Document Type (Journals)

Original Research


Rates of stress, anxiety, depression, and burnout for university students are concerning. As in other competitive professional fields, graduate students in occupational therapy, physical therapy, and speech language pathology face many performance pressures. Creating supportive learning and wholeness climates along with individual grit, resilience, and healthy spirituality have the potential to positively impact these pressures. The study’s purpose was to examine factors related to burnout within an institution committed to creating supportive learning and wholeness environments. Three hundred and fifty-three graduate students from occupational therapy, physical therapy, and speech language pathology graduate programs were recruited to participate in a cross-sectional survey exploring student functioning using primarily validated measures. Hierarchical multiple regressions were utilized to test the unique contributions of perceived learning and wholeness climates, demographics, mental health factors, and potential coping factors to better understand burnout/disengagement and burnout/exhaustion. All models accounted for a significant amount of the variance in both burnout/disengagement (38.2%) and burnout/exhaustion (46.9%). Higher student perceptions of positive wholeness and learning climates, grit, and personal spirituality/peace suggested lower burnout/disengagement, but spirituality/meaning had an unexpected negative outcome. Burnout/exhaustion was negatively associated with anxiety, depression, and spirituality/faith while positively with spirituality/peace. Overall, students’ views of the university providing a supportive wholeness and learning climate as well as their personal grit was associated with lower burnout. Depression and anxiety were negatively associated with burnout/exhaustion. Spirituality was more complicated with variation in risk versus supportive factors. Results may help guide future studies, provide suggestions for specific programming, and promote supportive university environments.


Stacey Cunningham, PhD, MHS, OTR/L is an occupational therapist with experiences within neurology, pediatrics, school-based practice, and higher education. She has studied education, occupational therapy, and social sciences. Stacey has further experience within disability resources, and she especially enjoys mentoring students through the interactive classroom environment to collectively strive to make a difference.

Susanne Montgomery, PhD, MPH, MS is a social/behavioral epidemiologist with an interest in translational, applied health and wellness research. In today’s competitive and stressful higher learning environment she is committed to mentor students to find their passion and pursue wholeness, and as a result become effective and successful professionals.

Brian Distelberg, PhD, MA is a Professor in the Loma Linda University School of Behavioral Health as well as the Director of Research for the Behavioral Medicine Center. His research expertise is in the area of mental health and health integration, he has also developed programs and nonprofits in these areas.

Qais Alemi, PhD, MPH, MBA is a global health researcher studying populations affected by political violence. His research includes studies of refugees and asylum-seekers and contributes to the expanding knowledge of psychosocial needs of resettlement communities in the U.S. and abroad along with how social factors, including discrimination, add to adjustment challenges.

Declaration of Interest

The four authors are or were employed at the university studied. More specifically, the primary author/student researcher completed the research as part of a non-funded/non-sponsored dissertation while simultaneously employed by the Department of OT after receiving permission from the School of Allied Health Professions and approval by the university’s IRB. To limit bias and/or influence for graduate students to participate, protocol included having the student researcher exit the room when OT students voluntarily took the survey after initial recruitment. Data responses appeared candid, and may serve to further inform research.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.