DESCRIPTION (provided by applicant): We propose a randomized clinical trial to test the efficacy and durability of an Individualized Representational Intervention (IRIS) to reduce symptom distress and improve quality of life in older breast cancer (BC) survivors. IRIS is conceptually grounded in Donovan and Ward's Representational Approach to Patient Education (Donovan & Ward, 2001; Leventhal, Meyer, & Nerenz, 1980) and extensive preliminary research by the investigators in which beliefs about symptoms and symptom management were identified and an intervention to address these beliefs and improve symptom management was developed. Although 50% of breast cancers are in women over 65, their problems and needs have not been identified or addressed. Older breast cancer survivors face unique challenges because they experience symptoms of their disease and its treatment concurrent with symptoms of age related chronic illnesses, and they may hold beliefs that may function as barriers to effective symptom management. From this perspective, age is the salient context influencing women's experience of breast cancer as well as the dimensions that comprise quality of life. A sample of 207 women, aged 65 and over, and at least three months post-treatment for non-metastatic breast cancer will be randomly assigned to IRIS or Wait-List Control. IRIS is an individualized psychoeducational program delivered by an advanced practice nurse in a face-to-face interview with four telephone reinforcements. Data collection will occur at baseline and two, four, six, eight, and 16 weeks post-intervention using standardized instruments. The specific hypotheses are that IRIS will be superior to wait-list control with respect to symptom distress and quality of life from baseline to post-test and from baseline to follow-up and the effect of IRIS will be mediated by symptom management beliefs and strategies.