THE EXPERIENCE OF ACADEMIC SUCCESS
AMONG NON-TRADITIONAL AGED LEARNERS:
THE ROLE OF POSSIBLE SELVES IN THE PERSISTENCE
OF OCCUPATIONAL THERAPY STUDENTS
By
Susan Tons

A DISSERTATION
Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of
DOCTOR OF PHILOSOPHY
Educational Administration
2011

ABSTRACT

THE EXPERIENCE OF ACADEMIC SUCCESS
AMONG NON-TRADITIONAL AGED LEARNERS:
THE ROLE OF POSSIBLE SELVES IN THE PERSISTENCE
OF OCCUPATIONAL THERAPY STUDENTS

By
Susan Tons

This study explored how non-traditional aged students in professional level
occupational therapy programs persisted through their long and challenging academic
curriculums despite facing obstacles. Non-traditional aged students are gravitating to
majors in the professions and there are very few studies in which theoretical frameworks
on student departure or persistence have been applied to students in the professions, such
as the health care profession of occupational therapy. Most retention studies focus on
students in non-specified majors. It was suspected that students majoring in a health care
profession such as occupational therapy may have characteristics and needs that differ
from students seeking degrees in other majors.
This qualitative study asked participants who successfully persisted despite
obstacles to tell their story in the narrative inquiry tradition. Cross-case analysis was also
done to discover common patterns of experience related to the phenomena being studied.
Sixteen non-traditional aged students from four institutions with accredited occupational
therapy academic programs were interviewed.

A distinctive finding was related to the motivation of the participants. The
participants in this study expressed unique motivations for pursuing their degree, which
are not explicitly mentioned in the education retention literature. Participants all spoke of
a desire to become someone different or someone better, the majority stating that they
wanted to be in a position to help others or contribute to society. Enrollment in their
program was viewed as a way to enact this desire to become “a new possible self” and
was intertwined with strong determination, what some participants described as
“mindset.”
The findings also reflected that these occupational therapy students were similar
to other non-traditional aged students in some ways. Their persistence was affected by the
type and amount of support they received, and they also faced challenges balancing
competing roles in their life such as employee, student, parent, and spouse. However, the
majority of these participants faced an additional challenge to balance. Many were also
struggling with a medical condition in themselves or had a close family member who
faced significant health issues.

ACKNOWLEDGEMENTS
I am deeply grateful to a number of people who supported me while I pursued
my doctoral degree. First, I would like to express my gratitude to three very special
people from my past: my father, mother, and grandmother. My father and his mother had
a passion for life long learning which inspired me to take on this endeavor. I would also
like to acknowledge my mom who was always there for me, even though she didn’t quite
understand why I was endlessly pursuing college degrees. She respected my choices and
never discouraged me.
I would also like to thank my friends and family who were very supportive; they
understood I had less time to “play” and were always encouraging. I would especially
like to thank my Chris, for all his encouraging words and his much needed technical
support. I also need to express special gratitude to my daughters, Allison and Marissa,
who encouraged me by simply telling me how proud they were of their mom; it meant so
much.
My appreciation certainly extends to my dissertation committee: Kris Renn,
Cary Roseth, Matthew Wawrzynski, and John Dirkx, my research advisor. They all
provided me with valuable input that helped me develop as a researcher. Special thanks
need to be expressed to John Dirk. I felt privileged to have him as a mentor during this
journey, as he helped me “contribute to the body of knowledge.” I also need to
acknowledge the late Dr. Jere Brophy who introduced me to the possible selves literature.
Lastly, I want to thank my wonderful research participants. I couldn’t have done
this without their cooperation. They gave me their very precious time to share details
about their past, present, and their hoped for futures.

iv

TABLE OF CONTENTS

List of Tables……………………………………………………………………………viii
List of Figures…………………………………………………………………………….ix
Chapter One
Introduction
Purpose of the Study…………………………………………………………........1
Background to the Study..........................................................................................4
Significance of the Study .........................................................................................6
Context for the Study………………………….......................................................8
Problem Statement .................................................................................................13
Research Questions................................................................................................13
Introduction to the Conceptual and Theoretical Frameworks................................14
Chapter Two
Literature Review
Introduction............................................................................................................18
Persistence in Occupational Therapy and Related Health Professions..................20
Education Perspective…….………………………………………………...……25
The Adult Learner and Persistence ............................................................26
Retention of Students in Higher Education………………..…………….27
Non-Traditional Students in Higher Education .........................................30
Psychology Perspective .........................................................................................32
Possible Selves Theory ..............................................................................34
Social Cognitive Perspectives Supporting the
Possible Selves Concept ............................................................................36
Summary ....................................................................................................39
Chapter Three
Methodology
Introduction............................................................................................................40
Research Design.....................................................................................................40
Narrative Methodology..............................................................................41
The Kawa Model........................................................................................42
Site and Sample Selection......................................................................................44
Site Selection .............................................................................................44
Weekend College ...........................................................................46
Career College ...............................................................................46
Regional University .......................................................................47
Research University .......................................................................47
Participant Selection ..................................................................................47
Data Collection ......................................................................................................50

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Data Analysis .........................................................................................................55
Trustworthiness......................................................................................................59
Orientation of the Researcher ................................................................................60
Strengths and Limitations ......................................................................................61
Chapter Four
Student Profiles
Introduction............................................................................................................64
Participants from Weekend College: Ellen, Helen, Ivan, Fiona, Gale ..................65
Participants from Career College: Barb, Anne, Carey, Donna ..............................76
Participants from Regional University: Julie, Karen, Lindsay ..............................83
Participants from Research University: Nicole, Paula, Olivia, Marie ...................89
Chapter Five
Emergent Themes
Becoming an OT: A Way to Become Who I Want to Be......................................98
Their Desire Interacts with an Awareness of the Profession .....................99
Altruism as a Motivator to Becoming Someone Different ......................101
Becoming Someone “Better” for Themselves .........................................102
Becoming Someone Better in Reaction to Others or for Others………..104
Bound Together: Motivation to Initiate and Motivation to Persist……..106
Summary ..................................................................................................108
Balancing: Getting Around the Boulders.............................................................108
The Challenges they Anticipated .............................................................109
Adapting to the Challenges they did not Anticipate ................................111
Persistence in the Face of Boulders: Strategies
to Address the Challenges........................................................................113
The Largest Boulder for Participants: Medical Problems .......................118
Summary ..................................................................................................125
Support: People on the River Bank......................................................................125
Types of Support......................................................................................126
Resources for Support..............................................................................127
Student Cohort and Personal Friends...........................................127
Faculty Support............................................................................131
Spouse/Partner and Family Support.............................................137
The Affects of Support on Academic Persistence ...................................141
Summary ..................................................................................................142
Mindset: Smooth Sailing versus Choppy Waters ................................................143
The Impact of Determination and Stubbornness on Persistence .............144
Determination Influenced by the Need to Prove One’s Self....................145
Taking Responsibility versus Blaming Others for Struggles...................146
Summary ..................................................................................................151
Conclusion ...........................................................................................................152

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Chapter 6
Discussion
Introduction..........................................................................................................154
An Overview of What was Learned.....................................................................155
Congruence with the Conceptual Framework......................................................159
Higher Education and the Adult Learner ...............................................159
Motivation for Learning .........................................................................160
Possible Selves Theory: The Primary Theoretical
Framework for Understanding the Participants’ Motivation .......161
Social Cognitive Perspectives Supporting
Possible Selves Theory ................................................................164
Extending Beyond the Possible Selves Framework: Implications
for Theory ............................................................................................................168
Identity Development: Evolving in Adulthood ......................................169
Altruism: The Importance of Having Purpose .......................................173
Implications for Further Research .......................................................................176
Implications for Practice ......................................................................................178
Conclusion ...........................................................................................................181
Appendices.......................................................................................................................182
Appendix A..........................................................................................................183
Appendix B ..........................................................................................................184
Appendix C ..........................................................................................................185
Appendix D..........................................................................................................186
Appendix E ..........................................................................................................187
Appendix F...........................................................................................................188
Appendix G..........................................................................................................190
References........................................................................................................................206

vii

LIST OF TABLES

Table 1 Ethnicity of Students in Occupational Therapy Programs................................183
Table 2 Gender of Students in Occupational Therapy Programs ..................................184
Table 3 Retention Rates of Students in Occupational Therapy Programs.....................184

viii

LIST OF FIGURES
Figure 1 Pictorial Representation of the Kawa Model.....................................................185
Figure 2 Pictorial Representation of Kawa Model (cross-sectional) ...............................186
Figure 3 Ellen’s Drawing.................................................................................................190
Figure 4 Helen’s Drawing................................................................................................191
Figure 5 Ivan’s Drawing ..................................................................................................192
Figure 6 Fiona’s Drawing ................................................................................................193
Figure 7 Gale’s Drawing..................................................................................................194
Figure 8 Barb’s Drawing .................................................................................................195
Figure 9 Carey’s Drawing................................................................................................196
Figure 10 Anne’s Drawing...............................................................................................197
Figure 11 Donna’s Drawing.............................................................................................198
Figure 12 Julie’s Drawing................................................................................................199
Figure 13 Karen’s Drawing .............................................................................................200
Figure 14 Lindsay’s Drawing ..........................................................................................201
Figure 15 Nicole’s Drawing.............................................................................................202
Figure 16 Paula’s Drawing ..............................................................................................203
Figure 17 Olivia’s Drawing .............................................................................................204
Figure 18 Marie’s Drawing..............................................................................................205

ix

Chapter One
Introduction
Purpose of the Study
The study of students in higher education gained momentum in the 1960s and
1970s with the work of Chickering (1974), Perry (1970), and Tinto (1975). Their studies
focused on traditional students born in the post-war period, namely White males from
middle to upper socioeconomic groups, aged 18 to 24. During this same time period,
some researchers were also trying to increase recognition of the older learner in both
formal and informal educational programs (Johnstone & Rivera, 1965; Quinan, 1961).
As time progressed, leaders in adult education started to focus more specifically on the
older student in higher education (Bean & Metzner, 1985; Cross, 1981; Schlossberg,
Lynch & Chickering, 1989). Whether these students were referred to as adult learners or
non-traditional aged students, the leaders in adult education called for research and
practice to address the unique characteristics of the mature versus conventionally aged
student.
As a result of the above studies, a significant amount of research has been done.
Theoretical knowledge and models about the retention and attrition of both traditional
and non-traditional students have been developed. Tinto’s (1975; 1993) work on
traditional students gained particular prominence and his model of student attrition
continues to be cited widely in the literature and used as a theoretical framework for other
studies. Although Tinto’s work and related studies on the traditional student still offer
applicable theory, the relevancy of some aspects of this work is limited for the current
student population. This is because the majority of students on college campuses are now

1

older and considered non-traditional students because of their age and/or the multiple
roles they hold in life (Kasworm, 1990; Richardson & King, 1998; Sissel, Hansman, &
Kasworm, 2001; Wlodkowski, 2008).
In order to understand the unique needs of the growing population of nontraditional students it is important to develop relevant theories and models of retention or
attrition (Cabrera, Castaneda, Nora, & Hengstler, 1992; Sissel et al., 2001; Sissel,
Birdsong & Silaski, 1997). The conceptual model developed by Bean and Metzner (1985)
has been used effectively to initiate a line of inquiry and practice related to the nontraditional student, but it did not take into account an important factor. This model
assumed that non-traditional students were a relatively homogeneous group. In fact, nontraditional, older students are thought to be a much more diverse group than their
younger, traditional counterparts (Kasworm, Polson & Fishback, 2002).
One model or one set of strategies cannot be expected to be effective in improving
persistence in a group as diverse as the non-traditional adult learner in higher education
(Cabrera et al., 1992, Kasworm et al. 2002; Tinto, 1993). Non-traditional aged students
differ demographically by age, gender, race, and socioeconomic background
(Wlodkowski, 2008). They also have differing levels of academic preparation, attend
different types of institutions of higher education, and have a greater variety of
motivating factors and roles in life. This makes it logical to explore student persistence in
sub-groups of non-traditional students (Kasworm, 1990; Kasworm, 2010; Kasworm et al.,
2002). Some evidence indicates that students in different fields of study should also be
considered as a sub-group to research because their rate of persistence and success differs
depending on major (Richardson & King, 1998). However, these studies are few. Most

2

retention or attrition studies focus on students in non- specified majors, whether the
context is older learners or younger students. This current study used participants from
different institutions with varying backgrounds, but it focused on students majoring in a
professional level occupational therapy program who were defined as non-traditional
because of their older age.
The literature is extremely sparse on adult learners in professional programs of
any type (e.g., law, medicine, engineering, health professions). This is a significant gap in
the retention literature because as Kasworm et al. (2002) state “the highest percentages of
adult students typically chose specialized professional programs (often 60-75%)” (p.4).
This high percentage of adult students in professional programs indicates a significant
non-traditional student presence. It is worthy of exploration to determine if the same
theories and models of retention (or attrition) are “a good fit” for this large sub-group.
Tinto (1993) concurred with the need for this research when he discussed the need for
models to address the persistence of graduate level students in the professions (1993).
Tinto added, “unlike undergraduate persistence, the process of graduate persistence
cannot be easily described by one model; this is the case because models of graduate
persistence are more likely to differ across fields of study…” (p. 238).
The purpose of this current study is to explore persistence of the non-traditional
aged learner in a health profession, occupational therapy, in order to understand the
experience of these students because we “have little insight into the forces that shape
graduate persistence” in the professions (Tinto, 1993, p. 230). Gaining an understanding
of the experience of students in combined Bachelor’s/Master’s level occupational therapy
programs offers an opportunity to learn how to support persistence in these programs, as

3

well as other related professions. It is important to make the characteristics and needs of
adult students in the professions more visible, not aggregating them as part of one large
group of non-traditional students, assuming they have more commonalities than they
actually do. This research study discovers that this sub-group of health professional
students, occupational therapy students, has needs common to the larger aggregate of
students. However, it also identifies distinguishing factors that could influence a change
in established retention strategies used for occupational therapy students and students in
related programs of study.
Background to the Study
Tinto’s (1975, 1993) theory of attrition provides a starting point for the
background supporting this study. His work looks at student departure as a longitudinal
process that occurs from interactions within the institution of higher education. Tinto
(1993) theorizes that persistence occurs when the student is successfully integrated in
both the social and academic environment of the institution, facilitating both a
commitment to personal goals and the institution. While Tinto discusses both student
persistence and departure, his focus is on why students left; therefore his ideas are
represented as the “theory of student departure” (1975; 1993).
My research design utilizes his conceptualization of departure as a longitudinal
process, but attempts to analyze retention in higher education by exploring what
influences those who successfully persist, rather than exploring why they may depart.
Tinto’s work (1975, 1993) is also valuable, because unlike other retention studies, he
looks beyond attributes or descriptions of successful students. Instead, he focuses on what
happens as the student interacted in the higher education environment. This perspective

4

informed the research design which used the narrative method of study to obtain the story
(e.g., the longitudinal process of persistence) for the sampled students.
However, a limitation of Tinto’s (1975) early work, which he started to rectify in
his later publications, is the lack of importance he assigned to factors external to the
college environment. Other theoretical models, which incorporate the importance of
external factors, needed to be considered in the conceptualization of this current study.
As mentioned previously, some researchers who studied the adult learner in the 1960s
and 1970’s realized that the participation of these students relied on the learner’s ability
to juggle multiple roles and conflicting priorities such as family, job, and civic duties, as
well as deciding on the allocation of limited finances while pursuing their education
(Johnstone & Rivera, 1965; Quinan, 1969). These factors are often conceptualized as
falling into the following categories: dispositional, situational, and institutional barriers
(Cross, 1981).
Bean and Metzner (1985) built on these realizations by developing a new
conceptual model more suited to the realities of the non-traditional student. This
conceptual model continues to perceive of attrition as a longitudinal process for nontraditional students, but recognizes that variables extrinsic to the university environment
are more influential than the interactions that occur within the university as in Tinto’s
model (Bean & Metzner, 1985). For example, extrinsic factors such as family
responsibilities, financial pressures, and employment affect the success of non-traditional
aged students. Bean and Metzner’s (1985) model does not exclude the importance of
academic factors or social interactions within the university environment, but recognizes

5

that for older students living off campus other variables over ride these two main
principles of Tinto’s framework.
Additional researchers used the conceptual framework of Bean and Metzner
(1985), which is a dynamic model including student background variables, academic and
social integration variables, environmental, and psychological variables to explore
departure and persistence. For example, researchers looked at the influence of
employment, family responsibilities, finances, classroom interactions, and psychological
variables such as interpersonal skills and motivation (Braxton, Bray, & Berger, 2000;
Braxton, Milem, Shaw Sullivan, 2000; Cabrera, Nora, Castaneda, 1992; Grosset, 1991;
McGaha & Fitzpatrick, 2005). Cabrera, Castaneda, et al., (1992) explicitly discuss the
value of both Tinto’s and Bean and Metzner’s models suggesting that to really
understand persistence in any college student, traditional or non-traditional, we need to
“consider the interplay between institutional, personal, and external factors” (p. 161). The
conceptual framework for this research proposal utilizes this perspective to learn more
about persistence in a large sub-group of non-traditional students, those in professional
level health care academic programs.
Significance of the Study
As stated in the introduction, a majority of non-traditional students are in
professional academic programs, yet there is little research about persistence in this group
of students (Kasworm et al., 2002). Tinto (1993) also viewed these students as unique
from the general undergraduate population and concurred that more knowledge is needed
about students in professional programs at the graduate level.

6

Academic programs in the health professions are of special interest because some
studies depict science courses as more challenging than those in the arts and social
sciences. Therefore, academic outcomes for these students are worse, placing them at a
greater risk for departure (Richardson & King, 1998). Astin (1993) also concluded that
students in health profession majors are at more risk for attrition due to the rigor of the
curriculum. Occupational therapy programs, like other health care professional academic
programs, have a significant portion of rigorous science classes (Mihelic 2006; Stout,
Everly, Poff, Lamport, Hamant, & Alvey, 1994). For example, “a high degree of stress
has consistently been part of the academic experience for occupational therapy students,”
as it is for other advanced degree health care majors (Conneeley, 2005; Pfeifer, Kranz &
Scoggin, 2008, p, 221). Secondarily, according to Dr. JoAnne Crain, Occupational
Therapy Program Director at Baker College, graduate level students in health
professions, such as occupational and physical therapy, take a minimum of 12 credits per
semester (part-time options are usually not available), making the curriculum pace more
challenging than other graduate level programs (personal communication, April 14,
2010). It may not just be the suspected rigor of the science curriculum which challenges
students. The length and the full-time nature of these programs have been shown to be
more challenging for the adult student to successfully integrate into their other roles.
Occupational therapy students must persevere through the prolonged study required in
the academic portion of professional education and then integrate that knowledge into
clinical settings (Pfeifer, Kranz, & Scoggin, 2008).
It is well documented that the attrition rate for non-traditional students is
especially high when compared to the traditional student population (Bean & Metzner,

7

1985; Swail, 2002; Wlodkowski, 2008). Many non-traditional students are encouraged to
major in health care professions during these turbulent economic times because the job
prospects are excellent in this sector and there is a need for these professionals in society
(Bureau of Labor Statistics, 2005; Shatkin, 2009). The coupling of poor retention in
health care majors and poor retention in the non-traditional students (who are being
channeled into these programs) makes it important and timely to explore how to facilitate
persistence in this student group. Non-persistence by students in the health professions
wastes institutional resources and has serious financial and psychological consequences
for students (Jones-Boggs Rye, 2005).
Lastly, it is important to study what helps students persist in the allied health
profession majors in order to meet the needs of society. There is a shortage of these
professionals and this is expected to continue as the baby boomer generation ages
(Shatkin, 2009). In fact, “non-traditional students may be a valuable (and a currently
available) resource for filling the demand for well qualified graduates” if we can learn
how to improve the retention of these students in occupational therapy programs (Menks
& Tupper, 1987, p. 22). Jones-Boggs Rye (2005) emphasizes that allied health programs
need to acknowledge that there are many more non-traditional students entering our
programs and that examining persistence in non-traditional students will help us
understand what factors improve or deter retention.
Context for the Study
Occupational therapy students were chosen as the context for this study because
they typify other health care professions in several ways which may help to inform
retention strategies not only in occupational therapy curriculums, but also in other related

8

health care academic programs. The experiences of occupational therapy students in a
combined Bachelor’s/Master’s degree level program were chosen to be studied because
the average duration of their entire academic program is six to seven years and is usually
full-time. This is similar to other health care professional majors such as physical
therapy, physician assistant, and speech and language pathology. Additionally,
occupational therapy is representative of other health professions because the average
expected salaries are relatively modest considering the length of time and effort invested
in school and clinical internships (Bureau of Labor Statistics, 2010; Shatkin, 2009).
Students in occupational therapy academic programs are of special interest to me
because I am both an occupational therapy educator and clinician. However, this fact
alone does not warrant the choice of these students as a focus of this study. The context
of occupational therapy education is also a timely choice because of recent policy
changes in occupational therapy education that could potentially affect retention. The
Accreditation Council for Occupational Therapy Education (ACOTE) recently mandated
that students meet higher academic expectations and complete an academic program that
takes several more years to complete than it did prior to 2007 (ACOTE, 2006). Prior to
2007, only a Bachelor’s level degree was required for entry into the profession. The new
standards require students to have a combined Bachelor’s/Master’s level degree taking
approximately six to seven years to complete in order to enter the profession.
This policy change was made because of the rapidly changing and dynamic
nature of contemporary health and human service delivery systems requiring
occupational therapists to be more autonomous in roles as consultants, managers,
researchers, educators, direct service providers and advocates (ACOTE, 2006). The role

9

of researcher is an important dimension of practice, and third party payers, such as
insurance companies, increasingly require evidence based practice methods (ACOTE,
2006). The current study explores the longitudinal experience of non- traditional aged
students who have successfully persisted through the academic curriculum in the health
care profession of occupational therapy.
Some occupational therapy academic curriculum are structured as combined
Bachelor’s/ Master’s level degrees with course work at both the undergraduate and
graduate levels. Other programs require a Bachelor’s degree in a related field, followed
by a graduate degree in occupational therapy. Both are considered entry-level Master’s
degree programs, which are necessary to gain entry into the profession as an occupational
therapist. Either format requires a longer time period (six to seven years) for students to
have continued motivation (volition) to complete their academic programs. The effect of
this policy change on students, faculty, and institutions has not been studied in any
manner. More non-traditional aged students than ever before are present in health
profession academic programs, such as occupational therapy (Jones-Boggs Rye, 2005).
As discussed earlier in the chapter, the literature also informs us that students in two subgroups, health care majors and non-traditional students have a higher risk for attrition.
The retention statistics for occupational therapy students does not show cause for
alarm at first glance (see Appendixes A and B). However, the statistics do not show all
the realities. The retention statistics do not give us student demographics beyond race and
gender, so we have no idea how students who would be considered non-traditional in age
are faring. Additionally, most students from more diverse backgrounds never get
accepted into the programs because they did not meet pre-requisite grade requirements

10

(Hayes, Fiebert, Carroll & Magill, 1997). Secondly, the retention rates are misleading
according to Dr. JoAnne Crain, Program Director at Baker College (personal
communication, March 1, 2010). According to Dr. Crain, the retention data for the
annual report is collected annually from program directors nationwide. She said the
report does not show the cumulative attrition rate in a student cohort group over the
length of an average six year program. For example, she was able to report attrition
statistics in the single digits annually for each cohort (and this was what shows up in the
annual report compiled by AOTA), but the cumulative attrition for a student cohort was
recently closer to fifty percent in her program (personal communication, March 1, 2010).
Non-traditional aged students were “hidden” in the retention statistics. I do not
have evidence that retention of non-traditional aged occupational therapy students is an
issue in the profession. However, it seems best to be proactive given what is known from
the literature about the risk for attrition of students who are non-traditional or majoring in
the health care professions. Stage and Hossler (as in Braxton, 2000) recommend that
research on retention of students should focus on specific populations of interest;
otherwise we are only repeating existing research. These facts, supported by the
following anecdotal information support the need for this research.
Within the past year, several program directors and faculty in occupational
therapy programs across the nation provided support for my suspicion that some
occupational therapy students were finding it difficult to persist in their academic
programs. They expressed their concerns in a survey distributed at a national conference
and through informal conversations. These professionals expressed concern about nontraditional students; they believed these students were having even more difficulty

11

progressing though their programs. In addition, they were very concerned about the
decreasing pass rate of students on the national licensing exam. In 2009, the pass rate fell
to 75% nationally, from a rate that usually ran between 87-90% (NBCOT, 2009).
Although the falling pass rate on the exam is not the focus of this study, it is a statistic
which supports the need to explore the effects of the recent policy change on students and
the profession.
The intent of this study is to learn from the students who are immersed in this
context. My experience as a faculty member working with students for the past 14 years
reinforces my impression that we need to start with the stories of the students to know
what it has been like for them to persist as non-traditional students in a health care
professional program. Identifying what helped them successfully persist through the
academic portion of their program, and understanding how they navigated difficulties or
barriers will be a step towards developing a theoretical framework on college persistence
that is applicable for students in the health professions. My involvement with students has
made me aware of their struggles, as well as their amazing successes, sometimes despite
great obstacles.
I believe the time is right for this type of research inquiry in light of changed
occupational therapy educational policy in 2007 and an older student body on campus.
We need to explore the experiences and the culture of students in the health professions,
especially the growing number of non-traditional students, so retention strategies and
policies can be modified or developed anew for this unique student population. Stewart
summarizes the situation well by stating “the escalating costs of tuition, the present state

12

of financial stringency in universities, and shortages of health care professionals all point
to the need to consider the costs of health professional students’ attrition” (1990, p. 4).
Problem Statement
This research study addresses a theoretical problem in higher education. The
retention literature assumes that non-traditional students represent a relatively
homogeneous group, when n fact there is great diversity among non-traditional aged
students. There are indications that this student body is quite diverse in their needs,
abilities, and motivations. Differences in students have also been noted across degree
levels, types of institutions, and area of study (Kasworm, 2010; Kasworm et al., 2002;
Richardson & King, 1998; Tinto, 1993), yet we do not have theoretical models of
persistence (or departure) for these sub-groups of students. There were very few studies
in which theoretical frameworks on student departure or persistence have been applied to
students in the health professions, such as occupational therapy majors. Studies are
needed to explore differences among the growing student body of non-traditional aged
students to ensure the strategies we implement for improving persistence are relevant for
sub-groups of students within the larger aggregate of non-traditional students.

