Dr. McDonald explored the subjective effects of Transformative Living Practices (originally known as Psychospiritual Integration and Transformation) on coping with breast cancer as her dissertation research. Her qualitative study explored the subjective effects of Transformative Living Practices (TLP) process groups and community-based breast cancer support groups on coping. Community-based breast cancer support groups seem to focus primarily on emotional expression and problem solving, whereas TLP is a set of processes that facilitate psychological, existential, and spiritual development. Two samples totaling 24 women, 12 from TLP process groups and 12 representing several community-based breast cancer support groups, participated in the study. All participants were diagnosed with non-metastatic breast cancer within the past 10 years and interviewed upon completion of at least 18 hours of participation in their chosen group. Data were analyzed using a combination of thematic analysis and grounded theory resulting in three major findings:

• TLP groups and community-based breast cancer support groups may have positively supported coping efforts and posttraumatic growth in the following areas:
  • Self-acceptance
  • Body image
  • Life purpose and meaning
  • Spirituality
  • Reassessment of values and priorities
  • Interpersonal relationships
• Both samples reported increased acceptance of self and situations and the ability to release expectations and control. This acceptance–release coping process seemed to assist participants in managing the perceived paradox of pre- and post-cancer global assumptions. Based upon these findings, a preliminary theoretical model of adaptive re-perceiving is proposed which may contribute to current models of post-traumatic growth and meaning-based coping.
• TLP sample participants reported more positive subjective effects on spiritual and existential development and coping, whereas comparison sample participants reported more positive subjective effects on comprehending and managing the breast cancer experience.

• McDonald, C. Coup de Grace (Strokes of Grace): A Qualitative Analysis of Two Breast Cancer Support Methods and Their Subjective Effects on Coping. Proquest Dissertations, UMI: AAT 3352773. (2009). Institute of Transpersonal Psychology, Palo Alto, CA, USA.