If You Have a Question, Others Probably Do Too
Do I belong here?
What do I wish I knew when I started this job, degree, or program?
You’ve probably asked yourself these universal questions when you’ve started a new educational program, job, or project.
A team of University of Pittsburgh researchers used the power of reflecting on these ever-present questions to develop a three-session, evidence-based ecological belonging program, Supporting Hardiness and Inclusion for New Endeavors (SHINE), for entry-level occupational therapy doctorate students. The research team engaged 41 graduate students in focus group discussions to shed light on key themes related to social and academic belonging, including making friends, balancing school and personal life, building confidence in learned knowledge and skills, and introspection about success in the occupational therapy (OT) field.
This research, conducted by Avital Isenberg, CScD, OTR/L, Erin L. Mathia, CScD, OTR/L, and Ketki D. Raina, PhD, OTR/L, FAOTA from the University of Pittsburgh Department of Occupational Therapy, Susie Chen of WGU Labs to provide support with qualitative data analysis, Erica McGreevy, PhD from the University of Pittsburgh Department of Biological Sciences, and Kevin Binning, PhD from the University of Pittsburgh Department of Psychology who specializes in ecological belonging interventions, was published in September 2025 in Social and Academic Belonging: Developing an Ecological Belonging Program for Occupational Therapy Students.
Normalizing the Ups and Downs of Graduate School
Focus group discussions warmed up with an icebreaker in which the researchers, who were also the facilitators, shared personal stories to highlight their own graduate school challenges and how they overcame them.
Upon reflecting on the academic experience, researcher Avital Isenberg shared, “When I was in grad school, it was the first time that I was really academically challenged. I was completely overwhelmed by the amount of studying that I was expected to do, and I didn’t even know how to start. I had no study skills at all! I remember feeling so overwhelmed to the point of tears, calling my mother and telling her that I was dropping out of OT school. She was able to provide me with studying tips and ways to learn how to break up the information so I wasn’t so overwhelmed. This was really helpful, and I was able to persevere with the help of those around me and a lot of coffee and exercise. Here I am today-- obviously on the other side of OT school.”
“When I was in grad school, it was the first time that I was really academically challenged. I was completely overwhelmed by the amount of studying that I was expected to do, and I didn’t even know how to start. [...] I was able to persevere with the help of those around me and a lot of coffee and exercise. Here I am today— obviously on the other side of OT school.”
Then, students were guided to reflect on and explore both the positive and challenging experiences of the occupational therapy doctoral program. As part of this facilitated exercise, students created colorful, descriptive journey maps of their paths in graduate school, including moments of worry, doubt, achievement, connection, and disconnection.
Following this activity, students engaged in a group discussion about their journey maps to explore and spotlight similar and different themes. To conclude the focus group, the facilitators asked students to write a postcard to their past selves, offering advice on what they wish they had known before starting graduate school.
The qualitative descriptive methodology used by the researchers acknowledged that belonging, specifically both social belonging and academic belonging, evaluated in this work, is a subjective phenomenon and was designed to reflect students’ diverse experiences, explanations, and concepts. This way, each student’s unique experience and perspective was used to develop a nuanced description and understanding of students’ experiences to develop SHINE.
Photo: Sarah b/Unsplash
Road Curves Ahead: Understanding and Accepting Key Transitions
The journeys that students reflected on, drew, and compared revealed themes related to social and academic belonging at three specific time points: 1) the first term of year one, 2) the start of Level II fieldwork in year two, and 3) the capstone experience in year three.
For example, regarding social belonging over these three years, students' concerns evolved from making friends and balancing school and personal life in year one, to support from faculty and fieldwork education and mentorship dynamics in year two, to getting used to being back in the classroom after conducting fieldwork in year three. While reflecting on social belonging during year one, a student shared, “One of my biggest fears … was being alone. I didn’t know anyone in the program, and I felt extremely isolated …”
“One of my biggest fears … was being alone. I didn’t know anyone in the program, and I felt extremely isolated …”
Similarly, related to academic belonging, the journey highlighted concerns such as questioning the choice of taking the path to become an occupational therapist in year one, to uncertainty about excitement about beginning Level II fieldwork in year two, to excitement and anxiety about starting to work as entry-level therapists, including passing national board certifications in year three. For example, one student shared the following reflection on academic belonging in year two, “I was a little nervous before we started fieldwork in the second year … you realize you have to actually apply what you’ve been learning with real patients.”
“I was a little nervous before we started fieldwork in the second year … you realize you have to actually apply what you’ve been learning with real patients.”
Photo: Timur Shakerzianov/Unsplash
You Are Here: SHINE Helps Students Accept the Journey
Based on the focus group findings and themes, the researchers aimed to normalize student struggles as expected, overall helpful, and a universal experience through the SHINE program, which is based on an effective ecological belonging intervention described in Kevin Binning, PhD’s 2020 publication. Related to Binning’s ecological belonging work, SHINE is incorporated into the overall academic experience by providing students with dedicated time to reflect on the challenges they may be facing.
SHINE includes three 45- to 50-minute sessions to address key times when occupational therapy doctorate program challenges occur. The sessions address the themes of adversity and belonging with an introduction, self-reflective writing, testimonials, small- and large-group discussions, and an actionable takeaway.
A central feature of the SHINE program is the ability to tailor the program. To achieve this, educators can support students at key times to normalize challenges encountered, address common questions students have, and encourage success. Avital Isenberg adds, “we hope to take the program school-wide for the University of Pittsburgh School of Health and Rehabilitation Sciences by considering the different programs and the unique points during the programs where students experience this lack of belonging, we can tailor the time points, number of sessions, and testimonials for each group. For the community, we have considered ways that we could adapt SHINE for entry-level clinicians (occupational therapy or other healthcare professionals) to address those feelings of imposter syndrome and see whether it impacts burnout or long-term job retention.”
SHINE sessions guide students to explore and reflect on social and academic belonging (Image adapted by Pearl Kaplan from Table 3 in Isenberg et al., 2025)
Finding Connection Along the Way
Drawing on insights from occupational therapy doctorate students in focus groups, SHINE aims to normalize challenges and address self-doubt by offering a series of sessions that guide students on a facilitated journey to reflect, explore, and connect with themselves and peers.
As the researchers state in their publication, the ecological belonging program is focused “on building confidence, belonging, and strategies to overcome self-doubt, helping students develop resilience for success in education and future practice.”
As belonging research is conducted more commonly for undergraduate student experience, this new program meets the needs to support graduate students’ belonging and educational journey. In addition to supporting academic performance and psychological health, this research focused on the unique experiences and needs of occupational therapy doctorate students, as these healthcare professionals encounter a specific curriculum, fieldwork, and requirements to train to enter the workforce.
References:
Binning, K. R., Kaufmann, N., McGreevy, E. M., Fotuhi, O., Chen, S., Marshman, E., Kalender, Z. Y., Limeri, L., Betancur, L. Singh, C. (2020). Changing Social Contexts to Foster Equity in College Science Courses: An Ecological-Belonging Intervention. Psychological Science, 31(9), 1059-1070. https://doi.org/10.1177/0956797620929
Isenberg, A. S., Mathia, E. L., Chen, S., McGreevy, E. M., Binning, K. R., & Raina, K. D. (2025). Social and Academic Belonging: Developing an Ecological Belonging Program for Occupational Therapy Students. American Journal of Occupational Therapy, 79(5), 7905205180. https://doi.org/10.5014/ajot.2025.051027