Research Questions
1. How do non-traditional aged students who successfully complete the academic
portion of the newly established entry-level combined Bachelor’s/ Master’s degree
curriculum in occupational therapy perceive and make sense of their experiences in
the program?
A. What helped them successfully complete the academic portion of the
program?

13

B. What challenges did they encounter and how did they navigate difficulties or
barriers?

Introduction to the Conceptual and Theoretical Frameworks
In order to answer these research questions, the experience and perspective of the
students needed be studied. This idea was the starting point for the conceptualization of
this study. Quigley (1998) said that too often he and his co-workers did not draw on the
perspective of the learners as they attempted to study persistence in adult education.
Learner input is necessary to have in order to direct our future research and retention
strategies. Very little is known about what helps occupational therapy students, or
students in related professions, persist in their academic programs. In this current study,
student participants were encouraged to share their story in the tradition of narrative
inquiry so their perceptions were gained (Denzin & Lincoln, 2005). In this way,
implications developed from this research involve the knowledge of all who were
involved (Creswell, 2007; Denzin & Lincoln, 2005).
It was expected that the students would have their own perceptions of what
factors influenced their persistence and their stories needed to be heard to shed light on
the problem (Clandidn & Murphy, 2009). Research on persistence in education, from
both the education and psychology fields, offers a holistic framework for the analysis of
the participants’ input. The psychology discipline, specifically the social cognitive
perspective, offers a theoretical lens which helps to understand motivation in nontraditional aged students who need to persist through a long and challenging health care
curriculum.

14

The social cognitive perspective incorporates multiple related, but distinct
theories, which were expected to be found relevant as the data was collected and
analyzed. For example, it was thought that belongingness theory (Baumeister & Leary,
1995; Baumeister, Nuss & Twenge, 2002; Osterman, 2000) and possible selves theory
(Cross & Markus 1994; Markus and Nurius, 1986; Oyserman & Markus, 1990) might
offer insight on pereistence. The work on self-efficacy (Bandura, 1991; Cross & Markus,
1994), self regulation (Schunk & Zimmerman, 1997; Wolters, 2003; Zimmerman, 1990),
and the value and expectation sides of motivation (Brophy, 2004; Svinicki, 2004) were
also considered as theoretical frameworks for this study. Analysis of the findings made it
clear that possible selves theory, which is derived from a large body of work on identity
development, offered the most relevancy as a theoretical framework. Possible selves
theory best explained the experience of the participants; their motivation to both initiate
the academic program and to persist despite challenges. This theory helped explain the
determination of these participants who persevered to achieve a new vision of
themselves. Possible selves theory, within the broader framework of identity
development, showed how the connection between socialization experiences in the past,
as well as the present, shaped the motivation of the participants.
The conceptual framework for this study was designed to be inclusive. The data
collection methods attempted to draw out dispositional factors which are sometimes
correlated with what the social cognitive perspective refers to as intrinsic factors,
individual traits. In other words, how “others” in a relationship with a student influence
their unique learning and motivation factors in an academic environment (Bandura, 1991;
Baumeister, Nuss & Twenge, 2002; Dirkx & Deems, 1994). The current study was also

15

designed to acknowledge that situational and institutional factors may be influential in the
nature of the participants’ persistence (Cross 1981; Johnstone & Rivera, 1965). For
example, participants were encouraged to speak about situational barriers, such as the
competing demands of children and employment, as well as institutional barriers, such as
lack of financial aid or the existence of college programs which were full-time and only
during the day.
Very little is known about how dispositional, situational, and institutional
deterrents affect occupational therapy students or students in related majors. We also do
not know how these barriers interact with positive situational, dispositional, or
institutional factors in students majoring in these programs. It was suspected that there
was a difference between students in unspecified majors in prior retention studies and
students in the health professions. These suspicions came about from two sources: (1) My
anecdotal teaching experience working with a significant percentage of non-traditional
aged students in an occupational therapy program, and (2) A small preliminary study
(unpublished) I did at my institution. Both experiences made me question if some
dispositional factors, such as altruism, facilitated persistence even when other barriers
were present. This 2007 preliminary endeavor was a qualitative study designed to
identify factors which promoted academic persistence. Six non-traditional aged
occupational therapy students near the completion of their academic program were
interviewed. The study identified the importance of self-efficacy, social and academic
integration, and family support, as well as the unanticipated factors of a “passion for the
profession” and altruism.

16

Researchers who have studied persistence in adult learners vary in their
perception of which factors are the most influential in persistence or the volition for
educational pursuits. For example, Cervero and Kirkpatrick (1990) emphasize the
influence of “processes occurring throughout the lifespan,” a person’s family, social and
educational history (p.77). However, Brophy perceives that the value an adult places on
the educational endeavor is central to persistence (2004). Finally, Quigley is convinced
that dispositional factors offer the most significant insight (1998).
The conceptual model for this study makes no pre-determinations, but instead
aims to include all the actions and words that participants provided in the domains of
situational, institutional, and dispositional factors. The research design provided an
inclusive framework that allows participants to share their reflections and their meaningmaking of the experiences they had on their path to completing the academic portion of
their programs.

17

Chapter Two
Literature Review
Introduction
The student body on campuses has become increasingly diverse with more
students of color and more variance in age and socioeconomic status. There are also more
students who are juggling employment and family responsibilities (Wlodkowski, 2008).
As mentioned in the first chapter, students who are non-traditional in terms of age are
pursuing degrees in the health professions because there are current job openings, as well
as a projected need for these professionals in the future (Bureau of Labor Statistics, 2005;
Shatkin, 2009). It is well known that the retention rate is poorer for non-traditional aged
students (Bean & Metzner, 1985; Swail, 2002; Wlodkowski, 2008) and also for students
majoring in health care professions (Astin, 1993; Richardson & King, 1998). It can be
safely extrapolated that adult learners who are majoring in a health care profession are at
a significant risk for non-persistence. Discovering how these at risk students managed to
persist will offer both theoretical and practice implications. The literature offers
background to explore various perspectives which have the potential to assist in
understanding the experiences of these students and how they persisted despite barriers.
The first purpose of this literature review is to demonstrate the paucity of
literature on retention in occupational therapy students and students in related health
professions. This literature review will support the need for more studies on this distinct
sub-group. One set of retention strategies cannot be expected to be effective at improving
persistence for all students in a group as large and diverse as non-traditional aged
students (Cabrera, Castaneda et al., 1992; Kasworm et al., 2002; Tinto, 1993). Little is

18

known about the experience of non-traditional aged students who are studying in
professional level health care programs, such as occupational therapy.
The second purpose of this chapter is to offer a conceptualization of the problem.
Theoretical perspectives from the literature will be highlighted to offer insight on how
non-traditional aged students in the health care professions persisted despite significant
obstacles. This literature review will discuss research in two areas of study: education and
psychology. Research from these two disciplines is relevant to the purpose of this study
and the related research questions. First, it is important to highlight what is known about
retention and student persistence from the discipline of education. This body of
knowledge offers great insight, but it is not adequate on its own to understand how nontraditional age students succeed in their occupational therapy programs or in similar
professional level health care programs. As explained in the previous chapter, it was
suspected that students in occupational therapy programs have a different set of
motivations for persisting in their challenging and long programs. They must persist
through academic programs that are almost as long as programs providing medical
degrees, but they receive salaries and prestige commensurate with health care
professionals such as staff nurses and dental hygienists. The latter professions only
require two year associate degrees to enter the profession.
It is also important to highlight what is known about motivation from the
psychology literature. It was anticipated that the retention and persistence theories from
the education discipline could benefit from the inclusion of theoretical perspectives from
the field of psychology on the motivation for learning. Knowledge about motivation
grounded in the social cognitive perspective and identity development literature offers

19

alternative lenses to view the problem. The literature on motivation offers a view of
persistence that looks at the reasons behind the behavioral choices students make,
emphasizing the dynamic interplay between the individual and the environment (Perry,
Turner, & Meyer, 2006). However, a shortcoming of this body of knowledge is the
absence of application to contexts, such as to higher education (Perry et al., 2006).
Collaborative use of the perspectives from adult learning, higher education, and the
literature on motivation was expected to be helpful in understanding motivation in nontraditional aged occupational therapy students who need to persist through a long and
challenging curriculum (Mihelic, 2006; Stout et al., 1994).
Persistence in Occupational Therapy and Related Health Profession Majors
There were some studies addressing retention issues in the health care
professions but it was minimal compared to the breadth of research on traditional and
non-traditional college students in unspecified undergraduate programs. As stated
previously, Astin (1993) concludes that students in health profession majors are at more
risk for attrition. However, there is a paucity of literature specific to attrition and
retention across various health care fields, including occupational therapy (Gupta, 1991).
Stewart points out that “the escalating costs of tuition, the present state of financial
stringency in universities, and shortages of some health care professionals all point to the
need to consider the costs of health professional student attrition” (1990, p.4).
Unfortunately, there are very few studies in which the theoretical frameworks on
persistence and motivation, from either the education or psychology literature, are
applied to students in health care majors.

20

After an exhaustive search of the literature it was noted that studies of retention
on students in occupational therapy academic programs were especially limited. This
statement is supported by the literature review done in a dissertation by Mihelcic, who
found no studies which applied theories of retention or attrition to student populations
studying either occupational or physical therapy at the professional level (2006).
Although Mihelcic's study had limitations, his survey based research found that there was
a problem with retention in both of these academic programs. The physical therapy
profession is also experiencing a shortage of professionals, and is the health care
profession most similar to occupational therapy in terms of curricular requirements,
professional salary, status, and job duties. Research done on physical therapy students
would be considered relevant to occupational therapy students, but unfortunately the
retention research was sparse in this curriculum area also.
Some of the studies of physical therapy and occupational therapy students
examined predictors of academic success by determining what factors (e. g., GPA,
interview skills, etc.) correlated with successful completion (Hayes, Fiebert, Carroll, &
Magill, 1997; Kirchner & Holm, 1997; Koenig, 2003; Lysaght, Donnelly & Villeneuve,
2009). The approach of looking at predictors does not answer the research questions and
was not considered relevant. However, there were a few studies from Great Britain and
the United States that were relevant to the research problem. Unfortunately, there were
very few studies and they had limitations. Their presence did indicate a need for more
studies focusing on this unique student population, even if they were lacking in strength
and quantity to give us the answers we need for the education of these professionals.

21

There were four relevant studies on occupational therapy students in Great
Britain. The first study was dated because it was based on surveys administered to
occupational therapy students who “dropped out” from 1975-1983 (Paterson, 1988).
However, it concluded that retention is important to study in occupational therapy
students because as the author stated “any reduction in wastage will increase the number
of occupational therapists and improve the cost-effectiveness of schools” (Paterson, 1988,
p. 81). Two other studies were very related to my research questions because they
focused on what supported the success of non-traditional students in British occupational
therapy programs (Watson, 2005; Wheeler, 2001). However, they were limited in
relevance, because these programs are not accredited by the same accrediting body as in
the United States. Additionally, their degree completion time is much shorter because
they have not changed the entry-level requirement from a Bachelor’s to a Master’s
degree. The last study done in Great Britain was of minimal relevance because it was
done on students who were already occupational therapists working towards an advanced
post-professional degree in occupational therapy, which is dissimilar to the students in
the current study who are seeking to gain entry into the field (Conneeley, 2005).
However, it was informative because it noted that the stress created by the curriculum
was a deterrent to persistence.
Two studies focused on occupational therapy students in the United States also
evaluated the variable of stress related to retention. One study explored the coping
strategies of occupational therapy students who were experiencing stress (Stout, Everly,
Poff, Lamport, Hamant, & Alvey, 1994). The other study was even more relevant to this
current study. It explored the amount of stress occupational therapy students experienced

22

and also identified coping strategies in these students (Pfeifer, Kranz & Scoggin, 2008).
This study looked at the retention problem from a different perspective than this current
research project and the student sample was from only one university. However, it was
relevant because it focused on students in the newly established entry- level Master’s
degree program. Pfeifer et al. (2008) share my concern and stated:
Very little research has been done regarding the experience of stress and earning
an entry-level Master’s degree in occupational therapy. Earning a Master’s degree
may add to the perception of stress by not only requiring skill based learning
needed to practice but advanced theory and higher level critical thinking which
are part of beginning research skills. (p. 222)
Three additional studies examined the needs of non-traditional aged students in
occupational therapy curriculums (Graham & Babola, 1998; Menks & Tupper, 1987;
Strickland, 1987). A limitation of these studies was that they were dated and did not
focus on students since the ACOTE policy changes. They were noteworthy, however,
because they concurred that “non-traditional students may be a valuable [and a currently
available] resource for filling the demand for well qualified graduates and potential
leaders in the profession” (Menks & Tupper, 1987, p. 22).
The research cited above was the extent of the studies related to persistence in
occupational therapy students or in the closely related profession of physical therapy.
Other health professions, such as nursing and medicine, have more extensive literature on
retention and this literature offered some insight on what helped students persist.
However, I posit that the contextual differences in the practice settings of nursing and
medical professionals are quite different from the practice context of an occupational
therapist, physical therapist, or speech language pathologist.

23

The field of nursing provided the widest breadth of studies. Some of the literature
concluded prior academics such as grade point average and standardized tests were most
indicative of retention in nursing programs (Benda, 1991; Laudicina, 1997). Several
studies emphasized the importance of a good academic fit between the student’s abilities
and the challenging nature of the coursework (Higgins, 2004; Laudicina, 1997). Glossop
(2002) identifies academic difficulties or wrong career choice as factors causing nonpersistence, but also identifies problems with health, finances, and family as reasons for
leaving programs.
There was also a group of studies finding non-cognitive variables to be better
predictors of retention in health care programs. The nursing literature also included
variables such as self-efficacy and found this trait to be crucial in the decision to persist
(Aber & Arathuzik, 1996). A nursing study looking at the non-traditional student cited
external influences as the most influential factors in attrition. This same study by Wells
(2003) also found relationships with faculty to be a more positive predictor of retention
than academic variables. As in the adult education literature, it was found that problems
with persistence could be related to intrinsic or extrinsic factors (Sherrod, Harrison,
Lowery, Wood, Edwards Gaskins & Buttram, 1992).
Although there was a fair amount of literature on the retention of nursing
students, these studies are not applicable to occupational therapy students. Educational
requirements in nursing are quite different than in occupational therapy. Nurses can attain
numerous advanced degree levels as options, but only need to have an associate’s degree
to enter the profession. It takes a significantly longer time period to become an
occupational therapist. The job duties and the culture of the two professions are also quite

24

different. Therefore, the nursing literature needed to be used with caution in
conceptualizing the persistence of the students in this current study.
Attrition among medical students was also discussed in the literature (Cariago,
Enarson, Crandall, Zaccarro, & Boyd, 1997; Simpson & Budd, 1996; Stetto, 2004).
However, it was not focused on in this literature review because after reviewing the
literature it showed limited relevance to this research study. While the period of time it
takes to attain a medical degree is similar to occupational therapy and physical therapy,
there are many differences in the career benefits and risks. Physicians have the potential
for significantly greater salaries and prestige than therapists, while they are also subject to
more malpractice risk as the primary decision makers on a healthcare team of
professionals. It was probable that these differences would have made the literature less
applicable to occupational therapy and related allied health care professions.
Education Perspective
This current study was first approached by acknowledging the importance of
supports and barriers that can be categorized as situational, institutional, or dispositional
factors (Cross, 1981). The literature on the adult learner was crucial in developing this
conceptual framework (Cervo & Kirkpatrick, 1990; Johnstone & Rivera, 1965; Quigley,
1998; Rubenson, 1998). However, the research on the adult learner is not specific to the
higher education environment. Therefore, it was necessary to use aspects of the retention
and attrition literature on traditional and non-traditional aged college students in the
context of higher education. The foundational research on the traditional aged student
was valuable because it provided a wealth of knowledge and a context for understanding
the higher education environment (Brower, 1992; McGaha & Fitzpatrick, 2005; Ozga &

25

Sukhnandan, 1998; Tinto, 1975, 1993). The literature on the non-traditional student was
especially relevant in the conceptualization of this study because it addressed the types of
barriers and supports that are common in non-traditional aged students, who were the
sample in this study (Allen, 1986; Bean & Metzner, 1985; Grusec & Hastings, 2007;
Wlodkowski, 2008).
The Adult Learner and Persistence
The most commonly cited reasons for non-participation in adult education
programs were lack of time and money; while these are legitimate reasons, they are also
the most socially acceptable reasons for people to state (Merriam, Cafarella &
Baumgartner, 2007). These two reasons do not provide a complete picture of why adults
fail to persist with their educational endeavors. In a classic in-depth study in 1965,
Johnstone and Rivera shed more light on why adults did not continue their participation
in adult education settings. They clustered 10 types of barriers to participation into
intrinsic (dispositional) and extrinsic (situational) factors (Johnstone & Rivera, 1965).
Extrinsic barriers are factors which are beyond the person’s control such as prohibitive
educational costs or lack of childcare while attending school. Intrinsic barriers reflect
personal attitudes such as beliefs that one will not be able to do the school work or that
the educational program will take too much time (Johnstone & Rivera, 1965).
Quigley (1998) emphasizes the influence of dispositional factors and thought
these factors offered the most insight into understanding the participation of adults in
education. Disposition toward adult education was thought by many to develop in
childhood through the influence of family and early school experiences and in later years
from work experiences (Cervero & Kirkpatrick, 1990; Rubenson, 1998). Rubenson

26

describes an individual’s attitude towards education as influences made up from “the long
arm of the family…and the long arm of the job” (1998, p. 261).
McClusky (as cited in Merriam et al., 2007) and McClennaghan (2000), who
focus on the adult learner in their writings, suggest that an individual’s situation in terms
of resources and position in life are very influential in the ability to participate in adult
education. Researchers have also focused on institutional barriers. For example, Tierney
(1993) published extensively on institutionally based cultural barriers, which were
deterrents for students of difference, sometimes described as non-traditional students.
Crowther (2000) proposes that non-persistence can be a deliberate act of resistance for
some students who experience either organizational or cultural barriers from the
educational institution. It can be concluded, even from this brief review of the literature
on adult education, that the persistence of occupational therapy students may be
influenced in some way by the institutional, situational, or dispositional factors discussed
in this body of knowledge. How adult learners are being influenced by these factors in the
college environment required use of retention studies done specifically in higher
education.
Retention of Students in Higher Education
The interest in adult learners enrolled in college began in the 1960s and 1970s
with the work of Chickering (1974), Perry (1970), and Tinto (1975), who were all
interested in looking at the formal and informal experiences of the college student. Their
studies focused on traditional students for that time period, namely White males from
middle to upper socio-economic groups, aged 18 to 24. Their work ultimately generated a
wealth of literature focused on retention and attrition issues of college students. This

27

work was important to consider in the conceptualization of this study, since both the
formal and informal college experiences of the participants was of interest in order to
understand how they persisted.
Tinto’s work gained particular prominence and his model of student attrition
continues to be cited widely in the literature. According to Tinto’s theory, attrition related
to the student’s interactions in the academic and social environments on campus (1975;
1993). The theory hypothesized that persistence occurred when the student was
integrated successfully in these two environments, facilitating both a commitment to their
personal goals and to the institution (Tinto, 1993). Brower (1992) builds on Tinto’s
theory by identifying “life tasks” students attempt to accomplish while in college. His
work proposes that the academic and social fit described by Tinto is not static. Instead, it
is dynamic; students use and shape their college environment to meet their life task goals
such as autonomy or academic achievement (Brower, 1992). One criticism of Tinto’s
work is offered by Tierney, who posits that academic and social integration should not be
considered essential for student persistence (1992). He states that students from different
backgrounds should not have to assimilate and adapt into a “uniform set of values and
attitudes...in an institution” in order to be successful (Tierney, 1992, p. 607).
A major gap in Tinto’s theory and related research was the neglect of external
factors in shaping perceptions and commitments (Cabrera, Castaneda, Nora, & Hengstler,
1992). Other researchers attempted to explore these external (situational) factors. For
example, Cabrera and Castaneda found that students who had adequate finances were
able to integrate into the academic and social components of an institution with more ease
(1992). External factors which were institutionally based were also studied. Several

28

studies demonstrate a positive correlation between student persistence and opportunities
for interaction with faculty and student peers (Astin, 1993; Braxton, Bray & Berger,
2000; Higgins, 2004; Wells, 2003; Woodside, Wong & West, 1999).
Retention in students has also been looked at from a classroom and curriculum
based perspective. Kuh (1995) found that students have more goal attainment in college
when they are involved in out-of-class experiences. Nunn (1996) found discussion in the
classroom encourages student involvement academically and with peers, which supports
Tinto’s emphasis on academic and social integration as necessary for student success
(Tinto, 1987). This assumption is also the foundation for a study that found active
learning methods correlate with increased social integration and subsequent institutional
commitment (Braxton, Milem, & Sullivan, 2000).
Lastly, dispositional factors were explored in studies done by researchers such as
McGaha & Fitzpatrick (2005), who assessed the influence of personal characteristics and
social competencies on drop-out behavior. They found that interpersonal incompetence
and marginality are risk factors for dropping out. Sedlacek (2004) is well known for
discussing non-cognitive variables (some of which resonate with the concept of
dispositional factors) as important for success in college. For example, Sedlacek
considers positive self-concept, realistic self- appraisal of abilities, and a preference for
long term goals as traits which support academic persistence in the college environment
(2004).
The studies above highlight situational, institutional, and dispositional factors in
the context of higher education institutions, which needed to be considered when
studying the persistence of students in professional level health care majors. However, it

29

could not be the only research to frame this study. Not all occupational therapy students,
or students in related majors, can be considered “traditional” college students. Factors
precipitating withdrawal are much different for non-traditional students than traditional
students (Ozga & Sukhnandan, 1998). Jones-Boggs Rye (2005) emphasizes that there is a
growing number of non-traditional students in allied health academic programs (such as
occupational therapy) with a diminishing number of traditional students. This trend, as
well as the focus on the non-traditional aged student in this current study, made it
necessary to incorporate the retention literature focused on the non-traditional student.
Non-Traditional Students in Higher Education
The majority of non-traditional aged students are from lower socioeconomic
backgrounds, defined as having parents with less education and occupational status, not
just lower income levels (Grusec & Hastings, 2007). They typically do not perform as
well academically and bring less social capital to college settings, than “traditional”
students (Grusec & Hastings. 2007; Wlodkowski, 2008).
The conceptual model developed by Bean and Meztner (1985) has been utilized
as a perspective for the design of numerous studies on retention and attrition in the nontraditional student population. Bean and Metzner (1985) realized in the 1980s that older,
part-time and commuter students made up an increasing percentage of the undergraduate
population, while traditional aged college students were on the decrease. When these
non-traditional students showed a higher rate of attrition in the 1970s and 1980s, there
was a need to expand research studies to this population (Astin, 1993; Bean & Metzner,
1985). The following literature review is reflective of that trend.

30

The student attrition model developed by Bean & Metzner (1985) applies to nontraditional students and theorizes that a student’s experiences with course work, friends,
and faculty shapes beliefs. Beliefs subsequently influence behaviors and decisions about
the college experience (Bean & Metzner, 1985). Many of the variables involved in this
research were non-cognitive in nature. For example, the support and encouragement of
family, psychological attitudes precipitated by prior academic success, and one’s attitude
towards goals are considered non-cognitive variables (Bean & Metzner, 1985). Sedlacek
(2004) also considers non-cognitive variables as relevant for persistence. Sedlacek
identified eight non-cognitive variables that are integral to a student’s success (2004).
Some of these variables relate to “social integration.” For example, students who learned
how to handle the university system were more likely to persist (Wawrzynski, 1999).
Bean and Metzner (1985) also stated persistence relied on external factors such as family,
employment, and finances, which is a significant difference from Tinto’s model (Cabrera,
Nora, et al., 1992; Ozga & Sukhnandan, 1998). Mature students are more likely to drop
out because of external circumstances such as family or employment issues (Ozga &
Sukhnandan., 1998).
Additional studies built on the work of the student attrition model (Bean &
Metzner, 1985). In more recent work, Tinto (1997) examines the use of learning
communities to enhance student learning and persistence in commuter students, many of
whom were non-traditional aged students. He found collaborative learning activities
promote student involvement, which in his model of student attrition correlated with
academic persistence (Tinto, 1975). Secondarily, social and academic integration were
not found to be two distinct areas in the non-traditional aged student population, which

31

differed from his original model developed in the 1970’s (Tinto, 1997). Additional
researchers also found that academic integration is more important than social integration
for retention of non-traditional students (Allen, 1986; Ozga & Sukhnandan, 1998).
In conclusion, the growing body of literature on the non-traditional student was
important to keep in mind for this current study because the sample was purposefully
made up of non-traditional aged students. However, this literature did not speak to the
unique motivations of students persisting in long and challenging professional level
health care majors, such as occupational therapy programs.
Psychology Perspective
The literature on the adult learner and the retention research on college students
are effective in describing the choices students make relative to persistence, and begins to
uncover why students make their behavioral choices to leave or to persist. However, the
literature on motivation offers a view of persistence that deeply examines the reasons
underlying the behavioral choices students make in regards to their goals. According to
Brophy, the social cognitive perspective on motivation incorporates multiple frameworks
such as possible selves theory and belongingness theory, as well as the role of self efficacy, self-regulation, and the perceived value and expectancy of the goal for the
individual (personal communication, February 10, 2009). These theoretical perspectives
highlight persistence from a different orientation than the education literature, and were
helpful to understand motivation in the individuals being studied in this current research
project. The addition of this perspective facilitated a better understanding of the
participants’ behavioral choices as they faced challenges in their academic program. It

32

also provided a context for understanding how people in the participants’ past and present
influenced their persistence.
The psychology discipline describes persistence in terms of motivation or
volition. Motivation initiates the process towards the educational goal, but it takes
volition to persist in order to “protect the intention to accomplish goals from competing
intentions and other distractions” (Corno, 1993, p.14). In other words, a person can be
motivated to start a task, but needs to have continued motivation or what is described as
“volition” to continue pursuing the goal (Brophy, 2004). The literature on motivation
from the social cognitive perspective offers another lens to view this current study’s
problem. It has great potential to help in understanding the experiences and motivations
of these students. The following overview clarifies this perspective.
The social cognitive perspective starts with the premise that social influences
become internalized in learners and become a part of that individual’s view of self and
their personal belief system (Schunk, 1999). For example, other individuals can affect a
student’s volition to persist in college both positively and negatively (Grusec & Hastings,
2006). This section of the literature review focuses on the human socialization factor as it
affects volition towards academic pursuits. Although aspects of motivation and volition
can be said to reside within the learner, a case can be made with the social cognitive
perspective that these intrinsic perceptions develop from the interaction between the self
and the environment (Schunk, 1999; Svinicki, 2004)
It is a dynamic viewpoint which proposes that learners are not just passive
recipients of these social influences. It can be a bi-directional process as learners react
and alter their social environment (Bandura, 1991; Schunk, 1999). This aspect of the

33

perspective allows for a belief that positive change is possible for college students. For
example, students who come to the college environment with low self-efficacy for
academic work or without strategies to self-regulate during the learning process can be
successful with the appropriate socializing experiences (Wlodkowski, 2008).
Several frameworks, which have grown out of the social cognitive perspective,
will now be discussed. It was anticipated that one or several of these frameworks would
be influential in explaining the findings. Upon data collection and analysis, it became
apparent that possible selves theory explained the dominant theme, which is described
first in Chapter Five. The other frameworks of the social cognitive perspective were
secondary in relevance for explaining how non-traditional aged occupational therapy
students stayed motivated to persist in their goal to become the self they envisioned.
Possible Selves Theory
Possible selves theory developed from both the social cognitive perspective and
the literature on identity development. This theory gives cognitive form to our desires for
achievement or affiliation and our fears of failure or incompetence (Markus & Nurius,
1986). Possible selves are elements of self-concept and they function as incentives for
future behavior, including our motives (Oyserman & Markus, 1990). They are visions of
one’s self in future circumstances and are “essential elements in the motivational and
goal setting process” (Oyserman & Markus, 1990, p. 113). Students, similar to the
general population, have several possible selves that have developed from past
experiences and the socializing influences of others in their life such as parents, spouses,
or friends. It is this aspect of possible selves theory that shows the influence of the social
cognitive perspective.

