the pink-ribbon binding four out of five narratives. We miss you so! Thank you for sharing your wonderful light, life, and “effervescence” as one interview participant stated. Thank you for making the difference in so many lives while you were here. Munchie loves you! Thanks to the 2010 Counselor Education and Supervision cohort, Drs. W. David Lane, and Arthur Williams for your support and belief in my ability to complete this process. I would like to express my deepest appreciation to Dr. Karen Swanson for answering her phone in 2012 and allowing me to enroll in her Qualitative Analysis class with two hours notice. Thank you for sharing your time, stories, and experience with me. My thanks goes to Dr. Donald Redmond for encouraging me to part-take in a qualitative study, opening up the world of narrative, and for always being so honest and supportive. I would like to thank Drs. Renee Ned and Theresa Reese for jumping into this process with little notice or explanation beyond openness to the process. Finally, this dissertation contains the words, emotions, and medical details of five individuals who generously shared their most intimate experiences with cancer and beyond. I offer you my most sincere gratitude and share your hope that your personal stories will help improve public and professional understanding of what it means to be a survivor and thereby enhance the quality of care that health professionals provide to patients. TABLE OF CONTENTS Page ACKNOWLEDGEMENTS................................................................................................................iv ABSTRACT......................................................................................................................................... xiii CHAPTER 1. INTRODUCTION TO THE STUDY.......................................................................................1 Narrative Therapy ....................................................................................................................... 3 Narrative Methodology .............................................................................................................. 4 Purpose of Study ..........................................................................................................................7 Theoretical Framework...............................................................................................................8 Rationale for the Study ...............................................................................................................10 Definition of Key Terms .............................................................................................................12 Assumptions .................................................................................................................................13 Limitations ....................................................................................................................................15 Delimitations ............................................................................................................................... 16 Summary......................................................................................................................................16 2. REVIEW OF RELATED LITERATURE.............................................................................. 18 Self-Efficacy............................................................................................................................... 18 Control ............................................................................................................................19 Human Agency ............................................................................................................. 20 Coping................................ 21 Adaptation ...................................................................................................................... 22 v TABLE OF CONTENTS (Continued) CHAPTER Page Emotional Expression ...................................................................................................22 Coping Styles.................................................................................................................23 Coping Support..............................................................................................................26 Social Support.............................................................................................................................26 Self-Regulation thru Social Support.......................................................................... 27 Unsupportive Behaviors................................................................................................31 Coping as a Couple..................................................................................................................... 33 Child and Adolescent Adjustment ...............................................................................35 Supportive Others ........................................................................................................................36 Multicultural Perspectives ......................................................................................................... 38 Implications .................................................................................................................................. 41 Summary.......................................................................................................................................43 3. METHODOLOGY..................................................................................................................... 46 Narrative Phenomena .................................................................................................................46 Narrative Researcher ..................................................................................................................46 Phenomenology ...........................................................................................................................49 Experience ...................................................................................................................... 49 Perception ........................................................................................................................50 Problem and Purpose Overview ................................................................................................52 Research Question ......................................................................................................... 53 Data Collection ...............................................................................................................55 vi TABLE OF CONTENTS (Continued) CHAPTER Page Analysis ........................................................................................................................................ 56 4. PARTICIPANT 1...................................................................................................................... 58 Introduction ................................................................................................................................. 58 Individual Themes .......................................................................................................................58 Theme 1 Support............................................................................................................58 Friends and Neighbors ..................................................................................... 60 Physicians and Hospital Staff. ........................................................................62 Theme 2 Coping and Optimism ................................................................................... 62 Theme 3 God, Church, and Religion ...........................................................................64 Theme 4 Group Support..............................................................................................