Across the nation schools are adopting Positive Behavior Interventions and Support as a school management plan. Despite the vast research on PBIS implementation and the effects of the program on student behavior, little is known about the sustainability of the model. This qualitative single case study examined stakeholder values, beliefs, and feelings in relation to PBIS in a western North Carolina middle school in which School-wide Evaluation Tool evaluations over six years point to a successfully sustained program. Under a framework of symbolic interactionism, in which the dynamics of interpersonal relationships, leadership, communication, and the local environment are acknowledged as factors on perceptions and attitudes, data was collected in the form of personal interviews, observations, and artifacts. Findings show important contributing factors to the sustainability of PBIS at the sample school include teacher buy-in, program effectiveness, communication, commitment and collaboration, teacher leadership, and teacher voice. The PBIS program suffered in its implementation due to teacher perceptions of the initiative as top heavy and administratively forced. Sustainability was made possible when teacher voice was heard and teacher leadership emerged. Implications of this research extend beyond the PBIS program to any initiative introduced into schools. Teacher buy-in is key to program sustainability. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]