34

The possible selves concept, which is situated in the work on identity
development, focuses on how others in a student’s life affect their volition to complete
college. It shows that not only socialization experiences of the past shape the individual’s
sense of possibilities for the self, but also shows that this process does not stop.
Socializing experiences in college that are positive have the potential to create new
possible selves that come into fruition. For example, the student becomes more successful
because the positive feedback from faculty, university administration, or student peers
makes the discrepancy shrink between their ideal new self and a past self that has not
been successful. Conversely, these social interactions could confirm the worst fears that
are present in their old possible selves (Markus & Nurius, 1986). For example, academic
struggles or negative feedback could confirm for students that they are “not college
material.” The discrepancy between the desired and the actual possible selves could be
confirmed by the actions of those the student comes in contact with resulting in emotional
distress and drop out behaviors (Cross & Markus, 1994).
Students often find that it is not a linear trajectory to transition from their former
self to their new possible self. There may be steps forward and then backward in response
to other people in their lives (Higgins, 1987). Loved ones and friends are not always
comfortable with the changes they see in the student. They may exert pressures that
create circumstances distracting the student’s focus on academic achievement (Bean &
Metzner, 1985). Because of these occurrences, the value a person places on academic
achievement in college can be sidelined by others. Therefore, the concept of “goal value”
needed to be considered, because the participants in this study had many competing
priorities.

35

Individuals have more than one possible self they carry within them and are
influenced by a variety of socializing agents from the past and in their new present
(Grusec & Hastings, 2006). In order to have volition for persistence until graduation
students need to continue valuing the reasons that motivated them to initiate the college
process or develop new reasons to value the goal (Svinicki, 2004). The new self they
envisioned, which was embodied in the desire to be an occupational therapist, was
influenced by a variety of factors. No matter how strong their desire was to be someone
new, better, or different, this desire was still mediated by other factors. Perspectives
which discuss factors that may influence the achievement of a new possible self are
discussed next.
Social Cognitive Perspectives Supporting the Possible Selves Concept
An individual expects certain outcomes from goal attainment and then confers a
value on this goal (Brophy, 2004). For example, the value students place on their
academic achievement while enrolled in college varies. Svinicki (2004) reported that
some students maintain a strong self identity as workers who go to school part-time in
addition to their current life. Other students move closer to actualizing their new possible
self as full-time students working towards a professional career. It can be expected that
students will vary in the development of their new identities as professional level
occupational therapists for a variety of reasons (Eccles, 2009; Svinicki, 2004). Both
intrinsic or dispositional factors, as well as extrinsic or situational variables can be
expected to be influential in determining the value the student can place on their
academic pursuits.

36

In addition to valuing the educational goal, students must be able to expect that
the goal can be achieved. In order for non-traditional students to have a strong image of a
possible self that succeeds in the college environment, they must have a strong belief that
they can master tasks in the college classroom. According to Bandura, “people’s beliefs
in their efficacy influence the choices they make, their aspirations, how much effort they
mobilize in a given endeavor and how long they persevere in the face of difficulties and
setbacks…” (1991, p. 257). Those who have doubts about their abilities are easily
discouraged by obstacles or poor performance (Bandura, 1991; Cross & Markus, 1994).
Self- efficacy can be gained not only through mastery experiences, but also by
vicarious learning from watching others who are similar to oneself (Brophy, 2004).
Associating with others who are similar to oneself has been found to be important in
motivation for learning. For example, belongingness theory discusses the need for
relatedness with others who have similar goals (Baumeister & Leary, 1995). Relatedness
has been shown to be a basic psychological need necessary for motivation to learn
(Osterman, 2000). Weiner (as cited in Skinner & Belmont, 1993) found that students’
need for belongingness or connectedness to a community of learners is a strong motivator
for learning. Three studies done by Buameister, Nuss and Twenge (2002) found that
college students’ cognitive processes became worse after they were told they were likely
to end up alone in life. Even anticipated aloneness negatively affected intelligent thought
on achievement tests such as intelligence tests or the Graduate Record Examination
(Baumeister et al., 2002). These findings are significant because they help explain why
students may not be able to achieve their goal of a new possible self.

37

Additionally, occupational therapy students, similar to others pursuing a
profession, face a “new culture” as they enter and proceed through their academic
program. An implicit part of occupational therapy curriculum is the professionalization of
the student into the occupational therapy community of practice (Hooper, 2007). Hooper
explains that this is done by educators to convey and encourage students on “who they
should become and the ways of knowing” to embrace (2007, p. 228). These students, who
are immersed in a new culture, may have a strong need for relatedness within the
academic program to develop their new “possible self.”
As stated previously, students in health care majors at the professional level need
to persist for a relatively long time period of six to seven years. It takes self regulated
learning to make the transition to college successfully and show volition throughout the
college years until they graduate (Lindner & Harris, 1992). A growing body of literature
concludes that successful academic performance is related to the degree of self-regulation
the student utilizes (Zimmerman, 1990). Volition to persist on a long term goal, such as
completion of the academic portion of an occupational therapy curriculum, requires two
types of self-regulation: regulation of cognition and regulation of motivation (Wolters,
2003).
Students pursuing a new possible self in the context of an occupational therapy
curriculum need to “sustain cognitions, behaviors, and affects that are oriented toward
goal attainment” (Schunk & Zimmerman, 1997, p. 195). Self-regulation is an inter-play
of three factors: the person, their environment, and the behaviors of the individual. This
was originally described by Bandura as triadic reciprocality (Schunk & Zimmerman,
1997; Zimmerman, 1989, 1990). The recognition of the multi-directional nature of these

38

three factors was important to consider as I listened to the complex stories of the
participants who described the challenges of becoming the possible self they envisioned.
Summary
The perspectives described in this chapter were important in the conceptualization
of this current study because aspects of these frameworks held potential for
understanding the academic persistence of non-traditional aged students in health care
professions. It was unknown which factors, or what combination of unique factors, were
applicable for non-traditional aged students majoring in a professional level health care
program such as occupational therapy. The prevalence of theoretical and practice based
literature needs to be increased on this growing population of at risk students to prevent a
waste of institutional and student resources (Jones-Briggs Rye, 2005). The collaborative
use of the perspectives discussed in this chapter helped develop my research design and
guided the analysis of the data. The current research study offers an excellent opportunity
to further understand the persistence of non-traditional aged students majoring in an
allied health care profession by answering the following questions:
1.

How did non-traditional aged students who successfully completed the
academic portion of the newly established entry-level combined
Bachelor’s/Master’s degree curriculum in occupational therapy perceive
and make sense of their experiences in the program?
A. What helped them successfully complete the academic portion of the
program?
B. What challenges did they encounter and how did they navigate
difficulties or barriers?

39

Chapter Three
Methodology
Introduction
The purpose of this study was to explore persistence of non-traditional aged
occupational therapy students in order to understand the experience of these students.
Gaining an understanding of the experience of students in combined Bachelor’s/Master’s
level occupational therapy programs offers an opportunity to learn how to support
persistence in this program, as well as other related professions. Since there is little
relevant research applicable to this student group, which is immersed in a unique context,
the line of inquiry needs to start with the experiences and insights of the students. The
stories of these students and how they make sense of their experiences can facilitate
additional research studies that illuminate effective retention solutions for students in the
health professions (Lowenberg Ball & Forzani, 2009).
Research Design
A qualitative research design was necessary to understand the context and
experiences of these students. The purpose of this study was best addressed by using a
method which emphasized the socially constructed nature of reality in order to
understand the experiences and meaning making of the participants (Denzin & Lincoln,
2008; Lieblich, Tuvai-Mashiach, & Ziber, 1998). The problem described in this study
needed to be explored in the qualitative tradition, because there was little information to
rely on from the literature and the available studies were not conclusively applicable
(Creswell, 2007). Within the qualitative paradigm, the narrative method of study was
used because it captured the experience of individuals by allowing the narrator to

40

construct their own meaning of the experience in the process of their story telling
(Creswell, 2007; Denzin & Lincoln, 2005; 2008). In addition to learning from the
individual narratives of the participants, I also chose to look for patterns of common
experiences among participants. Chapter Four will present brief individual profiles of the
participants developed from their narratives, and Chapter Five will discuss the
commonalities of their experiences which were developed around four themes.
Narrative Methodology
Student participants were encouraged to share their story in the tradition of
narrative inquiry. The narratives students constructed while reflecting on their
experiences in their academic programs increased the understanding of the phenomena
being explored (Chase in Denzin & Lincoln, 2005; Coulter & Smith, 2009). The stories
of the narrator participants reflected their uniqueness as individuals with personal
histories, as well as the effects of social influences on their inner self and the
environmental context (Clandinin & Murphy, 2009; Loewenberg Ball & Forzani, 2007).
Gaining knowledge from the students who had been immersed in this experience offered
an excellent method to discover what facilitated or hindered their persistence.
Theoretical and practical solutions can also be generated by understanding the
patterns across their stories. Chase (2005) acknowledged that while “every instance of
narrative is particular, researchers use this lens to attend to similarities and differences
across narratives” (as cited in Denzin & Lincoln, 2005, p. 657). These patterns of
similarities and differences can be seen in their stories (Clandidn & Connelly, 2000;
Denzin & Lincoln, 2005). As students narrated, they constructed their stories by both

41

reaffirming and modifying them to create narratives which educated themselves and
myself, as the researcher (Clandidn & Connelly, 2000; Clandidn & Rosiek, 2007).
The research design made very conscious efforts to let the voices of the
participants generate the data. I tried to allow the construction of their experiences to be
created by the student and minimally influenced by me as the researcher. I kept in mind
the caution expressed by Quigley (1998) when he stated that there is a gap in our
perception relative to our students’ perceptions and this can be a “source of serious
unseen, under-researched problems” (p.3). For example, my experiences in higher
education as an educator may be different from the experiences of the student
participants. Quigley states that “the culture of school we (as former students) so enjoyed
is not necessarily a culture into which our students fit” (1998, p.2). This is why I chose to
use the Kawa Model as a theoretical framework to obtain narratives from students in a
holistic manner, free of biases (Iwama, 2006).
The Kawa Model
The Kawa Model is a relatively recent addition to occupational therapy frames of
reference created by an occupational therapist named Michael Iwama, who has both
Eastern and Western roots (personal communication, December 11, 2009). This model
was an important perspective for the conceptualization of this study because occupational
therapy has sometimes been characterized as a “White, middle class, women’s
profession” (Iwama, 2006, p. xvi). I fit this demographic precisely as an occupational
therapist and an educator of occupational therapy students. I believed the incorporation of
this model was an important way to improve trustworthiness because it limited the
influence of any biases I might bring to this study.

42

The Kawa Model uses the symbolism of a river (Kawa in Japanese) and its’
natural surroundings as a “wonderful and dynamic metaphor for life and the complexities
of life’s challenges; like the flow of life itself, the model is fluid and as such, lends itself
well to the subjective nature of human experience” (Iwama, p. xii). Narrative researchers
concur, as they describe “experience as a changing stream that is characterized by
continuous interaction of human thought with our personal, social, and material
environment” (2007, p. 39). This model, in conjunction with the narrative inquiry
tradition, helped insure that as a researcher I would be open in all situational,
institutional, and dispositional influences relevant to persistence in education. Using these
approaches discouraged me from limiting or re-structuring the participants’ responses
(Quigley, 1998). I had the opportunity to learn from these narratives if I saw the
information with “open eyes,” not influenced by my own, possibly quite different
experiences in higher education (Merriam, et al., 2007, p. 208). This “new knowing”
would allow research on persistence in occupational therapy students to move forward,
understanding what might be most important to this unique group.
The Kawa Model was also used as an aid in the interview process to encourage
participants to reflect deeply and to provide rich detail of their experiences. Nontraditional students were expected to have minimal time for engagement in a research
project because of the many roles they balance (Bean & Metzner, 1985; Wlodkowski,
2008). My experience was limited with the use of this model prior to data collection, but I
noticed how using this metaphorical model in a healthcare environment in my role as an
occupational therapist had allowed patients to confide very personal details of their life
with apparent comfort and expediency. I anticipated the use of this model could help me

43

gain more insight than using conventional interview methods discussed by qualitative
researchers (Creswell, 2007; Kvale, 2006). I discovered this was true when I initiated my
pilot study. The two participants in the pilot study provided often very personal
information in approximately 60 minute interviews. The following metaphors are used in
this model and can often be “heard” in the voices of the participants in Chapter Five
(pictorial representations of this model can be found in Appendixes C and D):
Water= life flow or life energy
Rocks or Boulders= problems, barriers, or challenges
River Bank= micro-environment such as family and friends; macro-environment such as
institutional or political factors
Driftwood= personal attributes which can be assets or liabilities
Site and Sample Selection
Site Selection
Site selection began in earnest after receiving IRB approval for the study. One of
the sites, Career College, required additional approval from their own institutional review
board. The student participants were selected from colleges or universities that had entrylevel combined Bachelor’s/Master’s level programs in occupational therapy. It was
important that these post-secondary institutions were currently accredited by the
profession’s accrediting body, ACOTE. This was more important than whether the
institution was public or private, or where it was located in the United States. Initially, I
aimed to use three sites with a predominance of non-traditional aged students. I started
contacting post-secondary institutions which emphasize a greater level of access to higher
education by admitting students with a broader base of student backgrounds and

44

capabilities. These institutions are sometimes referred to as open enrollment colleges, or
they might be institutions catering to communities where there is a more diverse base of
applicants. I assumed persistence was unlikely to be a concern at universities who had
highly selective admissions because high GPA averages have been correlated with
academic success in occupational and physical therapy programs (Hayes et al. 1997;
Kirchner & Holm, 1997; Koenig, 2003; Lysaght et al., 2009).
However, I found that some of my assumptions were incorrect. For example, the
program director at one potential site in a major urban area that was assumed to have a
more diverse student population, assured me that they really didn’t have many nontraditional aged students. Therefore, she was reluctant to post an invitation to participate
in this research study. Within the same month, I discovered from another program
director that non-traditional aged students at a highly selective research university often
struggled with persistence. Even though the students at this latter university were in the
minority (most students were traditional age) I thought it was important to understand the
experience of any non-traditional aged occupational therapy student who had struggled
with persistence. This led me to change my approach slightly in terms of site selection. It
was still important to have only accredited professional level occupational therapy
programs, but I chose to sample non-traditional aged students who had faced challenges
from four different types of institutions.
A total of eight sites from three states were contacted and invitations to participate
were posted by program directors or faculty at each of these sites. (See Appendix E for a
sample posting). In most cases, several follow up calls were made to the university
contacts to develop relationships and make sure students had been informed of the study

45

since I often had no response to the posting to participate. Since it was challenging to
recruit participants, a personal visit to explain the research project to students was done at
one out of state site at the suggestion of the program director. Ultimately, four institutions
from two Mid-Western states provided 17 initial participant interviews (interviews from
16 participants were utilized) which exceeded my goal of 10 participants. These sites are
described as follows:
1. Weekend College is a small private, not for profit institution that awards degrees
from the associate level up through the Master’s degree level. It is categorized by
the Carnegie Foundation (2010) as a Special Focus Institution. This college had a
predominance of non-traditional aged students and according to its’ website
marketed itself as an institution catering to working adults. It has several majors,
including the occupational therapy program, that are weekend programs. Students
travel to campus for weekend classes approximately twice per month and also do
course work on-line. According to faculty member, Dr. Christine Nelson, the
majority of students who participated from this site are first-generation college
students (personal communication, August 3, 2010).
2. Career College is a small private, not for profit college that awards degrees at a
variety of levels from a certificate up through a newly accredited doctoral
program in business. It is also classified by the Carnegie Foundation (2010) as a
Special Focus Institution. According to its’ website, it markets itself as a college
designed to provide students a career and advertises its’ high job placement rate.
According to Dr. Jo Anne Crain, Program Director, there is a predominance of
non-traditional aged students at this college; many are first generation college

46

students. Classes in the occupational therapy program are on-ground only during
the week. It depends on the students’ pre-requisites, but students can often be
provided with a two day per week schedule of classes (personal communication,
June 10, 2010).
3. Regional University is a mid-size public university categorized as a “Master’s
College and University,” with at least 50 Master’s degrees but less that 20
research doctoral degrees (Carnegie, Foundation, 2010). According to faculty
member, Helen Herlache, the majority of students in the occupational therapy
program are traditional in age, but there are a few students who are slightly older,
married and with children. She added that classes are scheduled four to five days
per week on campus (personal communication, September 14, 2010).
4. Research University is a large public university categorized as having “very high
research activity” (Carnegie Foundation, 2010). Dennis Cleary, Fieldwork
Coordinator in the occupational therapy program, expressed that the majority of
students are traditional in age on campus, but that there were some non-traditional
aged students in the program. He perceived that some of these students had
struggled and would be interested in sharing their experiences (personal
communication, September 24, 2010). The student participants in their interviews
all concurred that classes were held five days per week on campus and
occasionally class times were adjusted by faculty.
Participant Selection
Sampling was purposeful, which allowed for increased understanding of the
research problem by accessing participants who were in a position to shed light on the

47

research questions (Creswell, 2007). Purposeful sampling was done at two levels: the site
level as described in the previous section and at the participants’ level. According to
Creswell, “in a good plan for a qualitative study, one or more levels (of purposeful
sampling) might need to be present” (2007, p. 126).
Critical case sampling was used to select participants who were almost complete
with the academic portion of an entry-level combined Bachelor’s/Master’s occupational
therapy curriculum. This specific type of purposeful sampling sought to find participants
who experienced a specific phenomenon (Creswell, 2007). The phenomenon to be
explored in this study is the experience of students who have successfully persisted
despite potential obstacles. Therefore, selected students had to meet the following
criterion:
1.

Students had completed or were near completion of their academic
course work, which demonstrates persistence through the academic
portion of the curriculum (e.g. be in their last semester or only have one
more semester to complete).

2.

Students were from institutions that met the criteria described in the
previous section. For example, they were from an ACOTE accredited
entry-level combined Bachelor’s/Master’s level occupational therapy
program.

3.

Students were older than 24 years old when they initiated the course
work in the occupational therapy program.

48

4.

Students could answer affirmatively that they had faced challenges that
caused them to consider leaving the program or caused them to “stop
out” for a period of time.

In other words, purposeful sampling was also judgment (i.e., intensity) based in
order to obtain participants who had information rich stories which manifested the
phenomenon to be studied (Creswell, 2007). For example, non-traditional aged
volunteers who stated they had struggled in the program, but had not considered leaving
the program were not interviewed. Only those volunteers who had either stopped out or
had seriously considered leaving the program were selected for participation. I attempted
to have representation from as diverse a population of non-traditional age students as
possible, but this was very challenging because the percentage of males and students of
color is small; less than 10 percent in each of these demographic categories (AOTA,
Academic Programs Annual Report, 2008, 2009). Sixteen of the participants were White
females and there was one White male. A total of 17 participants were interviewed; data
from 16 participants was analyzed. The seventeenth interview was done by phone at the
request of the participant who was extremely interested in being included. Her interview
was brief and primarily consisted of her recommendations for other non-traditional aged
students.
Narrative inquiry rarely uses this many participants and instead often focuses in
great detail on the life experiences of one or two individuals. However, it is permissible
to have more participants when the researcher is seeking to illuminate patterns of
experience (Clandinin & Connelly, 2000; Creswell, 2007; Josselin & Lieblich, 1995).

49

Data Collection
It was very challenging to find students who could commit to the time
requirements of this study because as non-traditional students they had limited available
time because of competing priorities in their lives. Students needed to agree to be
available for an in-person, estimated 90 minute interview, followed by a follow-up
interview on-line. These requirements proved to be very challenging for participants. I
had many requests for phone interviews only. Participants expressed that they were
interested in being involved, but did not have time to travel to their institutions for
interviews in person. Students who could not meet in person were not selected for
inclusion in the study.
Prior to the initial interview, I usually had several interactions with the
participants by phone and email. I found this to be helpful because it developed our
relationship and I discovered that students were more likely to agree to participate once
we had a phone conversation in addition to email communications. I also found that if I
could garner the involvement of one student they would connect me with other students
at their site who fit the criteria. Although I did the majority of interviews on their
campuses, I sometimes met with students in their homes because of childcare issues or in
coffee shops near their places of employment due to their time constraints.
The narrative method was used to obtain the lived experiences or stories of the
narrator participants. The interview process in the narrative tradition is less structured and
controlled by the researcher (Josselin & Leblich, 1995). Participant narrators were invited
to share their stories and to take responsibility for how their story was told as much as
possible (Bertraux, 1981; Josselon & Lieblich, 1995). For example, after showing them

50

the Kawa model (see Appendix C) and explaining the metaphor, they were asked to think
about their experience in the program and to first draw in their boulders. They were
prompted to explain them if they needed to be encouraged. Conventional methods of
interviewing which use a more formalized interview protocol of questions tend to
suppress people’s stories, but it was helpful to have a set of possible questions and
prompts when a participant was reluctant to let their story “tumble out” (Bertraux, 1981).
It can be stated with confidence that their stories were not suppressed by the use of the
Kawa Model, but I cannot be sure if the way they told their story or what they included in
their narratives was influenced by the use of the metaphors in this model. Guidelines for
the interview process are in Appendix F, but they were not adhered to rigidly. It was
expected that these prompts would evolve with subsequent interviews as I discovered
what best invited stories from participants (Clandinin & Connelly, 2000).
A pilot study was done prior to data collection using these procedures to refine
my interview skills using the Kawa Model. I utilized two participants from Career
College who met the sampling criteria. Their data were not included in the analysis. I
learned that I sometimes needed to use the prompts to guide the participants back to
discussion of the phenomenon being explored in this study. However, I also realized that
it was beneficial to let students discuss topics out of sequence and to allow for some “off
topic information” since it often led to relevant disclosures. Lastly, I learned that for one
participant drawing using the Kawa Model was very helpful during the interview process.
He stated that “it let the focus be off me.” However, the other participant was quick to
launch into her story using the metaphors in the Kawa Model but not completing her
drawing. I found that it did not matter if the drawing was completed. The intent of the

51

invitation to draw using the metaphors provided by the Kawa Model was to prompt a
story rich in detail, even prompting participants to reflect on occurrences in ways they
had not done previously (Iwama, 2006).
I began data collection after reflecting in my journal and de-briefing with my
dissertation advisor about my experiences with the pilot study. During data collection, the
stories of the participant narrators were audio recorded after participants were assured of
confidentiality, including proper storage of the data. The purpose of the study was
explained and they were asked to read and sign an informed consent form. I had
considered taking field notes during the interviews, but decided to do this immediately
after each interview so the process did not interfere with the narrators’ telling of their
story, or my ability to listen actively. These notes focused on the participants’ actions,
facial expressions, and body language. I also made memos of my feelings and
perceptions on what was occurring during the interview process, because narrative
inquiry is not just listening to interviews (Candidn & Connelly, 2000; Clandidn &
Rosiek, 2007). In addition, I found it helpful to journal my thoughts and feelings during
the data collection and analysis because as an inquirer with a personal history relevant to
the topic, I was really a participant observer (Bateson, 1994). As Bateson (1994) states,
we all live storied lives and I was clearly present in the same storied landscape as the
potential participants, because of my presence in the field of occupational therapy as an
educator.
In order to facilitate the narration of the participants’ experiences surrounding
their participation in the occupational therapy academic program, I initially asked how
they came to become interested in occupational therapy. I asked this introductory

