To present a cross-sectional qualitative exploration of how individuals cope with a lower limb amputation and to examine the influence of positive coping and stress-related psychological growth on adjustment. Participants: 12 patients with a lower limb amputation. Setting: Artificial Limb and Appliance Centre in South Wales, United Kingdom. Design: Semistructured interviews, using grounded theory for analysis. Measures: The Hospital Anxiety and Depression Scale (A. Zigmond & R. Snaith, 1983) and the Rosenberg Self-Esteem Scale (M. Rosenberg, 1965). Results: No evidence of psychological distress among participants. Qualitative analysis revealed 5 categories of coping, and a theoretical model of positive coping following lower limb amputation was generated. Conclusions: Coping strategies evolve, reflecting the changes in psychological demands postamputation. Positive coping and psychological growth facilitates psychological adjustment. Clinicians may facilitate adaptive outcomes by appreciating the positive psychology perspective.

Background: The current study was concerned with the issue of service user involvement in the planning and running of mental health services within the UK.

Objectives. To examine the effects of a 1-day acceptance and commitment therapy (ACT) workshop on the mental health of clinically distressed health care employees, and to explore ACT's processes of change in a routine practice setting.Design. A quasi-controlled design, with participants block allocated to an ACT intervention or waiting list control group based on self-referral date.Methods. Participants were 35 health care workers who had self-referred for the ACT workshop via a clinical support service for staff. Measures were completed by ACT and control group participants at pre-intervention and 3 months post-intervention. Participants allocated to the waitlist condition went on to receive the ACT intervention and were also assessed 3 months later.Results. At 3 months post-intervention, participants in the ACT group reported a significantly lower level of psychological distress compared to the control group (d = 1.41). Across the 3-month evaluation period, clinically significant change was exhibited by 50% of ACT participants, compared to 0% in the control group. When the control group received the same ACT intervention, 69% went on to exhibit clinically significant change. The ACT intervention also resulted in significant improvements in psychological flexibility, defusion, and mindfulness skills, but did not significantly reduce the frequency of negative cognitions. Bootstrapped mediation analyses indicated that the reduction in distress in the ACT condition was primarily associated with an increase in mindfulness skills, especially observing and non-reactivity.Conclusions. These findings provide preliminary support for providing brief ACT interventions as part of routine clinical support services for distressed workers. Practitioner pointsA 1-day ACT workshop delivered in the context of a routine staff support service was effective for reducing psychological distress among health care workers.

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