52

question to develop rapport so the participants felt safe to talk about more personal
questions and feelings with me, rather than provide only polite answers when we got to
the central portion of the interview (Kvale, 1996). After the narrators completed their
response, I then asked them demographic questions such as their family and employment
status, as well as the educational backgrounds of family members and friends. I then
presented a pictorial representation of the Kawa Model (See Appendix C). I asked them
to draw a river and reflect on their experiences as they proceeded through their years in
the program (the river). The metaphor of the river was helpful in prompting participants
to start telling their story, because we tend to think and learn in metaphors (Bateson,
1994). I next prompted them to think about the obstacles they encountered and diagram
those as rocks or boulders in their rivers. The metaphor of the river let the temporality of
narrative inquiry to be realized and participants took advantage of this when they drew
(Clandidn & Connelly, 2000). For example, students drew a large boulder at the mouth of
the river when it was one major issue at the start of the program, and a series of smaller
rocks throughout the length of their river if it was a problem that was ongoing. Little
prompting was needed for them to discuss their barriers (See Appendix G for the
drawings done by the participants).
I would then ask them to discuss how they persisted despite the obstacles. They
were prompted to discuss environmental factors that assisted them (the riverbank in the
metaphor) and their personal attributes (the driftwood) that hindered or facilitated their
persistence. Students often needed prompts to reflect on all types of environmental
influences. I asked them to consider people and situations in their personal life, as well as
institutional factors. When they discussed institutional factors it was usually in reference

53

to the influence of governmental funding for their education, or they spoke of faculty
practices or college policies. These initial participant interviews ranged from 32 to 113
minutes; the majority were approximately one hour in length. These interviews were not
lengthy, but the findings in Chapter Four and Five reflect deeply reflective narratives rich
in detail. In discussions with my dissertation advisor and professional peers we
hypothesized that it was the result of using the Kawa Model, but there may be other
explanations.
Follow up interviews, approximately one week after the initial interview, were
done by phone or by email at the request of the participants. They reported they did not
have access to other types of on-line communication such as video chat via the web at
home. Follow up interviews were initiated because both the researcher and the participant
were expected to have additional thoughts upon reflection which can facilitate the coconstruction of findings which are valued in narrative inquiry (Clandidn & Connelly,
2000). It was an opportunity for me to ask further questions or to clarify the meaning of
what was said or drawn in the initial interview. Participants were asked in these follow
up interviews if they had anything additional they wanted to share about what had been a
barrier or what had helped them to persist. They were also asked to consider if there was
anything they wanted to emphasize.
Twelve out of 16 respondents answered the follow- up questions. Ten out of 12
follow up interviews were done by email at the preference of participants. Many echoed
sentiments similar to Karen who said: “that way I can respond whenever I can…like
when everyone is sleeping at night.” Email responses varied in length from very brief
such as Nicole’s statement: “I think I said what I needed” to half- page single spaced

54

responses which emphasized points made in their interviews. The two telephone
interviews averaged 8 minutes in length and were not richer in detail than the email
responses. These participants clarified their previous points and the remainder of the time
was spent asking about the progress of this research study. Efforts to contact the four who
did not respond was discontinued after two attempts in an effort to respect the time
constraints these students all described.
Data Analysis
Data analysis required me to analyze the participants’ stories from three
perspectives (Clandin & Connelly, 2000; Creswell, 2007). I needed to consider the data
in terms of: (1) place and situation, (2) time (past, present and the future they anticipate),
and (3) who the person is (defined by their personal attributes and social interactions). A
holistic-content perspective was used to analyze the experiences of the narrators because
their stories were “multilayered and complex as are human identities” (Lieblich et al.,
1998, p. 167). This holistic content perspective is reflected by the inclusion of profiles of
the participants in Chapter Four, even though I also used a cross case analysis. The
findings from the cross case analysis are described in Chapter Five. The perspectives
described in this paragraph guided the procedural choices explained below.
Data analysis first involved extensive and repetitive reviewing of the collected
data, which in this case was the taped stories narrated by the participants and the visual
data drawn by participants using the Kawa Model as a framework. It also included
integration of my field notes and journaling memos. After each interview, or in some
cases after a series of interviews at a site, I listened to the audiotapes while looking at my
field notes and their drawings to gain an initial perception of the data. Then within a few

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days, I listened to the audio recording again and hand transcribed the interviews, often
stopping and starting the recordings to get accurate notes. Transcribing by hand allowed
me to focus and process the data better. I thought it was necessary to listen to the
recordings more than once because I could “hear” the story of individuals much better by
repeatedly listening to audio tapes, rather than reading transcripts. When listening to
audio tapes I could hear voice inflections and pauses, conveying emotions that would not
be apparent in written transcripts. As Lieblich et al. (1998) state, there are no clear
directions for this stage except that the researcher should “read or listen” in a way that
allows the “story to speak to you” (p. 62).
Then using these handwritten transcriptions, I described events that formed a
chronology in the life of each participant starting with their life after high school and also
noted epiphanies or themes in each narrator’s story (Creswell, 2007). In order to do this
task, I took my handwritten transcriptions from the audio recordings and composed two
types of written summaries: the chronological life story of each participant and an
interpretive summary which formed a global impression of each participant’s story
(Lieblich et al., 1998). The writing of this global summary allowed me to get a feel for
what was in the data, beginning to interpret the data, noticing not just what was said but
also noting any disharmonies or inconsistencies which were heard in the narrator’s story
or seen in their drawings (Boyatzis, 1998, Lieblich et al., 1998).
After I wrote these two summaries, I made a “map” for each participant, noting in
one column the factors that were obstacles to their persistence and in the other column
the factors that facilitated their persistence. I then determined the emphasis of each of
these factors so I had a perception of which factors had the most impact on a participant.

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Asterisks were used on the map to indicate which factors seemed to be the most
influential. I considered how many times in an interview a participant referred to that
factor, as well as their emotional intensity when discussing the factor as judged by their
facial expressions, body language, and tone of voice. These factors ultimately created
meaning units for the second phase of analysis and from this point the data was reduced
further. For example, meaning units which were topically similar became a coding
category.
I then integrated these previous analysis steps and composed a “story” of each of
the participants. These stories were approximately three pages in length, with direct
quotations used to support my interpretation of the patterns, themes, or tensions within
each individual participant’s life (Clandidn & Connelly, 2000; Creswell, 2007)
Abbreviated versions of these stories became the profiles in Chapter Four, and the details
of their narratives and direct quotes from their interviews were used to support the
emergent themes discussed in Chapter Five. Reflexivity was facilitated through
journaling and de-briefing with my dissertation advisor and professional peers during the
analysis phase. It was helpful to have these discussions with others to clarify my thoughts
and to insure an analysis as free as possible from my assumptions.
The narrative inquirer may use coding of their field texts to identify themes, but
this coding is more commonly done within the life story of an individual as I did initially,
rather than across a group of participants (Clandidn & Connely, 2000; Creswell, 2007;
Lieblich et al., 1998). Therefore, guidance from the phenomenological tradition of
qualitative research was utilized. I used a modified version of the Stevick-Colazzi-Keen
method discussed by both Moustakas (1994) and Creswell (2007) by looking across cases

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for common units of meaning which were developed into coding categories. Themes
reflecting the participants’ experiences then emerged from these coding categories.
As mentioned previously, I first needed to reduce the data. I looked across the
variety of facilitators and barriers that had been identified on the participant “maps.” I
thought of these as meaning units. For example, I had a participant that discussed the
impact of her husband’s help around the house and another participant that spoke about
how faculty adjusted the due dates on her assignments. This became a coding category
known as “practical support.” I developed a list of coding categories that cut across the
maps of all of the participants. I initially had not planned to have type written
transcriptions of the participants’ interviews because I felt I could hear their stories better
listening to the inflection in their voices and noting pauses while handwriting detailed
transcription notes. While this was very effective for analysis of each participant
individually in the first stage of the analysis process, it became clear that I would need to
have type written transcriptions to code across the lives of the participants accurately as
my handwritten notes made this task too challenging. Additionally, my handwritten
transcriptions were written with abbreviations and in handwriting that only I could
decipher. In order to have a peer review my methods I needed to have the audio data from
the interviews in typed transcriptions. I did four of the typewritten transcriptions from the
audiotapes that were less audible because they were done in coffee shops or in a
participants’ home, while a third party was hired to transcribe the remaining transcripts.
After I coded across the transcripts I realized there were common themes related
to the phenomena being studied. I started to see patterns when I was collecting data that I
later confirmed when I did the more formal step by step coding analysis, which was done

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by highlighting the typewritten transcripts and writing in the margins. Patterns emerged
that were present in the majority of participants. I grouped coding categories that were all
speaking of the same phenomena. For example, support emerged as a theme whether
participants were describing a type of support (emotional or practical) or were discussing
different sources of support (family, spouse, cohort peers, or faculty). The analysis
process also involved reading additional literature, searching for alternative explanations
that were not considered in the conceptualization of the study. It also involved extensive
use of journaling as I considered the new literature in relationship to the data. Lastly,
discussions with my dissertation advisor and a professional peer proved beneficial to
refine these coding categories into themes and sub-themes that would best represent the
findings.
Trustworthiness
Informal external auditing was done by two professional peers knowledgeable in
the analysis of qualitative data. These peers were asked to review the methods I used to
analyze the data during the first phase of analysis when I was analyzing the data from
each participant individually and then again when I was coding across the transcripts of
the participants in the second phase of analysis. They were asked to read the
chronological stories and the global impression summaries, as well as review the maps
and drawings of two participants. Later on, they gave feedback on the coding categories
by looking across the typed transcripts of two participants for consistency of coding. I
also met with my dissertation advisor throughout the data collection and analysis phases
to de-brief and have him review written examples of my analysis process at each phase
(Creswell, 2007). No inconsistencies in my methods were found but it was helpful to

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have questions from these professionals that prompted me to reflect more on my
impressions of the data and the categories I established.
I journaled my feelings and perceptions in order to bracket, as well as I could, the
biases I brought to this research study. For example, I think it is best if students can work
part-time rather than full-time when they attend their challenging full-time academic
programs. The use of the Kawa Model helped limit the infusion of my biases because it
prompted students to tell their story on their own initiative, rather than being asked
prescribed questions by me. I supplemented this plan to establish trustworthiness by
using rich thick description of the participants and their direct quotes to support the
themes in Chapter Five (Creswell, 2007). I also included the next section of this chapter
to describe the orientation of myself as the researcher in an attempt to make my
assumptions and biases clear so that it “guarantees a fair mature and critical dialogue”
between myself and readers (Lieblich et al., 1998, p.170).
Orientation of the Researcher
According to Clandidn and Connelly, “as narrative inquirers we work within a
three dimensional space, not only with our participants, but also with ourselves” (2000).
As a researcher in this problem area, I bring perspectives and biases from my story; my
past lived experiences. I grew up as a White, middle class female in a home where
education was highly valued on my father’s side of the family. Although none of the
females on either my mother’s or father’s side of the family attended post-secondary
education, my father and paternal grandfather did. My paternal grandmother did not
attend college traditionally, but took many community and college based classes for
enrichment. Unlike the experience of many first generation college students, my siblings

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and I assumed we would attend college. I also assumed my children would attend college
and they did so. My children and I would have been considered traditional college
students. We could place our primary emphasis on our academic work with job duties
being secondary and minimal. Although on a cognitive level I realize students need to
balance other priorities, I must admit that in my soul I think it unfortunate that nontraditional students cannot always place their college work as primary.
My more recent story provides me with a wealth of experiences as a faculty
member in an occupational therapy program at an open enrollment college which admits
a significant number of non-traditional students, many of whom are first-generation
college students. My joy at seeing these students succeed and transform to professionals
outweighs any frustration I have as we all struggle through the challenges they face as
students, and I face as their instructor and mentor in their academic program. I have seen
students succeed who seemed to have little potential, and believe their motivation along
with our special efforts at our college helped them succeed.
These experiences drive my interest in this topic and make me believe that the
occupational therapy profession and other related professions need to recognize that some
students need something more from us to be successful. We need to explore how we can
help students from all types of backgrounds be successful. These are the perspectives and
biases I bring to the conceptualization of this study, as well as the data collection and
analysis processes.
Strengths and Limitations
One limitation of a study that uses narrative methodology is the criticism that
stories told by narrators may not be accurate and may be told as the participants wish

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events had occurred (Clandidn &Connely, 2000). However, this is actually the point of
narrative inquiry; participants collaborate with the researcher to construct meaning from
their experiences relevant to the phenomenon being studied (Clandidn & Connely, 2000).
I sometimes needed to “read between the lines” to incorporate apparent absences and
contradictions of information as the participants told their stories, but this co-construction
of knowledge was expected to occur (Lieblich et al., 1998). For example, Barb mentioned
at the start of her interview that her greatest boulder was the guilt she felt because she
spent less time with her children because of school. However, she seemed to contradict
this statement by repeatedly mentioning, sometimes with tears in her eyes, how the lack
of support for school from her husband increased her struggle. Another limitation of the
study is that I may have had assumptions or biases about what I think this study would
find. However, I have made every possible effort to bracket these assumptions by the act
of disclosure in the previous section, and I planned for reflexivity by taking field notes,
journaling, and de-briefing with other professionals.
This study also has strengths. I had planned to have 10 participants at a total of
two to three institutions. Despite challenges finding participants who had the time for inperson interviews, I was able to utilize data from 16 participants from a total of four
institutions. Narrative studies usually only focus on one or two participants (Clandin &
Connely, 2007; Creswell, 2007; Leiblich et al., 1998). This study allowed for more
trustworthiness since the identified themes were developed from more participants. An
additional strength is that the participants were from institutions which varied in size and
context. This supports the idea that non-traditional aged students in a health care
profession, such as occupational therapy, have commonalities as a group, since the

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themes were represented across different types of institutions and varying student
demographics. A final strength of this study is the depth of reflection participants offered
in their interviews which resulted in a richness of detail on the phenomena being studied.

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Chapter Four
Student Profiles
Introduction
All of the participants met the criteria listed in Chapter Three in the section
describing participant selection. They all were in accredited professional level
occupational therapy programs. The participants were in the graduate level phase of their
curriculum near completion of the academic portion of the program, prior to six months
of required clinical internships. Only one student, Marie, was at a different stage of
completion. She had also finished her clinical internships. I considered not including data
from this participant but her narrative provided valuable information about how she
persisted despite obstacles.
All of the students were older than 24 years old when they started their
occupational therapy programs, categorizing them as non-traditional aged students. Their
ages ranged from age 25 years to age 39 years when they enrolled in their respective
occupational therapy programs. Twenty- nine was the average age when they initiated
their programs. Students took various lengths of time to complete their degrees because
some had periods when they stopped out from school. At the time of the interviews their
ages ranged from late twenties to early forties. Fifteen of the 16 participants were White
females and one participant was a White male. The participants all had encountered
significant obstacles. They also met the criteria for participation because they could
answer affirmatively that they had either stopped out at one time or had considered
leaving the program.

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This chapter will provide the reader with background on each participant. It will
focus on the sequence of events in their lives that prompted their interest in occupational
therapy including highlights of their experiences after high school until they enrolled in
an occupational therapy program. Each profile concludes with their experiences related to
the phenomena being studied while they were in their respective occupational therapy
academic programs. There were five participants from Weekend College, four from
Career College, three from Regional University and four from Research University.
Participants from Weekend College
Helen
Helen was a 39 year old married female with two teenagers when she started her
program. Her husband and other relatives did not have postsecondary degrees. She
reported that her initial obstacle was her own perception that she was too old to be going
to school and had been away too long from the routine of studying. However, she stated:
“I soon realized I wasn’t the oldest… that age didn’t matter and they (faculty) did value
your experience.” She learned that her primary, recurring obstacle though the program
was her chronic condition of rheumatoid arthritis.
Helen was diagnosed with rheumatoid arthritis at age twelve and learned about
occupational therapy as a result of her condition. She reported receiving services from an
occupational therapist that impressed her because she was the only health professional
that asked her how she was feeling and cared about what she thought. “I was 12 years
old, big hair was in, and the only thing I wanted to be able to do was curl my hair. She
made a huge impact because she adapted my curling iron to where I could do it.”

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Helen was trained as a cosmetologist in high school and worked in the field for
two years but the symptoms of her disease didn’t allow her to continue. She qualified for
the state’s vocational program because she couldn’t do the job she was trained in
secondary to her disabling condition. They paid for her to get her associate degree in
occupational therapy and she worked as an occupational therapy assistant for nineteen
years. Despite making adaptations in her life, she again became involved in the state’s
vocational program when this position became too challenging and she went on partial
disability status. Helen said the state was willing to pay for an education that would move
her to a therapist level position which could potentially be less physically taxing. Her
vocational counselor did not agree with her vision to move forward to the therapist level
but Helen described herself as very determined. “I told them if I can’t do something, I
will figure it out… I will find a way… I will get the job done.” She was not interested in
going on full disability which had been a proposed option.
Helen did encounter obstacles balancing school, employment, and
responsibilities as a mother. She had exacerbations of her symptoms which prevented her
from attending the weekend program a few times. However, she reported: “I learned how
to prioritize and find that balance and get that rest so that I could control how these flareups were happening.” She stated that she learned to rely on help from her husband for
household tasks and realized she could not be at all her children’s events. She also
decreased her hours of employment until eventually she worked very few hours.
It took me a long time to figure out it’s okay to let somebody help you cause I felt
like I’m the mom and I should be doing x, y, and z, but then I had to realize by
doing this degree and having more of an income I will actually be setting up my
family stronger.

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Helen gradually became more comfortable with her identity as a student and
professional but seldom put her professional endeavors before the needs of her family.
She reported she didn’t think she would have pursued the degree if she had not received
money from the state because if she had used her family’s income “it would have been
taking money from my son and daughter for college.” However, Helen was definitely
able to put her professional aspirations “before” her chronic condition. As she told her
story, it became apparent that she had never limited who she wanted to be: a wife, a
mother, and a health professional helping others. While she had considered dropping out
of the program when she had obstacles, she credited her “can do” attitude, the support of
her family with practical help, and the emotional support of friends in the program who
“consistently try to keep each other going.”
Ellen
Ellen was a single 37 year old with an adolescent daughter when she started the
occupational therapy program. She described her family as blue collar, with one sister
having a two year degree in nursing. She traveled almost four hours each way to attend
this weekend program. Immediately after high school Ellen attended a large university
for one year, but she stated that she did not like dorm life so she returned home to attend
a local “technical college.” She considered being a communications major but “decided
that was not for me.” Ellen described herself as “floundering around for awhile
considering career options.” She continued:
A friend of mine who had already started the program (a two year associate degree to be
an occupational therapy assistant) … when I was saying I don’t know what to do…said
‘why don’t you look into OT?’…so I did. I decided it was a good fit for me.

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Ellen felt it was a good fit for her because she had always wanted to work in a people
profession where she could help people.
Ellen worked as an occupational therapy assistant for approximately sixteen
years. She did not consider advancing to the therapist level until a supervisor and coworkers encouraged her. She stated:
My supervisor said ‘you’re good at what you do but you’re wasting your time.’
Other people were seeing the qualities in me…giving me the affirmations. I hadn’t
considered going on…I am from a family with very blue collar roots. I thought ‘hey’ I’d
give it a try.
When Ellen was asked to reflect on what was most memorable about her
experience in the program she stated emphatically: “Change! I had to change how I think,
change how I do everything…I had to modify and adapt in all aspects of my life.” She
continued: “the change coming back to school as a thirty-seven year old was major,
major, major!” She drew money problems and adapting to changes in all aspects of life as
her boulders at the start of the program. She went on to describe how she had to “learn to
balance things.” The financial stress of being a single parent while attending a school
with “very expensive tuition” forced her to leave a job she loved in order to earn more
income in order to pay for the program. She switched to a different full-time job and
added another part-time job. “My new supervisors hindered me going to school. They
were not very supportive of me returning to school and that made it more difficult. I
would have loved some mentorship.”
Ellen described learning how to get by with less sleep, discontinuing old
friendships, and “becoming OK with my (teenage) daughter going places…had to learn
to trust her more.” She mentioned how she and her sister decided to live together so they
could share daily financial costs and “be there” for each others children when they had to

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be absent. She called this their “five year plan.” Ellen also described deeper personal
changes she made in order to be successful. She described having to change her
personality, the way she interacted with others, and her thought processes. Ellen implied
that these changes were suggested by the faculty and program director. Ellen also said
she had to get more organized and learn to meet dead lines at school. She described not
only changing her ways of doing things; she also described a weight loss of 40 pounds.
She was proud of herself and the changes she had made in order to be successful.
She emphasized that she felt being in the program had “transformed” her. She credited
other people in her life for helping her persist, but also described herself as follows:
“I don’t like to fail, to look weak. I’m a very strong minded person who doesn’t step
back from a challenge.” Ellen was a student who clearly focused on doing what was
necessary in order to succeed. She came across as “a glass half- full person” who
managed to make many changes in order to be successful; even deep personal changes in
response to feedback from faculty at the start of her program.
Ivan
Ivan was a married male, 35 years old, when he started the occupational therapy
program. His wife and one brother had attended college. He described himself as coming
from a family where no one went to college. He had been working as a physical therapy
assistant for nine years and was in the process of pursuing the pre-requisite courses to be
a physical therapist but “made a left turn” and decided to be an occupational therapist.
This was prompted by an experience with his father who was dying from throat cancer.
He related a story about helping his dad have a ‘pizza night”, a family gathering where
his dad made pizza and the family played cards. Ivan reported he could see the joy his

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father experienced that evening, despite his father’s inability to eat the pizza and fully
participate. He decided he “would rather help people in another way (not physical
therapy), by helping them do what is most meaningful to them.” He said: “I would not
have considered occupational therapy if not for my dad…and if not for my wife who
helped me see it was a better idea for me.”
Ivan’s motivation to do the occupational therapy program was related to his
desire to help others, but this need to assist others, such as his wife and family members,
seemed to be a force spiraling him towards academic failure by the time I interviewed
him. Ivan stated with emotion that “I wouldn’t have done the OT program without my
wife pushing me…but at the same time, she’s dragging me down.” He told a story of his
wife’s struggle with the symptoms of a bipolar diagnosis, which had caused several
hospitalizations and significant financial debt. It also caused erratic behavior which made
it difficult for her to be left alone at times and he had seriously considered quitting school
to spend more time with her. Conversely, he also stated he had once considered divorce.
Ivan alternated between anguish expressed in statements such as “I don’t understand why
I can’t get my wife better,” and frustration at how she was making it very difficult for
him to balance full-time employment, school work, and caring for her. Ivan also was
distracted by the plight of his mother, who had been widowed and was in poor health
with minimal financial resources. He felt he “couldn’t take this on too” and described
aggravation with his siblings whom he felt should take on more responsibility with his
mother.
Ivan’s dream of being a professional helping others seemed to get lost as he
related his complicated journey. He spoke of just needing to complete the program, no

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longer could he aim for “As” because of his personal issues; that he just had to hope he
didn’t fail a course he was in. Ivan said that his initial barrier was a lack of confidence in
his ability to do well at school, but that he was bolstered by his wife’s encouragement. As
Ivan told more of his story, it became apparent that he no longer felt support from her and
instead viewed her as a barrier to his success in the program.
Ivan’s wife was the only support he had identified. He stated “I’m not the kind
to go to others.” He did not feel his family understood what he was doing since only one
brother had any post-secondary education. He said his parents never encouraged him to
do homework…they were janitors and didn’t get it.” Ivan related that he thought this is
why he did not go to college after high school and waited until he was 23 to start his
associate degree. Ivan also drew no support form his peers in the program. He said he has
always felt isolated from the other students because he was the only male in his cohort.
When asked, Ivan did admit that he probably wouldn’t have “gotten buddy” with male
students either as he did not stay in town for the weekend but instead needed to go home
for his wife. He also reported not reaching out to faculty unless “necessary.” Although he
stated his advisor was willing to help him with his personal problems by listening and
offering counseling referrals he stated, “I talked to her (professor) just in case I got too
behind on assignments.”
Ivan’s narrative only occasionally revealed beginning insight for the things he felt
were out of control in his life: finances, academic performance and his marriage. He
tended to blame others for his difficulties. He reported that he thought it best to cope by
“not thinking about things too much.”

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Fiona
Fiona was a thirty year old married female when she started the program. No one
in her personal life had attended college except a sister, but Fiona dismissed her
achievement saying “she never used her degree.” She had one son who was born when
she was seventeen years old as a result of an unplanned pregnancy. She stated that she
finished high school but her plans to go to a major research university to study marine
biology or be a veterinarian no longer seemed feasible since “I needed to stay close to
home and couldn’t very well take a baby to the dorms.” She decided to get an associate
degree in occupational therapy at a local school because an interest survey in high school
pointed her in the direction of health professions. She reported she chose occupational
therapy because “it sounded less boring than physical therapy.”
Fiona worked as an occupational therapy assistant for approximately nine years
and decided to proceed with her therapist level degree because occupational therapists at
her place of employment “thought I could do it “and because “ I wanted to be better than
a lot of crappy OTs I’d seen.” Her motivation to persist in the program came from a
desire to have a better life for herself. Fiona said she grew up “severely poor” and stated
“I’m not going to do this…I want to make a good life for myself.” She also said she was
motivated to continue because she wanted to prove her mother wrong. The words of her
mother at the time of her unplanned pregnancy, “there you did it…now you won’t make
anything of yourself” were still resonating within her as she described her journey in the
academic program.
Fiona described one of her biggest challenges as balancing her time between
employment and school work. She explained that she needed to work a full-time job as an

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occupational therapy assistant, as well as waitress because her husband seldom worked
and she was responsible for the bills. She also said she was responsible for all the
household chores and assisting her son with homework. Fiona reported that her husband
did not help in any way and he was extremely upset that she was going to school. The
schedule she described sounded grueling. When asked about the status of her health, she
explained that mid-way through the program she was hospitalized for a week because she
had ignored a medical problem. She stated that she didn’t feel she could take off time
from work or school, but admitted that ignoring the problem had ultimately cost her more
time.
Fiona reported that she really doesn’t have support from anyone, but doesn’t feel
she needs it because she “is strong and I don’t need others.” She said she does not spend
much time with her family, with no expressions of regret observed, and reported she “had
to let go of friends.” Fiona voiced resistance to faculty suggestions and their offers of
support. She reacted with anger in the interview when asked about her relationship with
cohort peers. She felt they had life easier because they didn’t have to work as much and
said the other students were critical of her work when they worked in groups. Fiona
stated that school is just not a priority for her like making money and paying bills.
Although in her initial interview Fiona seemed to pride herself on not needing
support from others, she stated in a follow-up communication that lack of support was
one of her biggest challenges. Fiona occasionally made a statement that showed she
might be starting to take some responsibility for her rocky course through the program.
However, the dominant pattern she displayed was to blame others for her struggles. It
seemed like her determination to get through the program was fueled by anger at others.

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Gale
Gale is a married female with a 4 year old son. She was 25 years old when she
started her program. Gale explained that she had always wanted to help people,
“especially kids.” Her first contact with an individual with special needs was her aunt
who was developmentally delayed and blind. Gale reported that she was always very
involved with her aunt and helped implement strategies to improve her aunt’s
independence and quality of life. This experience drew Gale to pursue a special education
degree out of state after high school graduation. However, she explained that when she
returned home at the holidays in her first year of college she abruptly changed direction
and started to pursue occupational therapy as a career. Gale reported that in a
conversation with her hairdresser, when she was describing what she wanted to do
professionally, the hairdresser stated: “that sounds more like OT.” Gale subsequently
investigated the profession and initiated her goal of becoming a professional level
occupational therapist by first getting a two year degree to work as an occupational
therapy assistant. She worked for a few years as an assistant and also had a child before
she started at Weekend College.
Unlike her fellow participants at Weekend College, Gale had some family
members who had college degrees. There was a predominance of registered nurses in her
family and in her husband’s family. When she started the program both she and her
husband were working full-time and also pursuing degrees. She was working as an
occupational therapy assistant while she started to pursue her professional level degree in
the field and her husband was working as a registered nurse as he pursued a degree to
become a physician assistant. Gale said that her initial boulder was a lack of support from

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her husband and family as she tried to combine roles as a full-time employee, full-time
student and be a mother to a newborn son who was born prematurely and had medical
problems. She said that gradually her husband became more supportive and they decided
to “take turns.” For example, when one of them was in school with a heavy course load,
they would work less hours. This caused more financial stress because they had less
income so they made adjustments such as downsizing to a smaller home.
Gale said that just as things were going a bit better, her son’s health worsened
significantly because he started having seizures that could not be controlled medically.
She described that she and her husband have experienced increased stress because her
son has been hospitalized several times. She is several hours away when she attends
Weekend College and worries while she is gone. She has had to leave the college several
times because of his life threatening condition. Additionally, despite having health
insurance, there have been uninsured costs such as 500 dollars per month in prescriptions.
These medical costs, plus her need to cut her work hours to almost nothing in order to
take her son to medical appointments, worsened their financial situation. She stated she
was proud of her husband and herself because they “had done things in the right order…
we saved and we married before we had kids” but lamented that because of this, plus
their salaries, they did not qualify for financial aid.
When Gale was asked what was helping her persist despite the obstacles she
described, she credited the faculty as her primary source of emotional and practical
support. She said they were very understanding when she had to miss classes and have
been willing to help her succeed in any way they can. She felt little support from her

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cohort peers speculating that they didn’t know what was happening in her life, or if they
did, they might be jealous of the accommodations she received from faculty.
Career College
Barb
Barb is a married 29 year old female who started the occupational therapy
program at age 25. No one in her personal life had a post-secondary degree except a
cousin with a law degree. She had planned to enter the Navy after high school but met the
man who eventually became her husband and because she wanted to continue her
relationship with him decided to instead work as a medical biller in her hometown. She
started college at age 22 with plans to be in a health career where she could help people
but reported she discontinued because the financial aid was not adequate. At age 25, after
the birth of her first child, she re-entered the same college because she reported she
qualified for more financial aid as a single mother. She was pursuing a two year physical
therapy assistant degree after she became aware of the profession when her brother had a
serious accident. She switched to the occupational therapy program at the suggestion of
an advisor who mentioned that she might be more interested in a professional level
degree in the health professions. She eventually married the father of her first child and
they had another child together while she was in the occupational therapy program. She
dropped back for a year at this time to stay home with her infant.
Barb also seriously considered dropping out twice because marital problems
were causing her significant stress and adversely affecting her school performance. She
explained that she came the closest to dropping out at two times: once when she did so
poorly she was placed on academic probation and more recently when she was making

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plans to leave her husband and get a divorce. Currently, she is going for marital
counseling with her pastor and is hoping her husband will also attend.
When Barb started to reflect back on her course through the academic program
she described her biggest barrier as the guilt she had about not having as much time as
she would like with her young children. However, as she continued narrating her story it
became clear that she thought her husband and his resistance to her attending school was
her largest boulder. She was very emotional when she spoke of her husband’s lack of
emotional and practical support and kept coming back to the topic in her narrative. She
described in detail how she thought he would purposefully not help a child with a request
so that she would have to stop studying. She said that she could not count on him for any
household chores or assistance in raising their children, but that she understood that
because he worked a lot of hours. She continued, saying that he seemed jealous of the
time school took from the family and that he had expressed concern that she would leave
him once she obtained her degree. She repeatedly expressed that she wished he valued
education like she did.
When Barb thought about what kept her persisting through two “stopping out”
periods, she said that students needed support from everyone, inside and outside the
program. However, she emphasized her personal attributes the most. Barb said that her
desire to help people was “just so strong,” plus she was determined. She also reported a
need to prove she could do the program to herself, as well as to friends and her
instructors.

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Anne
Anne is a married woman with two school aged children. She started the
program at age 27 with the encouragement of her younger sister Barb who was profiled
in the above paragraphs. Anne said that she dropped out of high school at age 17 when
she got pregnant. She later obtained her GED at the insistence of her mother who
promised her a car if she met this goal. Anne stayed home to take care of her two
children, while her husband supported the family as a handyman. Once her youngest
went to kindergarten she started working at a “dollar store” for about two years. It was at
that time that her sister Barb was starting the occupational therapy program and she
encouraged Anne to enroll also. Anne, similar to Barb, was surrounded by friends and
family without post-secondary degrees, but received encouragement from her sister and
her mother to continue her education.
Once Anne was in the program she reported she relied heavily on the support of
others. She credited her husband for helping support her emotionally, “he got me through
my break downs when I thought I couldn’t do it.” She also explained that he was always
willing to step in and help with household chores or caring for their children so she could
study. Anne added that her sister was helpful, “we hold each other up.” She also
emphasized the support of her aunt who not let her quit studying and her son who would
do homework with her. She found strength in a group of cohort peers who often studied
together and stated that the instructors were helpful in providing both practical and
emotional support when she was failing or encountering personal issues. Despite this
amount of support, Anne said she struggled in school and was on academic probation
twice.

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Anne said that school work was hard to concentrate on because there had been a
series of serious illnesses and deaths in family members during the program. She stated,
“every quarter, someone seemed to be dying.” She described in detail the illness and
death of a favorite brother-in-law after he had a long battle with cancer, and then the
subsequent illness and death of this brother-in-law’s 17 year old daughter who also was
diagnosed with cancer. She said these were the most challenging times for her because
she often needed to miss class to help with their care or advocate for them in the hospital.
Even when she could be in class, she had difficulty concentrating. She went on to explain
how she and her husband took her brother in law’s remaining children for a time period
into their home. She also mentioned the illnesses and deaths of a few other relatives.
Although Anne never explicitly stated that she wanted to go into occupational therapy
because she wanted to help people, it was clear that she was a caring person who put
needs of her family before her own academic or career goals Although at the time of the
interview she was very motivated to complete the program, she seemed solely motivated
by the hopes others had for her. Unlike other participants, Anne never stated why she
wanted to get her degree.
Carey
Carey was a 26 year old female who had just bought a home with her female
partner when she started the program. Carey described a complex family history which
she described in detail because she felt it related to her experiences in the occupational
therapy program. She and some of her siblings were raised by her maternal grandparents
after her mother died when she was 11 years old. She said her father was not involved in
raising her and she mentioned his abusiveness towards her at one point in her narration.

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She had several siblings and step siblings but no one in her personal life had postsecondary education except for one sister who had an associate degree. She described
other siblings as unmotivated and often in trouble, citing examples to support these
statements.
Carey had always intended to get a college degree and had always been
passionate about the idea of helping others, citing the movie “Patch Adams” as her
favorite film. She mentioned that her interest in therapeutic professions began when a
close friend was hospitalized for cystic fibrosis and she saw the positive impact the
therapists had on her friend. She started her post-secondary education living in the dorms
at a public institution, majoring in music therapy, but returned home in her first year to
help her grandmother care for her ill grandfather. When he recovered sufficiently, she
obtained a certificate as a medical assistant and became acquainted with health care
professionals in her employment setting. She learned about occupational therapy in this
setting and decided with encouragement from other employees to obtain her degree.
Carey said when she started in the program it was “smooth sailing.” However,
her relationship with her partner became “extremely rocky” and she said this caused so
much stress she did poorly at school and dropped out for a year. She returned to the
program and became involved in another relationship with a woman who had a five year
old son with a genetic disorder accompanied by significant medical problems. Because
Carey considered herself a parent to the child she often missed school when he had
medical appointments or health crises. During this three year relationship, Carey also
took in her troubled adolescent younger brother and sister at different times trying to help

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them with their lives. Carey said her school work suffered as a result and she was forced
to leave the program because she had failed classes.
Carey said she had to wait a year to re-apply to the program but learned a lot
about herself during her year off when she worked at odd jobs and spent time reflecting
in a journal. She credited an instructor who “set me straight” when she was dismissed
from the program. Carey said the instructor told her she had to reach out to other students
and to faculty or she wouldn’t make it. She confided that she realized her bipolar
diagnosis had caused her to struggle at times while in school, but she learned that she
really had two barriers that caused her more difficulty: (1) a tendency to keep to herself in
the classroom, because of her grandparents advice to keep family matters private (Carey
explained that there was always so much drama going on her life that she didn’t want to
be asked anything), and (2) “learning to say ‘no’ and stop helping people who are
dragging me down and to focus on things that are helpful for me in succeeding.”
Donna
Donna was 30 years old and single when she started taking pre-requisites for the
occupational therapy program. At the time of her initial interview she was married with
three children and two step-children. She reported that she intended to enroll in college
immediately after high school to pursue a career, but that her “high school sweetie talked
her into getting married.” Donna reported she soon had a baby from an unplanned
pregnancy and had a very hard time adjusting because she had not wanted children. She
did not think she could be a good mother because her mother had been “non-nurturing.”
She stayed home to raise her first child and became interested in occupational therapy
after the birth of their second child who had a disability due to a spinal abnormality. He

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needed rehabilitation services including occupational therapy. During this time period
when she stayed home to raise her children she decided she could be nurturing and
thought she would have the characteristics to be a good health care professional.
However, she did not immediately pursue this career path because she got
divorced when “my husband cheated on me.” Instead, she went to cosmetology school
which took less time and “did hair” for eight years before starting college. During this
time she had a third child with a man she never married because “he was trouble.”
Donna said she wanted to start college but her relationship with him was very stressful
even once she was no longer living with him. She recounted a complex story involving
police involvement and restraining orders against him because of incidents of stalking
and home invasion. Her twenty-ninth birthday prompted her to enroll in college because
she had planned to have a degree and a career by age thirty.
She started college taking pre-requisites for an associate degree in physical
therapy and then planned to move on for the advanced degrees required for occupational
therapy. A counselor advised her against pursuing an associate degree if she ultimately
wanted to be an occupational therapist so she followed that advice. She found that adding
school to her life was very challenging because she was a single working mom and
“finances were tight.” When referring to her years in college she stated that she had rocks
throughout the program but that her problems became worse when she re-married one
year into the occupational therapy program. Donna stated: “it was harder than being a
single mom.”
Donna said that she had to stop out of the program twice because the task of
blending their families together was so challenging and caused severe marital strife which

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almost led to divorce. Her children developed behavioral problems and she said the house
was so small for all of them, plus she had no quiet place to study. She said she could not
concentrate on school and her grades suffered. However, Donna did re-enroll after each
time she stopped out.
She credited her strong work ethic and determination for her persistence. She said
these traits came from having to be self reliant because her “whole life had been a
challenge.” She described how she had been a loner as a child with no siblings and
friends because her parents had moved 12 times. She said she learned not to trust others
including her mother. She blamed her childhood history for why she resisted working
with other students in the cohort even though faculty suggested she develop these
relationships to improve her interpersonal skills and academic performance. Donna did
not feel she had any type of support from other students, friends, her spouse, or family
except for her grandmother who provided emotional support. Donna re-emphasized in her
follow up interview that she has persisted despite “road blocks” because “more than
anything I want to help people get back their lives and have quality of life and I have to
think about my kids’ future…this keeps me going.” She said that she really wants to
understand the health care system and be more knowledgeable because “I couldn’t trust it
(health care system) when my son was ill.”
Participants from Regional University
Julie
Julie was a 29 year old divorced female raising two children when she
completed her pre-requisites and started her graduate level occupational therapy program.
She had one sister with a college degree, but her brother and parents had not gone to

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college. Julie described herself as someone who always wanted a college degree and to
work in a health profession. However, she did not pursue this goal after high school
because she said she got married young and then stayed home to raise two children. Julie
reported “it was always something I knew I was going to get whether it was on the
standard timeframe or not.” Julie was introduced to the field of occupational therapy
when her son received services as a young child. She said the career seemed to be a good
choice for her because she wanted a career in a health field, and “I really like people…I
just really care about the general population.”
Julie explained that she went to college part-time once the children were in preschool but that she did not go full-time and truly commit to a degree until she divorced.
Julie was living in a southern state with her husband and two children until she divorced.
She then moved back to her hometown where she had extended family and began to
pursue the courses she needed for an occupational therapy degree.
Julie had altruistic motives but seemed facilitated into action by her divorce which
she described as “throwing me into a situation where I was financially unstable…I had
two kids relying on me for support.” She explained that it motivated her go to school fulltime “to just get it done.” Julie also described her financial instability as her first and
biggest “boulder,” but said over time things have gotten better: “we are afloat…I work
twenty hours a week and they get some support from their father.” She moved back to her
home town to be near her extended family after the divorce, but stated that an ongoing
challenge has been the lack of emotional support from them. She reported family
members actively discouraged her from starting the program and still do not understand
why she is pursuing a Master’s degree instead of just getting a job.

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Julie conceded that family does give her some practical help such as caring for her
children even though they disagree with her choice to further her education. She reported
she has support from very few people. Julie expressed annoyance at the younger students
in her cohort because they talked about things like parties and going to the movies which
she felt “have nothing to do with my life.” She did feel a connection with one nontraditional aged student who also had children. Julie felt “the faculty is awesome,” but
also expressed quite a bit of frustration when it came to their expectations for work
outside the classroom. Their expectations were difficult for her because she had to find
childcare and she worked part-time. She explained that she had recently become reacquainted with old friends from her home town. Julie reported that it was hard to find
time to do things with these friends but that she started scheduling some time with them a
couple months ago because “ they are my emotional support…most of them have college
degrees and they get where I’m coming from…they can relate more (to her
circumstances) than my family.”
Although Julie expressed regret that she “could not be a mom like the other
moms” at her children’s school, she got past this and their complaining about her
inability to do as many “mom things” by telling them: “I’m doing this for us. I want you
guys to look at me and be proud that I have an education. To know that life can be hard
but you just can’t back down.” This strong determination seemed to be the primary factor
which kept her persisting, along with her active pursuit of finding emotional support in
old acquaintances.

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Karen
Karen was 28 when she started her occupational therapy program after
completing her pre-requisites. At the time of the interview she was married and had a two
month old infant and a two year old toddler, both children born while she was in the
program. Karen went to college immediately after high school and received a Bachelor’s
level degree in physical education. She found it difficult to find a full-time position in this
field so she subbed for several years. She got married two years after graduation and her
husband also found it difficult to find a full-time position using his college degree in
business. As a couple, they decided that one of them should go back to school because
“we didn’t want to settle.” She said they both wanted more for themselves.
Karen added that she wanted to help people and liked the idea of promoting
health in others. She had numerous family members and friends with college degrees,
including her sister who had a nursing degree. Her sister encouraged her to become a
nurse, but Karen did not think that was right for her. Karen said she explored her options
in health care majors before she ended up choosing occupational therapy after getting
some exposure to several types of rehabilitation therapies where she worked as a
receptionist. She said: “I connected with OT…helping people live their lives.”
Karen said that she would have had to quit school when she had her children if
not for her “great riverbank of support.” She said her greatest challenge was balancing
her roles of being a student, wife, mother, and employee. Karen recognized that her
extensive system of both emotional and practical support allowed her to successfully
persist in school. She credited her husband and extended family members in each of their
families for emotional support and practical support such as child care. Karen stated that

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between her sisters and both sets of grandparents they found it easy to find someone to
care for their children. She was able to discontinue working at her job when life became
too stressful balancing her responsibilities. The couple did not end up in financial distress
because her mother-in law gave them money for tuition and expenses.
Karen also emphasized the emotional and practical support she felt from cohort
peers and faculty. She expressed enjoyment about her time spent working on projects
with her cohort peers of all ages. She described that she enjoyed feeling connected to
other people interested in occupational therapy, plus she said it gave her “a break from
her mother role.” She seemed very confident about her ability to juggle her roles partly
because she had such extensive support, but also because she explained that she had a
great role model in her mother who went back to school for her teaching degree after
raising four children. Karen stated: “if she can do it, I can do it”!
Lindsay
Lindsay attended several other post-secondary institutions before enrolling in
her occupational therapy program at age 25, just prior to her marriage. Her husband had
just completed a degree and her brother was in school. She said her parents had not
attended college, nor did her best friends. After high school she attended a community
college with the intention of pursuing a teaching degree but “couldn’t find a subject I was
passionate enough about to teach.” She explored other majors by meeting with a
counselor at the college and considered a degree in psychology because “I wanted to
work with people, to help people.”
Coincidentally, at about the same time, she received a letter recruiting students for
an occupational therapy assistant degree which required an associate degree. Lindsay

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decided this was the “perfect fit” and obtained the degree while working as an aide in a
variety of health care settings. It was in these settings that she learned about the
professional level occupational therapy degree which she wished she had chosen to
pursue from the beginning. Within six months of graduating with her associate degree she
started to take pre-requisite courses at Career College. She was planning on obtaining her
occupational therapy degree there, but decided to move closer to her boyfriend “up
north.” She also enrolled at Weekend College, but ultimately ended up at Regional
College because it was the shortest commute, although it was still almost two hours
away. This was important because Lindsay was dealing with chronic pain from two auto
accidents and driving exacerbated her symptoms.
Lindsay described pain as an ongoing problem which started prior to her
enrollment and continued throughout the program. She described her chronic pain from
the auto accidents as the primary factor that made persistence challenging because it
affected so many aspects of her life. The pain interfered with her full participation in
class laboratory activities and made work in health care settings as an assistant
increasingly challenging. She was physically not able to do the job requirements in some
cases and ultimately “lost” her last position. Because she was unable to work secondary
to her limitations, she had increased financial stress and lost her health insurance.
Lindsay explained that she also missed more classes then she should have because of
therapy and physician appointments. She also admitted that she was often late for classes
or had poor attention in class because she slept poorly. She said she was usually too tired
to do any of the assigned reading for class. She eventually failed one of her classes and
was at risk for having to stop out for a year.

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Fortunately for Lindsay, she had the emotional and practical support of many
people. Her marriage eliminated her financial distress and provided her with health
insurance on her husband’s policy. She reported that classmates were always willing to
give her notes from class and that instructors were supportive and made accommodations.
They adjusted the physical requirements for her in lab classes and allowed her to re-take
the failed course as an independent study so she would not have to wait a year to
complete the program. She was able to get her books recorded on tape so she could listen
to the assigned readings while she commuted. Because her commute exacerbated her
symptoms, she sometimes stayed with two cohort peers close to the university.
Lindsay felt that her attitude was the biggest factor that had helped her persist in
the program. She stated that “this (becoming an occupational therapist) has been a goal
for so long that everything else adapts around it.” It can be assumed that Lindsay had
made some adaptations on her own, but her interview suggested that most of the
adaptations she described were done by other people to help facilitate her success.
Participants from Research University
Nicole
Nicole first became interested in the profession in adolescence as a result of a
career survey. She then job shadowed her uncle who was an occupational therapist.
Nicole always assumed she would attend college because many of her friends and family
members pursued post-secondary education. She stated she felt “all set” to pursue this
career path. However, Nicole did not enter an occupational therapy program until she was
age thirty. She described attending college after high school but implied she did not
complete her degree and stated she was unsuccessful because “she was interested in

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things other than school.” She returned to post-secondary education at age 23 and earned
an associate degree in early childhood education. She became a pre-school teacher and
obtained a Bachelor level degree as a condition of employment.
Nicole related that she loved teaching in a pre-school classroom for seven years
but reported that “it (OT) was always in the back of my mind… I wondered,
wondered…if I should go back. Every time I put my head on the pillow…think it was
kind of a spiritual thing…a calling to do.” Timing ultimately got her started back to
school for occupational therapy because she and her husband decided to postpone starting
a family since he was about to start law school. It reinforced for her that it was time to
pursue her goal.
Nicole’s motivation to persist in the program centered on two themes she
repeatedly emphasized with great passion in her voice and in her body language. First,
she stated that she felt a spiritual calling to become an occupational therapist and related
stories to support this statement. She reported she has never wavered in her interest in this
profession. She reported feeling a connection with the profession because “I like helping
others meet the goals they want…I love watching others succeed.” Second, she discussed
a need to “make up for screwing up college the first time.” This motivated her to work for
all “As” in the program until she said her health and balance in life became significantly
jeopardized.
Her initial obstacle in pursuing this long held desire was the role change she
experienced as she transitioned from a professional to a student role. She felt a great loss
and a decrease in competence because she did not feel respected for her professional and
life experiences by the faculty. She said, “a lot of the passion (for pursuing her degree)

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went out of me.” She also found it challenging to continue employment part-time because
the professors assumed students’ schedules could easily be changed to accommodate
their needs or the needs of the college. These challenges early on made her question her
decision to return to school, but she reported meditating and reminding herself that “this
(the challenges) is only for a season.”
Mid-way through the program she encountered what she described as a very large
boulder; a “melt down.” She reported a non-specific health crisis which she developed
because she no longer was able to maintain a healthy balance in life because of school
and work responsibilities. Although she considered it, she didn’t quit school because she
still had a passion for being able to offer others help through the profession of
occupational therapy. Nicole said, “I treated myself using OT principles.” She described
very specific steps she took in order to eat healthier, exercise, meditate, and make time
for relationships again. All of these changes required her to say “yes” less often to
helping others and to aim for “Bs” rather than “As.” She reflected that this required her to
let go of her unsuccessful first attempt at college; "to stop being so Type A and be ok
with Bs.”
Paula
Paula was a 27 year old single female when she enrolled in her occupational
therapy program. She received a Bachelor’s level degree in psychology at Research
University right after high school but reported she never used that degree. Instead, she
became certified as a personal trainer and worked in that capacity full-time for four years.
She explained that she was introduced to occupational therapy by her apartment
roommate who was an occupational therapist. According to Paula, her roommate stated

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that OT fit all her interests such as helping others with wellness and fit her belief that
people should have the best quality of life they can. Paula agreed because “I always knew
I wanted to help people.” After investigating other related health professions, Paula chose
occupational therapy and enrolled because she felt that this profession would allow to her
to help others in a more meaningful way than her personal training position.
Paula continued to work as a personal trainer 30 hours per week to support
herself and became engaged during the program. She was appreciative that her work
hours training clients could be scheduled around her classes, because otherwise she
would not have been able to pursue the degree. She stated she did not receive practical
support such as financial assistance from anyone, but explained that her family and fiancé
were very supportive emotionally. They encouraged her and understood the time
constraints she had because of school work. Paula was surrounded by individuals with
college degrees: her parents, brothers, fiancé, and old friends all had degrees. Paula said
that she was balancing her personal life, school, and employment well until about midway though the program when she seriously considered dropping out despite good
grades.
At this point in time she described losing her motivation to continue for several
reasons. She was becoming very frustrated with the amount of “busy work” instructors
were assigning. She did not think the assignments were relevant and felt that the
instructors were not interested in providing an education that would help her do well in
the clinical setting because they relied on lectures and testing. Paula said she got very
little feedback besides a grade on a test which she felt did not reflect what type of
therapist she would be. She also felt disrespected by the faculty because they did not

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recognize her previous professional experience. Paula hungered for more hands on “real
world” experience. She said “I expected graduate school to be more application of
knowledge…doing things.”
Paula credited a close family friend with discouraging her from quitting. He was
an attorney who discovered he did not like practicing his profession. He asked her to
consider if she didn’t like the profession any more or if she just didn’t like the academic
program. She said she reflected on this and realized that she still wanted to be an
occupational therapist; that she “loves being around other occupational therapists and I
know I will find a practice setting I will like.” Paula stated that she realized she would
have to tolerate the program (“get though this muddy water”) to obtain the professional
role that suited her. She said it helped that she grew up in a family that “quitting was not
an option.” She reported that she moved forward by putting only as much effort as she
needed to into the assignments and readings. She also seemed to be coping by reminding
herself that “the end is in sight;” this was stated three times during the interview.
Olivia
Olivia was 26 years old when she started to earn pre-requisites for her
occupational therapy program. Immediately after high school she had attended Research
University and earned a degree in landscape design. She worked in this field for over four
years but reported she did not find it fulfilling. She first learned about occupational
therapy when she received therapy for a nerve compression syndrome in her arms. She
reported that this condition was caused by her work on a drafting table at her job. She
also found out about the profession from her same sex partner who was an occupational
therapist. She explored occupational therapy and related professions with a career

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counselor and ultimately chose occupational therapy because ‘it allowed me to be more
creative.” She articulated that she was motivated to pursue the degree to have a better
life for herself and her partner and so they could start a family. Olivia was one of the few
participants that did not mention an altruistic motive.
Olivia described two significant health issues that caused her to be academically
separated from the program twice. These administratively imposed stop outs frustrated
her immensely because it extended the length of her program significantly and caused
severe financial stress because she could not qualify for loans when she was not enrolled.
Olivia said her initial challenge occurred near the beginning of the program when the
symptoms of her bipolar condition flared up causing hospitalization. She thought that this
occurred because adjusting to the requirements of school “set off” her symptoms. She
was unable to complete the semester of course work and had to wait a year to re-enter the
program, joining a new cohort group. She said she found little support in her cohort peers
because they were already in established friendships. Olivia also felt unsupported by
faculty and was quite angry at the administration in her program because she felt they had
not been helpful. She relied on extensive emotional and practical support from her
partner, along with words of encouragement from her out of state brother.
Her second medical crisis occurred about a year after she was re-enrolled. Olivia
suffered a traumatic brain injury when she fell down the stairs. As a result, she reported
she had significant cognitive, visual, and motor challenges which required a period of
recovery and therapy. Although it had been several months since the time of the injury
she was still not allowed to drive and showed some cognitive signs of head injury at the
time of our initial interview; her motor skills appeared to have recovered. Olivia again

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described her frustration with the college because they were having her wait to start her
clinical internships, and wanted her to first job shadow an occupational therapist. When
asked, she did acknowledge that they had given her extensions on her last semester of
course work, but this did not seem to be recognized as support by Olivia.
When she was prompted to discuss what helped her stay committed to her goal
she expressed that she was very determined and was going to obtain the degree, even if it
was not when she planned. She also repeatedly expressed how much her partner had
helped her with her school work, as well as financially. Olivia said that when they
encountered more financial stress because she could not qualify for loans her partner
borrowed from her retirement accounts so they would not lose their house. When she
needed medical insurance to cover health care costs she said her partner changed to a job
with less pay that provided health insurance benefits for her.
Marie
Marie was one of the youngest participants who started taking pre-requisites for
her program at age 25 years. However, at the time of our initial interview she was farther
along than the other participants in her pursuit of a career in occupational therapy. Marie
had already finished all her academic work and clinical internships. She had graduated
recently and was employed part-time so she could be at home with her young daughter
who had been born while she was in the program.
Marie went to a large university immediately after high school and received a
Bachelors level degree in Health Sciences. She had always been surrounded by family
and friends with college degrees, some of them with advanced degrees. She met her
future husband while she was at this university and they married after re-locating to his

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hometown, where Research University was located. Marie described doing a series of
part-time jobs including working as a care giver for two years with a boy who had
cerebral palsy. This child received a variety of therapy services and it prompted her to
remember that she had learned about occupational therapy services in a high school
career survey. She discussed her interest with her parents who were in health care
positions and decided to enroll. Although Marie did not explicitly mention that she went
into the profession for altruistic reasons it was implied. She clearly was influenced by her
care giving role with the boy and mentioned that she thinks “OTs have a personality that
want to help…to contribute.”
Marie described her first challenge as a ‘cute little boulder.” She explained that it
wasn’t the biggest problem but that it was a challenge to get married at the same time she
was starting school. She regretted that they didn’t have time for a honeymoon or to settle
into the marriage, getting used to married life. Marie said that it was “smooth sailing” in
the program until she unexpectedly got pregnant. She was very distressed and considered
quitting the program but she stated that her husband and in-laws said they would help her
manage so she said she gradually adjusted, saying “it is just the way it is.” She said that
once she came to terms with everything she was very determined to persist. Marie
reported that things went well at school during her pregnancy, although she did end up
leaving her position as a graduate assistant late in the pregnancy. Subsequently, she no
longer had her tuition paid for but she said her husband had no problem paying her
tuition.
The second time this participant seriously considered leaving the program was
after her daughter was born. Marie said she had great support from her cohort peers who

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did not mind if she brought her baby along when they had group projects. Marie
mentioned that faculty said they had never had a student have a baby while in the
program but she said they were encouraging. Faculty said that she could drop back a year
or continue going to school. She also said she had wonderful emotional support from her
husband and family, as well as practical support like help with errands, household chores,
and childcare form her mother-in-law. However, that was part of the problem. She felt
guilt leaving her daughter and was deeply disturbed when her daughter wouldn’t leave
her mother-in-law’s arms to go to her when she returned home at the end of the school
day. Marie said this was when she questioned her decision to continue school the most,
but she said she persisted because she was so close to finishing and it “would be silly” to
stop. When I met with Marie for her interview she was very proud of herself for
persisting, but she still showed emotion when discussing how hard it had been to balance
motherhood and school.

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Chapter Five
Emergent Themes

The richness of the narratives provided by the participants in this study
illuminated several themes which begin to explain how these non-traditional students
persisted in their academic program despite significant obstacles. When participants were
asked to reflect on their journey in the academic program it often took them farther back
into their past than expected; often to very emotional places in their childhood and
adolescence. This process of reflection also took them forward to who they wanted to be
and how they wanted to live in their world. Their narratives allowed me to find patterns
in why they persisted because when individuals tell their story they “organize fantasies
and daydreams, unvoiced stories, plans, and memories” (Hermans, 2002). These patterns
will be described within four emergent themes.
Becoming an OT: A Way to Become Who I Want to Be
In telling their stories, the participants first spoke of a desire to make a change in
their life. Their reasons for wanting to make a change varied, but they all had a vision of
the person they wanted to become. When the vision of their new possible self coincided
with the idea that becoming an occupational therapist could be the path to reach their
envisioned self they took actions to pursue the degree. The participants consistently
spoke of a desire to be something more or something different as their reason for
pursuing their degree in occupational therapy. The majority of participants wanted to
develop an identity that fit their altruistic tendencies. For other participants their desire
was influenced by wanting to realize their potential in another way. For example, they

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wanted to be more educated and professional, or to have a better life for themselves or
their families. In some cases, their goal of becoming someone different was also for
others or in reaction to others. Whatever their initial motivations were, the majority of
participants described following through on their goal for the same initial reasons. Their
initial motivations seemed to be bound together with their reasons for continued volition.
These sub-themes will be discussed in the following order:
1. Their desire interacts with an awareness of the profession
2. Altruism as a motivator to becoming someone different
3. Becoming someone “better” for themselves
4. Becoming someone better in reaction to others or for others
5. Bound together: the motivation to initiate and the motivation to persist
Their Desire Intersects With an Awareness of the Profession
The impetus to pursue this path usually occurred when their picture of who they
wanted to be intersected with the discovery of the profession. Their discovery of the
profession usually came from a personal contact. Many participants either had a family
member who had received occupational therapy services or they themselves had received
these services. The remainder of participants had friends, family members, or co-workers
who were occupational therapists. They often described with excitement the moment
when they discovered how the profession was a “good fit” for them.
Nicole job shadowed an uncle who was an occupational therapist after learning
about occupational therapy via a career survey in high school. She was working as an
early childhood educator when her interest in the profession was re-awakened. She was
able to identify problems in one of her pre-schoolers that she thought needed

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occupational therapy. Nicole added that “this fueled her passion for OT” when the child
was helped by an occupational therapist. It confirmed that occupational therapy was the
“right fit” for her. Helen and Olivia were introduced to the profession when they received
occupational therapy services themselves. Later on, when it came time to choose a career
these experiences influenced them. Julie and Donna first learned about the profession
when each of their sons received occupational therapy services. Julie explained that she
had always wanted to help people: “I just really care about the general population.” When
she divorced, she chose to pursue a career in the profession. Donna was motivated to act
on her dream because of her impending 30th birthday.
When I started having kids early I thought ‘that’s okay’…that things didn’t go as
planned. I’ll be done by the time I’m thirty. Well, I was approaching thirty and I
hadn’t even started!
As described above, some of the participants did not pursue a career in
occupational therapy until a life event facilitated them into action. For others, the
decision to pursue the career was more immediate. Ivan described making “a left turn”
away from taking pre-requisite courses for a physical therapy degree after an experience
with his ailing father. He decided the philosophy of occupational therapy suited him
better. Gale was enrolled in her first year of college pursuing a special education degree
when she made an abrupt change. She recounted the story of how she relocated to another
college mid-year and changed her focus to pursing a degree in occupational therapy. She
said:
I was telling her [hairdresser who had some knowledge of occupational therapy]
how I wanted to help people and I went into great detail on how I wanted to do
that with kids and she said ‘that’s not special ed, that’s OT,’ and so I went home
and researched that.

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All of the participants described in some way how they wanted to better themselves, or
become something different; something that “fit”. When they discovered the rightness of
the profession for themselves they moved forward with their goal at varying points in
time.
Altruism as a Motivator to Becoming Someone Different
For the majority of students this desire to better themselves was intertwined with
a desire to be more in a way that allowed them to help others or contribute to society.
Marie stated she thought that this pro-social attitude might be one reason why her busy
peers agreed to be part of this research project. She said “I think OT students have a
personality that wants to help, to contribute.” Thirteen of the participants expressed this
dominant altruistic theme repeatedly as they told their stories.
Ellen, a 38 year old female, credited three generations of her family for her desire
to help people. She enthused:
I always wanted to work with people in a helping way…we’re just a helping
people…three generations… a doing kind of family. It just made sense for me. It
was the perfect fit and I knew it was right for me.
Ivan summarized: “it feels really good getting people to go home and do something they
can’t do.” Paula, a personal trainer with a Bachelor’s level degree in psychology, always
wanted to help people. She wanted to be an occupational therapist because she thought
she could have even more impact with this degree. She explained, “it really fit my beliefs
about how people should have the best quality of life they can.” Nicole described herself
as a mentor and coach to the people in her life. She stated, “I have always liked helping
others meet the goals they want. I love watching others succeed.” She was an early
childhood educator, who found great satisfaction in that career, but said she still always

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felt a “calling” to be an occupational therapist. Gale described herself as someone who
wanted to help people and recounted examples of how she had done that in the past. She
explained:
My aunt was born premature. She ended up being blind and I used to go over and
help her…my grandma and grandpa would do everything for her but I was like
she can do things. I would help her learn how to put toothpaste on a toothbrush. I
also had a job helping an autistic girl and another girl with a lot of mental and
physical disabilities.
Marie said she always had a desire to help people. She first learned of
occupational therapy from a career interest survey and then from her parents who had
professions in healthcare. Her desire to help people as an occupational therapist was
reinforced when she worked part-time for two years with a boy who had cerebral palsy.
Lindsay initially wanted to help people by being a teacher, but “couldn’t find a subject I
was passionate about so when I learned about occupational therapy from a counselor it
seemed right for me.” Ivan stated “I wanted to help people get better, make them smile.”
Donna and Barb echoed this sentiment in their narratives. Carey, who eventually learned
about occupational therapy from co-workers said, “I always had an interest in healthcare.
I always wanted to help people…I just wasn’t sure how to go about it.”
Becoming Someone “Better” for Themselves
This notion of wanting to have an identity that fit better with their sense of self
was also influenced by something besides pro-social tendencies or what is often called
altruism. Some participants wanted to “be more” mostly for themselves, rather than
being primarily motivated by altruism. They viewed a possible self which was more
educated and professional, or to have a better life for themselves or their families.
Noticeably absent was any specific mention of a hope for more material goods or a better

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income. They instead spoke of wanting to avoid financial instability, being able to start a
family, or to be a better role model for their children.
For example, Julie and Barb explained that they had always viewed themselves as
professionals with college degrees, but got sidetracked when they married at a young age.
Julie stated: “I always knew it [degree] was something I was going to get whether it was
on the standard time frame or not.” Fiona and Donna also had planned to attend college
immediately after high school but unplanned pregnancies early on in their lives changed
their views of what was possible in their twenties. Donna described a turbulent period of
life events in her twenties but said: “it [college education] is just not something I am
going to sacrifice…one day I am going to school.” Karen expressed that both she and her
husband had jobs based on their Bachelor level degrees, but they were not satisfied with
these positions. She also described that she wanted to do better than she had done
previously in college. Karen stated:
We didn’t really have careers…our jobs weren’t taking us anywhere and we both
wanted more out of ourselves…more out of our lives than just settling for the jobs
we had. I’m not happy with how I did with my Bachelor’s degree in physical
education the first time around in school…I was young…I want to be more for
myself now.
She also expressed pride in herself for doing better now and said it was important to her
that her children be proud of her.
A small minority of students expressed motivation which centered on having a
more stable financial future. Olivia wanted to have a more professional career so that she
and her partner could “have the life they envisioned…starting a family.” Fiona said she
grew up “severely poor” and stated “I’m not going to do this…I want to make a good life
for myself.” Barb expressed repeatedly that she valued education for herself and her

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children. She was worried that her husband did not share this value. While it was
important for her to be in a helping profession, she also wanted to be financially stable,
unlike her mother, because she and her husband had considered divorcing several times.
She explained:
My mom had been a stay at home mom while our dad worked and when they split
up my mom had nothing to fall back on…she had to work at ‘Little Ceasars’ to
put herself through college. We watched her struggle to raise us and it’s like I
don’t want to do that. I want to have my ducks in a row. I want to be able to
support myself and my family.
Becoming Someone Better in Reaction to Others or for Others
For some participants, their desire for change seemed to be primarily for others or
in reaction to others. They held views of a possible self that was “better” in some way to
them, but these views seemed more in response to the influence of other people. Fiona,
Barb, and Julie seemed to find a large part of their energy for persistence because they
were reacting to the doubts of others about their ability to attain their educational goals.
They wanted to prove others wrong; that they could achieve this goal. Fiona expressed
this sentiment the most emotionally. She stated she was motivated to continue because
she wanted to prove her mother wrong. Fiona reported her mother stated: “there you did
it…now you won’t make anything of yourself” at the time of her unplanned teenage
pregnancy. Fiona was also fueled by wanting to prove other professionals wrong. She
stated “I want to be better than a lot of crappy OTs I’ve seen.” Julie’s extended family
thought she should get a job rather than pursue her degree, and she reported that they
tried to talk her out of it. She explained that she “doesn’t like to be told what she can or
cannot do,” and she can’t fail after not following their advice. Barb stated, “I think I have

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a push to prove it to people that I can do it…a lot of people are like you can’t do it with
kids and everything else, but I think it kind of pushed me to prove them wrong.”
For a few students the motivation to both initiate the program and persist in the
program seemed to come more from wanting to please other people in their life. Anne
and Marie exemplified this tendency the most. Anne explained that her sister who was
starting to attend school to be an occupational therapist got her interested in pursuing the
degree. She reported, “I wasn’t sure what I wanted to be…bouncing ideas around…so
when she [her sister] said ‘join the OT program with me’ (pause) I did”! Her persistence
in the program seemed to be reliant on the support and encouragement of her sister,
family members and faculty. Anne said “they help me so much…I can’t let them down.”
Marie came from a family where everyone had graduate degrees. As she
recounted her story it seemed that she was pursuing her Master’s degree for her parents.
Marie explained: “they said get your degrees, get your career going and then think about
having a family.” Marie’s course through school as an undergraduate, prior to the
occupational therapy program, was “laid back” with no clear direction; much different
than the linear aspirations of her parents. After a move to another state where her
husband’s family lived she started taking pre-requisites and entered the occupational
therapy program. She then unexpectedly got pregnant while in the program. Her husband,
as well as both of their extended families, saw no reason for her to interrupt her academic
goals. However, Marie expressed she was very conflicted. She did continue because they
were “all so excited about the baby” and “gave me so much help.” Both of these
participants did not seem to realize until near the end of the program that this career path
was indeed something they saw themselves doing. Their sense of self seemed to be just

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starting to develop near the conclusion of the program. For example, Marie stated “I think
I proved something to myself. I’m glad I did it. I felt that I was not very confident before,
but now I know I can probably do anything.”
Bound Together: The Motivation to Initiate and the Motivation to Persist
The reasons participants gave for initiating the pursuit of their academic program
in occupational therapy seemed to translate into their motivations to persevere. For
example, the desire to be someone who could make a difference in peoples’ lives was
often described as a motivation for beginning the program, but was also a factor that
helped individuals have volition to persist through challenging times. Barb recounted that
she didn’t initially know what career she wanted. She just knew she “wanted a career that
helped people…I just wasn’t sure how to go about it.” When she spoke about what
helped her persist in the program she added “another thing that has helped me [persist]
are my interests… I’m so interested in helping people.” Barb credited the out of the
classroom clinical experience she had in a pediatric occupational therapy setting for
helping her stay motivated. She continued, “it was amazing to see how it works, better
than just learning about it in class.”
Carey had a complex family history and had such a strong desire to help people
in her personal life that it distracted her from school. This culminated with her going on
academic probation and eventually being academically separated from the program for a
year. She journaled to remind herself why she was pursuing this challenging goal. Carey
explained:
I do a lot of writing about what I want to do and it keeps me motivated…keeps
me remembering why I started this…my biggest thing has always been about
helping people. When I first graduated high school I had no idea what I wanted to
do. I just knew I wanted to help people. My favorite movie ever since I was

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younger was “Patch Adams”. Love that movie…I watch it on a constant
basis…that’s the type of person I want to be. I want to help somebody physically
but I also want them to be mentally happy with themselves.
In fact, a few students stated that they almost quit their academic program
because it was mostly lecture and as Nicole explained, “it didn’t allow us to use our prior
professional experience and do real world meaningful tasks in the OT world.” This was
only mentioned by two students at a large research university, which students described
as “relying on lecture format very heavily.” (The other three academic programs were
described by students as having more opportunities for real world projects in the
community and hands on experiences in the classroom in addition to lectures.) However,
it did reinforce the idea that their initial altruistic motivations remained important to
students to maintain their persistence. They seemed to require opportunities to be in
situations where they could contribute in order to stay motivated. Paula said: “I was
expecting grad school to be more application of knowledge…getting out of the classroom
to do OT…three hour lectures just didn’t seem relevant.” She added that this was her
“biggest boulder” and made her unmotivated. She reported almost dropping out despite
good grades.
The only time students voiced a motivation for persistence which was different
than their initial motivation was when they described themselves as temporarily
exhausted or frustrated. Then they resorted to coping factors like reminding themselves
they only had a short time until completion. Nicole stated repeatedly in the interview
“this is only for a season” as she discussed “the end is in sight.” Paula explained:
Every time I’m doing an assignment I think isn’t worthwhile I remember the end
is in sight. I’ll like what I’m doing in the end. I just have to get through this
muddy water before I can do this [be an occupational therapist].

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In addition, when students were in challenging periods they also reminded
themselves that they couldn’t quit because they had so many loans to pay back. The
phrase “quitting is not an option” (because of student loans) was voiced by students at
several schools. Ellen reported, “failure is not an option…I have huge loans. We
sometimes joke that we [cohort peers] can’t quit now because of the loans.” Only one
participant appeared to have forgotten his initial altruistic motives, but this seemed to be
because he was overwhelmed by personal problems and the threat that he might be failing
a class which would postpone graduation. Ivan stated, “one year, just one more
year…stopping is not an option…gotta finish.”
Summary
In conclusion, the participants’ desire to become someone better or be someone
different was enacted in the context of a challenging occupational therapy academic
program. They hoped to achieve their desire by becoming an occupational therapist. The
participants envisioned that their new possible self could be realized through completion
of this program.
Balancing: Getting Around the Boulders
Similar to other non-traditional aged students who have been studied (Bean &
Metzner, 1985; Ozga et al, 1998), these participants also expressed that one of their major
obstacles or “boulders” was balancing the demands of their academic programs,
employment, and relationships. Karen, a mother of two young children who were both
born while she was in her academic program, explained she had an amazing support
system in her husband and extended family. She continued, “but the biggest challenge
has been balancing roles in my life as a wife, mother, and student and even as an

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employee.” Other participants echoed this sentiment. None of the participants had only
the responsibilities of a student “on their plate.” These students were balancing multiple
roles such as spouse, parent, and employee as would be expected in adulthood (Marcia,
2002; Tennant, 2008; Wlodowski, 2008). Additionally, a majority of these participants
had an illness in a close family member or a medical issue in themselves which were
obstacles they had to figure into the “balance.”
I will first explain the problems they encountered, both the anticipated challenges
as the initial sub-theme and the unanticipated challenges as the second sub-theme. This
will be followed by an explanation of the third sub-theme, which describes how the
participants coped with obstacles such as finances, family responsibilities, and
employment demands. The final sub-theme will detail the unanticipated challenges that
students encountered, and the strategies they attempted to use when they experienced a
serious illness, or when a close family member was in a medical crisis. This obstacle was
highlighted because it is not commonly spoken of in the literature and because of the
significant impact it had on a majority of participants.
The Challenges They Anticipated
The participants’ narratives did not indicate that they anticipated any other
issues except for those which fell into three categories: finances, employment demands,
and self-efficacy for the academic school work. They tried to made changes for these
anticipated challenges prior to initiating their program.
Students anticipated that finances would be a challenge, and that they would also
need to make adjustments in their hours of employment to have the flexibility to attend
classes. Nicole and Ellen left jobs they loved in order to have the time to attend classes.

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Ellen, Ivan and Helen all anticipated that it would be challenging to learn “how to study
again.” Helen and Ellen were especially concerned about this issue because they were
starting school in their late thirties, and as Helen stated, “if you don’t use it, you lose it.”
However, financial concerns were expressed the most frequently by the participants.
Although there were two exceptions, the majority of students were experiencing
financial stress, which has consistently been cited as an issue for non-traditional aged
students (Cabrera & Castaneda, 1992; Cabrera et al., 1992). The cost of school itself was
a concern for many of the participants. Several lamented that because they were
employed, they received less financial aid for tuition. They primarily made job or life
style changes in anticipation. Some participants, like Fiona, Ellen, and Ivan initiated parttime work in addition to their full-time employment in order to have enough money for
expenses. In order to be prepared financially, Gale and her husband sold their home and
bought a more affordable house since both of them were going back to school. Ellen and
her sister moved their families into a home together. Ivan said he and his wife were
already in debt when he started school, so things got worse with the cost of school added.
He stated that they cut their credit cards up, but finances were still a problem.
Fiona explained, “I’m the full provider for the family. He [husband] hasn’t
worked in the four years. He is very negative and does not want me to go to college…he
says my college is making us go bankrupt” Barb explained:
We have a lot of financial burdens. He [husband] is working fifty to sixty hours a
week to support all of us and he is like I need your help and he’s kind of pushing
me to get a job, but I keep telling him I’ve got less than a year.
Olivia explained that things had “been tight financially” once she started school, but they
got by making adjustments in spending. Financial stress increased when she no longer

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qualified for loans. This occurred mid-way though the program when she was
hospitalized and had to take a year off from school because she went into crisis secondary
to bipolar symptoms. “It [having to delay re-entry to school] was very frustrating and I
think it made my condition worse. My partner Sue had to take money out of her
retirement and we almost lost our house.” Even with their pre-planning for returning to
college they all encountered obstacles they never anticipated.
Interestingly, despite their anticipated concerns, participants did not discuss
anxiety about the decision to return to school, just the issues surrounding this decision.
Their concerns were limited to what they described in the previous paragraphs and they
assumed they had made the necessary adaptations. They told narratives which described
primarily excitement about returning to school for something that “fit them.” However,
as they continued the narration of their experiences they described a series of
unanticipated struggles once they returned to school.
Adapting to the Obstacles They did not Anticipate
Students anticipated some of the challenges they would face, but in most cases
they learned they needed to persist thought obstacles they had never imagined. Time, or
the lack of it, was consistently mentioned as a hurdle by students. They seemed surprised,
and sometimes resentful, by the amount of time school work took from their lives.
Cooneeley (2005) also discovered that although students were motivated to become
occupational therapists, they were “unprepared for the degree of time, effort, and
emotional energy involved” (p. 106). In addition to the unanticipated shortage of time for
all their previous roles, students found unanticipated challenges included lack of support
from family, spouses or friends, as well as worsening financial stress, marital strife,

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pregnancy, and most significantly medical issues in themselves or a close family
member. This last unanticipated challenge will be discussed as a distinct sub-theme
because of the pervasiveness of its’ influence on students.
The participants’ adaptations essentially focused on having more time for family,
employment or schoolwork, and occasionally for themselves. Ellen stated that lack of
time for everything, in addition to financial worries were her biggest barriers. Gale stated
that having enough time when she started back to school was hard and she needed more
support from her husband. “I was working full-time, going to school full-time, and then
was a wife and a new mom.” Nicole was stressed by having to fit so much into the week
that she made up color coded schedules with everything from planned “Friday night
dates” with her husband to study time. Fiona and Paula seemed to blame the school
projects and assignments for their lack of time. For example, Paula stated: “I think it’s
important to do other things like spend time with my grandmother; a lot of the work
seems like busy work that doesn’t matter.” Fiona stated: “school is just not a priority for
me like making money and paying bills.”
Unanticipated life events such as pregnancy, illness, marital strife, and just the
unanticipated rigor of the academic program changed what students saw as their primary
boulders over time. Donna and Carey described having to decrease their work hours
because the demands of the program got “more intense.” Barb stated, “you don’t realize
how intense the program is going to be and if you’re not in the program you don’t get
it…it knocks me down sometimes.” Gale said, “I don’t think they [her son’s
grandparents] realized in the beginning what this program entailed. I don’t think my
husband did. I don’t think I did either.”

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An unplanned pregnancy during the program became the major obstacle for
Marie. The pain and need for medical appointments because of fibromyalgia became
what Lindsay called “a series of rocks…life is not exactly smooth flowing water for me. I
thought my commuting time was going to be my biggest problem.” The three students
(Helen, Ellen and Ivan) who had initial anxiety about their ability to learn how to study
again discovered that this issue was not to be their primary barrier. For example, Helen
learned her chronic rheumatoid arthritis would be her primary obstacle, while Ivan
decided the symptoms of his wife’s bipolar diagnosis would be his biggest challenge. The
following section illustrates more unanticipated obstacles and how students coped.
Persistence in the Face of Boulders: Strategies to Address the Challenges
The narratives of the participants showed the need for ongoing adaptations and
coping strategies in order to persist past obstacles. Some students seemed to be more
adept at implementing the strategies they needed. Balancing the common roles of
adulthood while being a student caused struggles for some students which they were able
to surmount with adaptations. However, others shared stories of having to “stop out” of
the program, often for as long as a year. The following paragraphs illustrate how students
adapted to different types of “boulders”; how they changed the “balance” in their life to
persevere. While their challenges were different, most seemed to think it was important
to re-balance the priorities in their lives in order to have enough time for school and be
successful in life overall. Those who were more resistant to change were often the
students having a more negative experience in their programs, or were the ones forced to
stop out because of academic failure. The student voices in the following paragraphs give

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more examples of the phenomena of what students called the need for “getting a balance”
between areas in their life: relationships, employment and school work.
Similar to Lindsay, Ellen thought commuting to school would be her biggest
challenge. Ellen explained that she was grateful a weekend program existed for working
non-traditional aged students because otherwise she would not have been able to get this
degree. However, she lamented that the “three hours and forty-five minute commute one
way” took time away from her family and hours she could work. “I had to learn to get by
with a lot less sleep…doing my school work late at night so I could fit in my work hours
Monday through Thursday…Friday I had to travel here.” Ellen also explained that as a
single mother of a teenager she needed to have someone responsible for her daughter
while she was away at school on the weekends. She stated:
My sister and I share a house…a nice little homestead…she has teenagers
too…we watch out for each others kids. We’ll decide what to do with the house
when I graduate…we called it our five year plan.
Additional students shared narratives which illustrated that adaptations were
necessary for them to get past their “boulders.” Ellen was not the only parent who had to
be creative in balancing her role as a parent and a student. All the students who had
children felt guilt about spending less time with their children, but most managed to find
creative ways to have others “substitute” in the parent role as Ellen did. Barb described
how “if I can’t make it to something at my son’s school, usually I can get one of his
grandparents to go.” Other participants came to terms with the guilt they felt about
spending less time with their children by focusing instead on how they were working on
this degree for them. Julie stated, “I think they are proud of me but they are young…so
when they complain ‘why are you always doing this [school]?’ I told them ‘I’m doing

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this for us’.” Helen and Ellen, parents of teenagers, rationalized that it might not be a bad
thing for their teenagers to be more independent and to see their parents studying. They
both stated that they “share grade reports” with their adolescents and felt this had been
positive.
A few students who had less support from family members or seemed to have
more complex family dynamics ended up taking time off from school, sometimes for as
much as a year. Donna entered school as a single mother to three children, one of them
with a disability. She explained:
I didn’t know how I was going to juggle it…how I was going to fit everything in
because I was already exhausted all the time. But I decided there was never going
to be a good time…I was approaching thirty and hadn’t even started.
Donna reported that she had “rocks all through the program.” She stopped out of the
program twice because she felt she “needed to harmonize the family.” She had married
in the first year of the occupational therapy program, and the new blended family was
“causing me a lot of stress…we were even considering divorce and I couldn’t do the
work at school.” The second time she stopped out was because her children were having
“behavioral problems,” especially her son.
Participants also felt it was a challenge to find time for other relationships in their
life such as with spouses, extended family, and friends. The majority of participants lost
touch with old friends because of time constraints. Helen stated, “I don’t have time for
old friends right now.” Fiona stated, “I let go of friends.” Nicole reported that she lost
touch with friends outside the program because:
They just don’t understand how busy I am…one friend in particular is just too
needy. My social circle has been replaced with people in the program. I didn’t
realize how much a part of my social circle they were until we didn’t have class in
the summer.

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Old friendships also withered because as Anne explained, “no friends outside of school
understand…they’re not doing it [school]. They haven’t understood why I’m busy.”
Lindsay summed up what had happened to friendship connections for the majority of
participants. She stated: “I don’t really have time to see my old friends much anymore,
but I see my friends who are in the cohort…they’re supportive.”
They balanced their more intimate personal relationships and school
responsibilities with varying degrees of difficulty. Some participants like Lindsay, Anne,
Olivia, Helen and Karen had significant others who were extremely understanding of
their partner’s time commitment to school work, but others did not have this support.
Barb and Fiona described spouses who were extremely angry with them for pursuing
their degree. This made it more stressful for them to balance their roles. For example,
Barb’s husband wanted her to have a third child while she was in the middle of the
academic program. She was resistant because she had already taken time off when she
had their second child and this “had dropped me back a year.” She stated, “he puts more
stress on me…I already have all the responsibilities with our children and the
house…he’s kinda old-fashioned.” She added, “I already have the pressure here (school)
and then he’s giving me pressure…where do you give”? Fiona said her husband did not
want her to go to school. She reported he said: “I want to punch that computer through
the wall. I’m so sick of you being on that computer.”
Carey also told a story describing the inter-play between her intimate relationship
and school: “When I first started the OT program it was smooth sailing. It was going
really, really well and then I got into this relationship.” She described rocky points in the
relationship and concluded by saying, “I started having problems in school. I couldn’t get

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my studies done because of the problems we were having at home.” Marie described her
difficulty balancing school and a new marriage as “a cute little boulder.” “We didn’t get
to go on a honeymoon or get settled into our marriage…we just jumped right into
everything.” Paula reported experiencing difficulty balancing school work with the
current roles in her life as soon as she started the program. She stated: “as occupational
therapists we know a balanced life is important,” so she did not think it made sense to
give up time seeing her aging grandmother and her fiancé, stop running marathons, or
decrease her thirty hour a week job which she said was necessary financially. Paula
adapted by seeing friends less. She gave the example of studying on Friday nights rather
than going out. Paula confided she also managed the “balancing act” by not doing all the
school work at her maximum level of effort. “School is not my top priority. I can’t invest
all of my energy in the readings and a lot [of assignments] seemed like busy work.”
Many participants also expressed that they had made adaptations in order to
balance being an employee and a student. The vast majority needed to bring in an
income. Although a few students like Ellen, Fiona and Ivan actually increased their
employment hours to greater than full time employment to meet financial obligations,
most participants changed jobs to something with hours more conducive to their class
schedule. Nicole had to give up her job as an early childhood teacher and instead became
a “floater” subbing in classrooms. She reported it was frustrating because she earned less
per hour but needed the flexibility to attend classes. Paula said she is “not like the other
students [younger students] at the university who have parents paying their way…I need
to work thirty hours a week. I’m lucky it’s flexible hours, but it’s a lot of hours to work.”

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Other students decreased their work hours as the academic program became more
challenging. A few quit working entirely secondary to events like academic probation, or
because they realized they needed to spend more time on school work in order to be
successful. Donna reported her financial stress increased because “I had to keep dropping
work hours to keep up with school.” She ultimately found she needed to quit work
entirely to be successful. Lindsay implied that she was let go from her job at a hospital. “I
actually lost my job…it was just too much with school.” She stated this put her in more
financial stress and left her without health insurance which she needed for a medical
condition. Marie quit her job as a graduate assistant after giving birth to her daughter. She
said, “it was a really hard decision because it helped me pay for OT school.” Things were
already challenging financially for Gale and her husband, but when she quit working
because their son was having severe medical problems she said finances got worse. The
decision to quit working left these participants in more financial stress, but allowed them
time to balance school work with family roles.
The Largest Boulder for Participants: Medical Problems
A surprising and startling pattern which is not prominent in the literature was
illuminated in the narratives of the participants. A significant number of students had an
illness in either a close family member or a medical issue in themselves which were
obstacles they had to figure into the “balance.” In some cases, these medical issues were
the cause of “stopping out” of their academic programs or at a minimum caused absences
and academic struggles.
Olivia’s story of how medical struggles interfered with her ability to continue in
the program was dramatic. Olivia was living with bipolar disorder in remission when she

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started her program and was proud that she was able to be “medication-free.” She felt that
making the change to school from the structure of working “set off the start of my
symptoms again.” According to Olivia, symptoms worsened because of the stress from
the program and she was hospitalized. She said she had to withdraw from the program
because she missed classes and stated “that was very frustrating and made things even
worse during my recovery.” After her return to the program, she fell down a flight of
stairs and suffered a traumatic brain injury which affected her speech, cognitive and
motor skills. Remnants of these symptoms were still observable to this researcher at the
time of the interview, and were probably the reason the college had her waiting to go out
on her clinical internships. However, Olivia expressed that this delay was because they
were concerned about her bipolar condition re-occurring. It should be noted that her
opinion may reflect impaired insight, which is very common after a head injury (Gould,
2002).
Another participant also had to deal with the symptoms of bipolar disorder. She
also had to stop out of school, but was able to take steps to improve her health by making
significant changes in her life. Carey explained:
I’ve been diagnosed [with bipolar disorder] for about four years…probably
always had it. I have my ups and downs. There are nights when I can’t sleep at all
and sometimes the medication doesn’t seem to be working. Sometimes I can’t
focus and it’s hard to take tests or write papers. but when I had to take off for that
nine months before I could re-take the class [that she failed] it was actually really
good because having that break helped me learn more about myself and educate
myself…understand why I’m the way I am…and what I need to do.

Helen had painful and disfigured joints from rheumatoid arthritis, a condition she
had experienced since childhood. She did not have to stop out from school for any
lengthy time periods but she did miss some weekends of classes until she made some

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changes in her life. She reported she had difficulty balancing school, employment, and
her responsibilities as a mother. She stated, “I learned how to prioritize and find that
balance so I could get that rest so that I could control how these flare-ups were
happening.” She made many changes. She quit her job for the “time being,” asked her
husband to help with more household chores, and spent less time at her children’s events.
It made me feel guilty as a mom…it took me a long time to figure out it’s okay to
let somebody help you cause I felt like I’m the mom and I should be doing x, y,
and z, but then I had to realize by doing this degree and having more of an income
I will actually be setting up my family stronger.
Lindsay started the program knowing she had a back injury from two previous
auto accidents. However, she was receiving therapy so she felt fairly confident things
would improve. As time progressed, she was told she had another problem: a diagnosis of
fibromyalgia which is a chronic pain syndrome further complicated by fatigue (Gould,
2002). Lindsay explained, “my life is not exactly a flow of water…it’s my health
problems…pain has been there the whole time [in the program].” She explained that it
was hard to find time to schedule medical appointments and “it’s an always there thing,
interfering with school.”
It’s painful for me to walk now. I can’t sit for too long. I can’t stand for too long.
Too long is like fifteen minutes. Fatigue is another problem. I haven’t been able to
sleep and then I wake up late in the morning and get to class late. I’m now on
medication to help me stay awake and keep focused…I also have trouble
remembering to do things.
Lindsay said she failed one class and admitted she was often late to class because of
fatigue. She added, “I barely ever actually do the reading.” She mentioned that she had
made some adaptations such as listening to her books on tape while driving her commute
and using applications on her phone to remember things, but most adaptations seemed to
be made by others. For example, her instructor let her do an independent study to re-take

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her class rather than having her wait a year to take the class on rotation. Her peers gave
her class notes and she reported that her instructors were very accommodating of her
limitations in class. She described her fiancé, recently turned husband, as very supportive
because “I don’t have to work full-time anymore… I can just do my school schedule….
finances not an issue like they were.”
Other participants described themselves as healthy when they started the
program but “losing their balance” and subsequently having health issues they needed to
deal with while in the program. Nicole described a “melt down.” She reported a nonspecific health crisis which she felt developed because she was no longer able to maintain
a healthy balance with school work added to her other responsibilities. In order to get
school work done, she said she had given up things that kept her healthy such as exercise,
nutritious foods, sleeping enough, and meditation. Paula did not mention a health crisis
but said that she decided she could not give up running marathons to do school work
because it kept her healthy. She closed with “we all know a balanced life is important for
our health.” Conversely, Fiona ignored trying to get a balance in her life. She recalled
rejecting an instructor’s class activity in the beginning of the program. She described how
the instructor encouraged students to use a pie chart to think about facilitating balance in
their life so that they could be successful. When Fiona was asked about her health, she
described a medical problem she ignored later on in the program, which caused her to be
hospitalized for a week. She stated:
I just kept thinking it would go away but I ended up in the hospital for a week
with a blood transfusion and everything…my mindset was I have to work and I
can’t afford to get sick. I’ve got to keep working, plow through this and it will go
away.

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Karen, Barb, and Marie did not experience illnesses while in the program, but all
became pregnant and delivered children during their academic programs. Karen did not
express any challenges even though she had two children while in the program. She
credited this to the support of her husband, extended family, and the faculty. Barb and
Marie experienced significantly more challenges. Both experienced early nausea which
sometimes made it difficult to be in class and they were very conflicted about where they
should be: at home with their infants or in school. Barb elected to take a year off and
Marie feeling the pressure to continue from her husband and extended family stayed in
school. She described her conflict:
I kept going because I was so close and it would be silly to quit now, but it
crossed my mind. There were some really hard times when I would come home
and my mother-in-law was her babysitter. She [baby] wouldn’t come to me. It
broke my heart. I thought why I am doing this [school] if my daughter doesn’t
want to come to me when I get home?
Other participants faced obstacles because a member of their family had health
issues. The medical issues they described in their family members were quite severe and
it took extraordinary efforts to persist in their academic programs despite
accommodations and support from faculty. Gale and her husband had a son who was
born prematurely. She explained, “we had all sorts of [medical] issues with him and we
were just getting these settled when a year and a half into the program he developed
epilepsy…that is a big challenge.” She said his health is getting worse and she has had to
leave the weekend academic program several times because he has needed hospitalization
for life threatening complications. Gale continued:
The three hour distance from home to school is really hard…I want to be there.
Then there is the financial part…you know with me not working as much because
of his illness and school…the hospital bills and the medication bills. Our son’s

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medical bills are 500 dollars [a month] just for medication…insurance only
covers so much.

It was not entirely clear to me how this young woman was coping, but Gale was; she
even agreed to grant me an interview right after a recent hospitalization of her son. She
primarily credited the faculty for her success because of their support. “The faculty here
have been amazing and the emotional support they give me to continue is amazing. They
have been really good about letting me make up assignments and get what I need.” She
added:
My husband’s support has gotten better and I think my mom and dad’s support
has gotten better too. I think without them I definitely wouldn’t have made it
because they will take my son for a couple of hours so I can study or so I can get a
good nights sleep…my son doesn’t sleep at night.

Donna mentioned that a spinal malformation in her son was one thing that made
it more challenging to find time for everything in her life. She sometimes had to miss
school because of appointments with specialists. She added this was not the major
challenge it used to be since he was now older and she understood his condition. Her new
marriage and the task of blending their families was the cause of her stopping out from
school. Similar to Donna, Carey had other challenges which she described as her biggest
boulders, but the illness of her “adopted” son needed to be considered in the balance.
Carey had an unofficially adopted son with her same sex partner. This child had a
genetically based syndrome which was considered a terminal illness. Carey explained:
We had to go out of town to the hospital a lot…I had to miss classes, sometimes
my assignments were lacking because of that. There was a lot going on at
home…my partner was wanting to go into another relationship with
somebody….I started having problems in school. It was a lot of things that caused
me to have difficulty getting my studying done…dealing with his [the child’s]
medications, having to go to the hospital a lot and all the surgeries.

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Ivan stated that “I wouldn’t have done the OT program without my wife pushing
me…but at the same time, she’s dragging me down.” He told the story of his wife’s
struggle with the symptoms of a bipolar diagnosis, which caused several hospitalizations
and significant financial debt because of excessive spending during manic phases. He
described how her erratic behavior made it difficult for him to leave her over the
weekends when he had school. He gave this as a reason that he was considering quitting
school; so he could spend more time with her. Ivan added that his wife’s erratic behavior
also made it difficult for him to do group work over the school weekends when most
students did not commute home as he did. However, he conceded that he probably
wouldn’t have spent much time with the other students anyway.
Anne recounted a series of illnesses and deaths in her extended family. She felt
these occurrences had often caused her to miss classes and made it extremely challenging
to focus on school.
Every [vacation] break at school somebody passed away in my family. It was like
it never fails…we lost a lot of people while I was in the program. Everybody was
getting sick, dying of cancer, it was scary.
With emotion in her voice and tears on her face she told the narratives of a brother-in-law
who was ill with pancreatic cancer while she was in school. He subsequently died. Anne
also told the story of his daughter who became ill with cancer and also succumbed to the
disease. Additionally, she mentioned two aunts who died of breast cancer and another
aunt who died of lung cancer all during her years in the academic program. Anne was
especially close to her brother-in-law and although his illness took a toll on her and her
ability to do well at school, she said he was also a motivating factor for her to persist.

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He told me “you are not going to use me as an excuse to stop [school].” He kept
me going…kept pushing me but he also would call me when I was in class and I
never missed a surgery he had…it was really hard.
Summary
In conclusion, participants described struggles with balancing their time between
family, work, and school, as well as experiencing stress because of finances or marital
strife. However, obstacles in these areas usually did not cause participants to “stop out”
of the program. The participants who were academically separated from the program or
those who came very close to stopping out were those who either had a health issue to
negotiate in themselves or in a close family member. Unanticipated challenges of any
type caused more stress, and for some participants it caused either academic crisis or
“stopping out.” Those who were adept at developing coping strategies “mid-stream”
seemed to experience less frustration and struggle, and in fact took something positive
from the challenges they had faced. Ellen explained how it was necessary “to change how
I think, change how I do everything…because of OT, I knew I had to modify and adapt.”
Karen stated, “I see myself growing mentally from having the challenges….having to
learn to balance everything.”
Support: People on the River Bank
Students perceived varying levels of support for their goal to obtain this
professional degree. They all spoke of the importance of support from others; either by
expressing their appreciation for the support they had or by complaining about the lack of
it from key people in their life. Karen, who gave birth to two children while in the
program, said: “I couldn’t have done it without the people on my river bank, it’s the
support system, especially my family.” Students thought of support in two different ways.

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They mentioned what could be termed emotional support, and they also described things
which they called practical every day support. Furthermore, they categorized support as
coming from different sources: their spouses/partners, family members, faculty, friends,
or cohort peers in the academic program.
Types of Support
All of the participants spoke of emotional support in some manner. They
described either the presence of or the lack of emotional support with more emotion on
their faces and in their body language, than when they described practical support.
Practical support, such as financial help, childcare, or help with household tasks was also
reiterated in their narratives, but with less animation. Emotional support came in several
forms for participants. They were buoyed by expressions of encouragement and by
positive feedback on an achievement. They also felt emotionally supported when other
people told them they were proud of them or that they knew they were capable of doing
the academic program.
While emotional and practical support could be distinguished from each other,
they were usually bound together in the narratives of the participants. For example,
practical everyday support was often interpreted as emotional support, even if a
participant never verbalized comments from others which could be categorized as
emotionally supportive. Conversely, when a student expressed that they didn’t have
support from anyone in their life they usually described situations where there was no
evidence of either emotional or practical support.
Karen expressed how the comments of her husband and mother helped her
persevere in the program while she balanced her role as a mother to a newborn and

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toddler who were born during the pursuit of her degree. Her comment showed how she
linked emotional support with practical support. “My husband is very supportive, very
much wanting me to go back to school and very proud of me; and supportive….he will
do anything that I need in order for me to do my homework.” Helen expressed how much
support from her husband and teenaged children helped her believe she could accomplish
this goal, even with her rheumatoid arthritis:
It fluctuates, but he’s [husband] had to pick up a lot of slack around the house
because I was trying to do it all and that wasn’t working [speaking of rheumatoid
flare ups]. My kids are good, very supportive…we can compare grade cards so we
kind of make it fun. My husband made me a desk and put in an area where they
all know if the door is closed, mom is studying…and they leave me alone.

Resources for Support
Students received their support from a variety of sources: spouse/partner, family,
friends, cohort peers, or faculty. The majority of students expressed that they couldn’t
have done the academic program without the support of others; it didn’t matter so much
where it came from. Very few participants received support from all the sources
described above. Categories of support were established during data analysis and were
not used as priori categories established by the researcher during data collection. The
participants were prompted to discuss who or what supported their persistence. Their
responses were categorized as follows: emotional and practical support was discussed by
the participants within three categories: (A) Student cohort friends and personal friends,
(B) faculty, (C) spouse/partner and family.
Support from student cohort friends and personal friends.
Participants clarified the difference between friends they had made within their
student cohort and “old” friends they had in their personal life. The majority of

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participants reported that their “new” cohort friends were their primary source of support
for persistence in the program. Many participants explained, often with expressions of
regret, that they no longer had time to maintain old friendships. Students often expressed
that “you had to be in the program to really get it [the challenges],” and that “other people
really don’t really understand the intensity of the program.” There were only a few
students that expressed an exception to this perception. They were either non-traditional
students immersed in programs with a predominance of traditional aged students or
students who avoided interaction with their student peers.
Barb mentioned that it was important to have support from people in her personal
life, but “you have to have somebody in the program too. You need a friend who is going
to say ‘step it up a notch, you’re slacking or hey you ought to be studying.” She
continued, “they [cohort peers] are going through the experience first hand. You can tell
everybody it is so hard in school but they don’t get it unless they’re there.” Anne
concurred with Barb, explaining that her cohort peers not only helped her study and gave
her class notes when she had to be absent, but they also “gave me positive thinking
notes.” Anne said, “my friends outside of school don’t really understand when you’re in
school and I say ‘hey, I can’t talk on the phone, I have to study’.” Nicole explained that
she had lost touch with friends outside the program because they didn’t understand how
busy she was with school. “My social circle has been replaced with people in the
program. I didn’t realize how much a part of my social circle they were until we didn’t
have class in the summer.”
Nicole, similar to other students in programs with only a few non-traditional
aged students, only had one or two cohort friends. Nicole explained, “I don’t have much

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in common with most of the OT students…their concerns are about the next party, but I
have a few close friends.” Julie also did not have much in common with most of her
cohort peers, but one student in the program had children and she counted her as a
supportive friend. She explained that she didn’t get along with the other students because
they were ‘all young and just out of high school.” She continued, “I can’t hold a
conversation with them because I really don’t have that much in common with them.”
Julie was one of the exceptions, because she felt more support from her old friends than
her cohort peers. This seemed to be because her cohort peers did not have children like
she did. Julie explained that the only people she felt emotional support from were some
old friends she had made an effort to get re-acquainted with in the past few months.
“They are my emotional support…most of them have college degrees, as well as
children, and get where I’m coming from…they can relate more [to her circumstances]
than my family or the other students.”
Students who were attending a school with a majority of non-traditional students
emphasized the importance of cohort peers. Ellen, speaking of cohort support stated: “I
think one of us would have dropped out by now if we didn’t have each other. It’s a very
tough love we have for each other when anyone says they can’t do it.” Helen reported
that she was especially close with three classmates and talked to one of them everyday.
She explained:
We help each other a lot. We motivate each other when someone is having trouble
continuing. They say they’re quitting but we pretty much know someone in the
group will jump in and bolster each other up…help us move forward.
Helen explained, “at the start of every quarter you look at the syllabus and say ‘I quit…I
can’t do this…I’m done,’ but my roommates [students that share a hotel room on

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weekends] help out.” Anne said her cohort peers “held me up and dragged me along”
when she was struggling with personal and academic issues.
Some students chose not to find support in their cohort peers even when it was
advised by faculty for their own benefit. When Fiona was advised by faculty to reach out
to others in her cohort she expressed resentment towards her peers, and stated, “I’m
strong and don’t need others.” Ivan felt isolated from his cohort peers because he was the
only male in their class. He said, “I wouldn’t want them to get the wrong idea if I were to
suggest lunch.” When asked, he stated he probably wouldn’t have “gotten buddy” with
male students either since he chose to drive home each night on the weekends they had
school. “I’m not the kind to go to others.” Similar to Fiona and Ivan, Gale did not feel
comfortable using her cohort peers for support. She found her primary support in the
faculty. Donna experienced academic struggles along with personal struggles while in
school. She described herself as someone who didn’t trust other people and didn’t like to
rely on them. She explained:
I never had any siblings or any friends growing up. I went to about a dozen
different schools. I always had to be by myself. I learned not to depend on others,
especially my mother. She disappointed me a lot…she would forget to pick me up
after my sport practices. I think that’s why it’s hard for me to work in groups. I
don’t want to depend on others for my grades.
Donna also acknowledged that she didn’t talk much to her cohort peers because “I had so
much going on at home that I just wasn’t a pleasant enough person to be around. I knew
didn’t have anything nice to say. I knew I’d go off on them.”
In conclusion, the students who reached out and found support in a friend or
their cohort peers seemed very glad that they had chosen to do so and saw it as a factor
that helped them persevere. The latter group of students who chose not to reach out to

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their cohort peers, even when it was advised by faculty, had a much more negative view
of their experience in the academic program. This will be discussed in more detail later in
this chapter when the theme of “mindset” is described.
Faculty support.
The five participants (Helen, Ellen, Gale, Ivan and Fiona) at Weekend College
all agreed that support was readily available from faculty. Not all the participants took
advantage of this support, but the consensus was strong that it was there if needed. Helen
summarized this well: “I never went to a teacher with a problem, but I believe they would
be helpful. It’s an unsaid assumption that they’ll help.” Ellen reiterated this perception
when she said:
The staff did provide me with support emotionally, as well as extending my assignment
due dates. I think it is a small university that you can get that one on one attention. They
[faculty] do not want to see failure at any cost. They will work with you “ad nauseum” to
get you through.
Ivan acknowledged that support was available to him from a faculty member, his
advisor. He reported that she was willing to help him with his personal problems by
listening and offering counseling referrals for his wife and himself. However, he stated,
“I talked to her just in case I got too far behind on assignments.” He further explained, “I
feel like I’m failing and I don’t want others to know I don’t have things in control. I’d
rather get four hours of sleep than talk to my instructors or group members.” Fiona was
another student who acknowledged that faculty had reached out to her when she was
struggling, but similar to Ivan, she did not choose to benefit from the support of the
faculty. She reported that she found little of the faculty’s advice helpful. Fiona said “it
just doesn’t work for me” when faculty discussed making a pie chart to help students

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facilitate a balance in their lives. However, she did acknowledge that a faculty member
might have a point when she stated “you thrive on chaos in your life.”
Gale found the majority of her support in the faculty as she attempted to deal with
serious illness in her son. She explained:
The faculty has been more supportive than the other students. They [cohort peers]
know I have stuff going on [severely ill son] but I don’t know if they know the
extent of it. Everybody has stuff going on; it’s tough for everyone. Each professor
helps me a little differently when I miss class because of my son’s illness. Some
of them are just more flexible and let me call them and explain what I missed.
They make sure I get power points and stuff I need ahead of time…like when my
son had to be hospitalized for a week.
All of these students at Weekend College had a common perception of faculty; they
recognized support was there. They perceived there were opportunities for emotional and
practical support from the faculty throughout the length of their program. Even if they did
not accept the support of the faculty, there was no doubt in their minds that is was
present.
The four students at Career College (Carey, Barb, Anne, and Donna) also
acknowledged the presence of faculty support. However, they didn’t mention faculty
support being available until they experienced significant academic struggles, either in
the form of academic probation or having to stop out because of academic failure. Their
narratives showed a pattern of either not realizing this support was available or perhaps
not wanting to ask faculty for help. Carey exemplified this finding. She explained why
she never asked for help with academic challenges:
I’ve never talked to teachers or confronted teachers when I have trouble in a class.
I was nervous about explaining why I was having a difficult time understanding
and I think a lot of it was I just didn’t understand why I didn’t get it.

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Carey continued, explaining why she never shared with faculty why she was missing
class due to personal issues:
I think it has a lot to do with how I was raised because my grandparents [who
raised her] were huge on keeping things in the family to yourself…if there’s a
problem in the family you don’t go share it with the world and for a long time I
thought like that. I guess too the things that happened with my father caused me to
not trust adults, especially adult men. I had a lot of male teachers in my gen ed
classes and I would always sit in the back. I keep to myself when I’m in school
type settings or church or anything like that. Just not comfortable. I sit in the back
and just need to calm myself down.
Carey, similar to Barb, Anne, and Donna, all seemed to wait to speak to a
faculty member about their problems until they had an academic crisis. Then, with the
explicit advice of a faculty member they started to make more attempts to reach out to
faculty or cohort peers. When Carey failed a class she explained that she went to the
instructor and it was suggested that she talk to her more and ask more questions in class.
“I needed to reach out more to others…maybe I was intimidated by her [the instructor],
but I followed her advice and I’m a lot different now.” Barb reported:
I think I’ve matured a lot since I’ve been in the program. I used to just blurt out
answers without thinking in class…I wasn’t comfortable with the silence. She [a
faculty member] helped me with that; she said to write things down first and think
about them. Then when I failed a class, another instructor said ‘a lot of your
problems are outside…they affect your school work,’ like my husband, so now
we are seeing a counselor.
Anne finally relied on the support of a faculty member, who was her advisor, after she
was on academic probation twice.
She helped me catch up, go over things I missed and she just let me cry and
explode. I didn’t realize I could get that. She was very, very supportive. Even now
if I need help I know I can just go to her.
Lindsay, Karen, and Julie from Regional University also felt support was there if
they sought it out. Julie was the only one with mixed emotions about the faculty. She

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stated “the faculty is awesome,” but felt some frustration when it came to work outside
the classroom. She explained:
I don’t want special treatment but I wish students like us were taken into account.
They plan things I’m expected to be at outside of class when I might have to work
or watch the kids. It’s one of my biggest obstacles. It’s not easy to coordinate
things. I have to ask myself if I can afford to lose income on that day.
Karen, with her two pregnancies while in the program, and Lindsay, with her
health problems felt support from the faculty because the instructors were willing to
make accommodations for their physical needs. Lindsay took advantage of the
accommodations offered by faculty and was very appreciative. She said, “all I had to do
was help them understand my physical limitations.” Karen chose not to use
accommodations that were offered, but recognized that they were available. She stated,
“The faculty was just great… I would have been uncomfortable if they treated me
differently anyway…just because I was having babies. I’ve never gone to them for
special accommodations.”
The presence or the perception of faculty support was quite different at Research
University. Three out of four participants from Research University were quite adamant
that they felt no support from the faculty. Their comments about faculty were quite
disparaging. Nicole felt that faculty “has by far been one of the biggest problems.” Nicole
said that faculty did not consider that some of them had jobs.
They would change class days sometimes if they had a conference to attend and I
would end up missing class because I was already scheduled to work at the preschool. They wouldn’t let us eat in class which was the only time I had to eat
before going to work…they thought it was a distraction.
Nicole continued:

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I just don’t think they are that interested in teaching. I think they see it as a
bother. I don’t feel respected in the classroom for my [work] experience. They
just come in and do the lecture and leave.

Paula shared the same sentiments as Nicole. Paula stated, “I feel like the faculty teach at
their convenience…not that interested in teaching.” Both of these students reported they
were doing well academically in school, but lost motivation and considered quitting the
program because they were discouraged by having “assignments that seemed irrelevant
and just lectures…no practical experience.” They wanted to practice what they were
learning by “getting out of the classroom and doing OT,” or as Paula explained:
We could learn about something in lecture and then practice it on each other
even…I need more hands on like they have at my friend’s OT school. I don’t
really get meaningful feedback from instructors…just grades on tests…a grade
doesn’t mean you know what you’re doing in our field.
Neither of these students felt respected for their prior professional work experience. Paula
explained:
I don’t think the faculty knows anything about me…like that I work as a professional
trainer. I think they think we are all under-graduates…young with parents paying our
tuition. I don’t even think they know my name. They didn’t even seem to notice another
student was pregnant until she was nine months along.

The third student, Olivia, also felt unsupported by faculty and administration,
but for different reasons than Paula and Nicole. Olivia described frustration with faculty
and administration when she experienced two separate health issues. She described her
frustration that she had to “drop back a year” because of missing course work after
hospitalization for an exacerbation of her bipolar condition. She also described frustration
with the college personnel after suffering a head injury from a fall. She reported she was
given extra time to complete course work that she missed, but said she felt “very

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unsupported by the college” and considered quitting. She felt unsupported because they
were, at the time of the interview for this research project, not allowing her to go out on
her clinical internships. She said they wanted her to job shadow an occupational therapist
for a while and to do “an easier fieldwork” when the time came later in the year. She
strongly disagreed with this plan and thought they were “just afraid I was going to have
another [bipolar] episode.” However, Olivia also acknowledged that she was not yet able
to drive and was getting therapy for the cognitive problems she was experiencing since
the head injury.
The final participant, Marie from Research University, did not share in her peers’
frustration about the faculty or administration. She said her “OT family” was supportive
when she learned she was unexpectedly pregnant. Marie said:
Yup, they were great about it…the teachers, the professors. They were really
supportive. I was the first one to have a child while in the program. They hadn’t
had that experience before. They said I could drop back a year or just try it.
Marie reported it all went smoothly while she was pregnant, and she was lucky because
she had the baby while they were off on summer break. Perhaps Marie felt support from
the school because she reported no instances where she missed class or needed help from
the faculty. She was just very glad she did not have to drop back a year. It also should be
noted that Marie was only 25 years old when she started the program, the youngest of the
non-traditional aged participants at her university. She also had no professional work
experience, as the others did, which may have made her perception of the academic
program different.
In conclusion, the majority of participants perceived that faculty support was
available, even if they chose not to utilize this support. Some felt the presence of support

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throughout their program; this was most noticeable in the narratives of students at
Weekend College. Students at Career College and Regional University also reported they
received support from faculty, but usually did not seem aware of this support until they
were confronted with an issue that necessitated reaching out to faculty. Conversely, three
out of four students at Research University did not perceive that faculty support was
available. The fourth student felt support was available but in actuality she never utilized
their support. The sub- theme of faculty support was a source of support that seemed to
differ by institution.
Spouse/partner and family support.
Although the students at Research University did not report using faculty support
to support their persistence, they consistently emphasized the support of their spouse,
partner, or family. All the students had extensive emotional and practical support from
their families. This might have been because all of them had family members or
significant others with college degrees. Julie, Nicole, and Marie were surrounded by
parents, siblings, significant others, and friends with degrees, many of them advanced
degrees. They reported the people in their personal lives gave them the support they
needed. Olivia credited her partner, who was an occupational therapist, with ongoing
support. She described how she supported her in financial ways and helped her get
through the program. Olivia also said her brother and sister-in-law encouraged her to
keep going with her plans, “not to give up.” Marie found both practical and emotional
support in her husband and in-laws. She said, “they said ‘we’re here to support you.
We’re going to help you in any way we can’…they were my river bank.” Her in-laws
followed up with childcare and ran errands for her. She explained that her husband:

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Would make dinner or give her [baby] a bath so I could do homework and then
financially… obviously I’m not making any money. He is the only one working,
paying for school and everything. He totally stepped up.
Nicole reported that she and her husband sometimes “fight about who should do
laundry,” but that overall “he is very supportive because he is in law school…he
understands.” She said both sets of their parents are very supportive. She added, “my inlaws are paying for our degrees…we only have a few loans we use for living expenses. I
feel funny about it, but we’ll return the favor some day.”
Paula also experienced support from her fiancé and family, although it was more
emotional than practical support. She reported “they understand I can’t go out, that I have
less time for them.” She credited a close family friend with stopping her from leaving the
program. She said we talked a lot and he pointed out that she still liked the idea of being
an occupational therapist, even if she disliked the academic program. Paula said, “I
reflected on that and realized that was true.” Although there was occasional mention of
support from old friends who had college educations or cohort peers in the program, the
participants from this university primarily perceived their greatest support from the
individuals in their personal life.
Participants from the other sites varied in how much support they had from
significant others and family. Anne had both emotional and practical support from her
husband. She spoke of his support saying: “He’s very supportive of me. I am very
grateful.” Anne said in her follow up interview, “I want to stress the importance of my
family support all round…my husband, kids, siblings and parents. My entire family
backed me every step of the way.” Helen also felt support from her husband and family
was necessary for her to persevere. She said:

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On the weekends I’m down here [at college] he’s [husband] pretty much it and
even during the week he’s picked up more of the household duties like the dishes
and laundry. My son has a car now and that’s helpful. I give him a list and he goes
to the store for me.

Karen also had extensive practical and emotional support from her husband and
extended family. Speaking of her husband’s support, Karen said, “I can’t imagine doing it
without having his support. It would be awful if he was constantly saying why isn’t the
laundry done, why don’t you make dinner? Why is the house a mess”? Karen offered
numerous examples of emotional and practical support from everyone in her life. She was
very animated when she described what a good role model her mother had been as a nontraditional student, because her mother had gone back to school for a teaching degree
after raising four children. She exclaimed, “if she can do it, I can do it”! She described
how her grandfather and her friends were so proud of her because she was managing to
be successful at school while raising a family. She had an impressive list of baby sitters
for her children in her extended family. Her mother-in-law loaned her money for her
tuition with “no interest and no pressure on paying it back…we can pay her like 300
dollars a year.”
Other students such as Ellen, Lindsay, and Gale mentioned they had some support
from family or spouses, but it was not as extensive as in the lives of the previously
mentioned students. Lindsay felt support from her fiancé, turned husband, and her
parents. When Lindsay married she reported her “financial situation wasn’t as much of a
problem as it used to be in the beginning of the program.” She felt emotional support
from her mother and husband. She said, “You can always talk to your mom when you’re
frustrated….my husband is great too…he understands how much time school takes.”

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Gale reported that initially she did not have any help from her husband or family. She
explained that her husband was in school too and didn’t understand how hard it was to be
working, a wife, and a new mom while she was in school. However, she reported “my
husband’s support has gotten better and my mom and dad’s support has gotten better
too.” Barb had emotional support from her sister, who was in the same academic
program, and her mother, but expressed anger and hurt that she had no support from her
husband.
Barb and Donna both had spouses that gave them no emotional encouragement
and resisted giving them any practical support with household chores or children. For
example, Donna said her husband did not understand why she needed a quiet place to do
her homework. She stated:
We live in a really small house with his kids and mine and he said “I don’t
understand why you can’t study with the kids and I don’t understand why you’re
yelling at everybody. Everybody is sick of you.”
Barb’s husband was very angry that she was pursing her degree. She confided that
she had to keep her Bachelor level degree in a drawer. “I think maybe he’s jealous and
that he thinks I’ll leave him when I get the degree. I think some of his friends might have
said that.” Carey reported she had lived with two partners during the program, but never
mentioned that she received support from either of them. As mentioned earlier in the
chapter, Fiona was very angry that her husband did not help around the house or with
finances because he seldom was employed. She mentioned he was extremely upset that
she was going to school and had threatened to “throw my computer through the wall…I
guess because I’m on it so much.” Ivan’s wife was the only person he ever identified as a
person who supported him in his efforts to obtain this degree, so when he no longer felt

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support from her, he was essentially an “island.” He stated, “I wouldn’t have done the OT
program without my wife pushing me…but at the same time, she’s dragging me down,”
referring to the toll her bipolar symptoms were taking on him. Julie was divorced with
two children. Her ex-husband lived several states away so he was not taking on any daily
responsibility for their children. Her extended family lived in the area, but she felt a
marked lack of support from them. Although they would help her with childcare, they
were so against her idea to go to school that she felt unsupported. She explained:
They think I should have just gotten my Bachelor’s level degree in something and
work in an insurance company, but I would have been miserable. They think I just
should have gotten a job so I’ always fighting that.
The Affects of Support on Academic Persistence
The importance of emotional and practical support to students was documented
in the previous sections, and some of their quotes clearly connected the concept of
support with their ability to persist in their respective programs. It is more obvious that
practical support such as help with finances, childcare or household chores can give nontraditional aged students more time to balance their many responsibilities. However, the
importance of emotional support for persistence cannot be over-emphasized. Marie
summarized:
I think the support I had was crucial. If there was anyone along the way that had
said “You can’t do this, or you shouldn’t do this” …if there had been I would
have caved at the rough points. I would have said you’re right why I am doing
this luckily no one ever said that to me.
Barb, speaking of the importance of emotional support from a faculty member stated,
“She [faculty member] said ‘she knew I could do it’ and she’s like ‘don’t stop…I know
you’ll be a good OT’…that kept me going.” Finally Anne, speaking of the emotional
support from her husband said:

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My husband helped me a lot. He is my strength I rely on him. He pushes me a lot
and whenever I had breakdowns and said I can’t do this anymore, he would say
“you can do this… you can do whatever you want” and he would help me.
The participants’ narratives showed that the presence of support made a
difference in the quality of their academic experience. Students with more sources of
support told of good relationships with their cohort peers and were optimistic about their
ability to complete the program despite academic challenges they had experienced. Some
even expressed that the changes they were forced to make in order to be successful had
“made them grow or mature.” For those with little or no support, the quality of their
academic experience was chronicled with more academic struggles and conflict with their
cohort peers. They shared more anxiety and fear about not being able to successfully
complete the program.
Summary
In conclusion, all of the students needed to have determination to pursue their
goal, but the narratives of the participants illustrated that the more sources of emotional
and practical support they had, the “smoother the sailing.” Some participants felt that
they could not have completed the program without support from others. The other
students who had very little support reported a much more negative experience in the
program and felt they “had to go it alone.” Expressions of anger, despair, and frustration
were more prevalent in their narratives. When these students were asked what helped
them persevere they credited personal attributes such as stubbornness or dogged
determination; what some students referred to as their “mindset.”

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Mindset: Smooth Sailing versus Choppy Waters
The majority of participants recognized that support from others was
instrumental in helping them persist, as does an extensive body of literature on the
subject (Bean & Metzner, 1985; Cabrera et al., 1992; Higgins, 2004; Ozga &
Sukhnandan, 1998). However, all the students, even those with extensive support, spoke
repeatedly of a “mindset” which got them through challenging times. For those who had
little or no support, their mindset was the only thing that they said helped them persevere.
For example, Fiona, Ivan, and Julie perceived that their mindset was the only thing they
had to help them persist.
When students used the word “mindset” they seemed to be defining it as a trait or
an attitude that existed within them, what the literature has described as dispositional
factors (Johnstone & Rivera, 1965; Quigley, 1998). Paula described this concept as “part
of my personality… the kind of environment I grew up in [her family] keeps me
motivated. We were taught quitting was not an option whether it was in sports or
school…I guess that became a part of me.” Fiona, defending her grueling schedule of
school work and several jobs, said: “I have this mindset that I have to work this much and
I can’t afford to get sick. I’ve got to plow through and it [symptoms of an illness she was
subsequently hospitalized for] will go away.” These declarations gave signs of
dispositional traits, which some called their mindset. They were usually delivered in the
interviews with emotional intensity and could be thought about in several ways. These
dispositional traits that influenced persistence and the quality of the participants’
academic experiences will be discussed as three different sub- themes on mindset: (A)

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determination and stubbornness, (B) a “proving self” attitude, and (C) blame versus
taking responsibility.
The Impact of Determination and Stubbornness on Persistence
The majority of participants spoke about having a drive or determination so strong
to complete the program that they often described it as stubbornness. Julie stated,
I don’t like to fail. It’s a big motivator. I don’t like to be told I can’t do that…if I
set my mind to do something, I do it. I have always been that way…I mean to the
point of stubbornness.
Ellen echoed Julie’s sentiments: “I don’t like to fail and I don’t like to look weak. I’m a
strong minded person and I don’t step back from a challenge. I think that kind of attitude
helped.” Carey also identified stubbornness as a trait that helped her keep persisting even
after academic probation and being forced to stop out for a year because of academic
failure. Olivia also had university imposed “stop out periods.” However, she expressed
conviction that she would complete the program despite being on a second stop out
period at the time of her interview. “I ‘m not getting there when I planned, but I’m
getting there.”
Helen described herself as determined throughout her life because she had to deal
with rheumatoid arthritis. She said this trait did not change once she was in the academic
program: “I’m just very determined. When I’m told I can’t do something, I’m going to
do it and that’s just me. I’ll find a way.” Donna also credited “a life of challenges” for her
determination. “It’s [her life] given me my drive and determination…my self-reliance.”
Ivan, who had no supports for persistence in his life partly by circumstance, but also by
choice, relied only on his waning determination. He had less optimism about getting
through the program at the time of his interview since he was failing a class and was

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having conflicts with students on a group project. All he had left was the thought that
“one year, just one more year…stopping is not an option…gotta finish.” Even Marie,
who described herself as a very “eager to please other people person,” and was often
influenced by others in her narrative voiced determination. She explained:
Once I make up my mind on something, that’s just the way it is. I’m not wishy
washy. I’m going to have this baby and I’m going to finish OT school and that’s
just the way it is. I made up my mind I was going to do it.
Barb summed up the sentiment of the participants well: “One thing I discovered is you
have to have that drive or you won’t make it down that river.”
Determination Influenced by the Need to Prove One’s Self
Some participants expressed a mindset that helped them persist which was based
on proving themselves; sometimes to other people in their life and sometimes for
themselves. When they explained how they were proving it to others, their comments
were infused with facial expressions of anger and emotional intensity in their voices. As
mentioned earlier in the chapter, Fiona was motivated to complete her degree to prove
her mother wrong. Her mother had stated Fiona wouldn’t amount to anything when she
became pregnant as a teenager. Fiona stated: “I am just driven. I started this… so the
heck if I ‘m ever quitting.” Julie, speaking of her family’s efforts to discourage her from
attending school and instead get a job, explained:
I mean in a way they would like it if I said I made a mistake. They were like “you
just need to get a job.” I’m like “no!... this is my mindset… I am going to go to
school and get this degree.”

Barb felt a need to prove herself to others. “I have a push to prove to people that I can do
it [school]. A lot of people are like you can’t do that…you have kids and everything else
laying on you…and I think that kind of pushed me to prove them wrong.”

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Other participants had determination that was based on wanting to prove to
themselves they could do better than they had in previous academic experiences. Karen
explained,
I’m not happy with how I did with by Bachelor degree my first time around, but I
was younger and so I’ve been doing better now…I’d like to think I’m a really
hard worker and pretty stubborn. I don’t want to give up on something when I
started it.
Nicole stated she was very determined to complete the program, not only because she
wanted a career that would let her help people, but because she felt she had to “make up”
for “screwing up” when she first attended college after high school at a time when she
“was interested in other things besides school.” Marie, who was the only student who had
completed their degree at the time of the interviews said, “I think I proved something to
myself. I felt that I was not that confident before but I definitely know if I can do that [the
program], I can probably do a lot.”
Taking Responsibility Versus Blaming Others for Their Struggles
As I was analyzing the data, I was struck by how different the participants were in
temperament or disposition. I started to notice this during the data collection phase and it
was confirmed during the analysis phase. While these non-traditional aged students had
similar experiences across different types of institutions they framed their challenges in
different ways. This was another way that their mindset was expressed.
All of the participants had significant obstacles they had negotiated, and all had
either stopped out at one time or had seriously considered leaving the program. This was
part of the criteria for participant selection. However, participants then differed. They
tended to either blame others for their struggles or took responsibility for the changes
they needed to make in order not to fail at their goal. This latter group of students often

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went further and framed coping with adverse circumstances as a growth or maturing
experience. Those participants who blamed others for their struggles used less effective
coping methods, and viewed their college experience and the individuals within that
context with negativity.
Marie, Carey, Helen, and Gale all accepted responsibility for the changes they
needed to make when faced with the possibility of failure; they did not blame others for
their circumstances. When they met with unforeseen challenges they struggled and
sometimes faltered. For example, they ended up on academic probation or missed classes,
but they ultimately figured out how to move forward in their academic programs. They
did this with a relatively positive outlook towards the academic program in general and
the people they needed to interact with in the setting: the faculty and their cohort peers.
Barb, Karen, and Ellen also negotiated unanticipated challenges, but did so with
exemplary grace. They not only found ways to cope with problems, but they additionally
expressed that mastering these challenges had helped with their personal growth. They
managed to frame adversity positively. Ellen described changes she needed to make in
order to be successful. “I was always the sarcastic smart ass of the group. I’m the one if
it’s on my mind, it’s out there. I had to learn to stop and think before I talked.” She added
that she “had to get better with schedules and things…I’ve always been a free spirit, just
went with the flow. It’s [the program] is very structured, very systematic…I had to
change.” She implied that these changes were suggested by the faculty and the program
director. Ellen went on to explain how she used the knowledge she gained in the
program:
To get myself, the mind, the body and the soul working together…it makes me a
better student. Plus I lost almost 40 pounds since starting the program. You’re

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learning these things so why not apply them to yourself and prove that it works. I
think I gained a lot of maturity from being in a program like this.

Barb also thought she had matured by being in the program; having to handle the stress
and make changes so she would not fail. “By the time you’re up here [at the graduate
level of the program] you’ve matured a lot since the beginning of the program.” Karen
also credited the academic program with self-improvement. She explained that balancing
all her roles was her biggest challenge and having to figure out how to do that “I see
myself growing mentally.”
Two students, Lindsay and Anne, could not be categorized as either students
who took responsibility and made adaptations for success, nor could they be categorized
as students who blamed others for their struggles. They had such extensive support and
adaptations made by others that not much was left up to them by default. However, it was
clear that the remaining students focused more on blaming others for their struggles.
Julie, Paula, and Nicole blamed the nature of the academic program itself, which included
blaming the faculty. They felt the program had too much homework and reading, as well
as too many projects which required time outside of class. They faulted the full-time
nature of the program and the rigor of the curriculum, rather than realizing that their lives
as non-traditional students were quite full already. They resented that they had to spend
less time with children, spouses, or family, and had to work jobs around school
commitments. However, ultimately they all made adaptations to continue in the program
despite considerations of quitting, and none of them experienced any significant
academic crises or stop out periods.

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However, four other students (Fiona, Ivan, Olivia, and Donna) exemplified a
mindset of blaming others for all their problems. Their experiences in the program
showed a pattern of disharmony with faculty and cohort peers and more incidences of
“stopping out.” Fiona blamed her husband for the fact that she had to work several jobs
and seemed to resent her son for the time he took from her at home. She also stated, “I’m
not really learning anything from the faculty,” and “I don’t really get any benefit from the
work I do in the program.” She also did not get along with her cohort peers and expressed
resentment towards them when they commented on why she procrastinated on her group
work with them. She stated, “If they walked in my shoes for a week!…of course they can
get everything done…they don’t work as much.” She seemed to have no insight into the
lives of the other students who were also struggling to balance their challenges.
Ivan also blamed others for his problems. He went back to his childhood and
blamed his parents for his poor learning abilities and his delayed entry into college
because “they were janitors and didn’t really encourage education.” He blamed his wife
for distracting him; initially because he was so attracted to her at the start of their
relationship and currently because her bipolar symptoms were making it difficult for him
to focus on school work. He also blamed his wife’s manic phases for their financial debt,
but later admitted that he really enjoyed all the new purchases they made. Ivan blamed
the predominance of females in his cohort as the reason he did not work well with other
students. He escalated to significant anger towards members of his cohort group working
on a project with him, yet he also admitted that he was not understanding the material.
While he did not blame faculty for his potential failure in a current class, he described not
feeling supported by faculty and he thought it “best to just talk to everyone less.”

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Donna was another participant who often blamed others for her challenges. She
had no real practical or emotional support, but reported that she didn’t really want it
anyway because “I don’t really trust others.” Donna persevered on a mindset of “just grit
and determination.” She especially blamed relationships from the past for her current
difficulties in the program which included two periods of stopping out. She blamed an
early marriage for her delayed entry to college saying, “I married my high school sweetie
instead….he just wanted us to get married so much, but I really didn’t want to.” She then
blamed their start of a family and a second relationship with another man for distracting
her from her goal of starting school. She had another child with this second individual,
and later on in her story described him as a stalker who created a lot of stress in her life;
“so of course I couldn’t start school while that was going on.” When Donna was advised
by faculty to seek out relationships with other students because they wanted her to
develop better inter-personal skills for her internships, she defended herself in the
interview by blaming her mother and her childhood. She stated that she was an only child
and never had any friends because they moved so often:
I learned not to depend on others, especially my mother. She disappointed me a
lot…she would forget to pick me up after my sports practices. I think that’s why
it’s hard for me to work in groups.
Donna also blamed her current family situation for why she had done poorly
academically and had to stop out of school again. She had married a new husband while
in school and had the task of blending children from two families together. Donna never
mentioned that she had choice about how she interacted with others or who she got
involved with over the years.

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Olivia also blamed others for the two periods when she was separated from the
program. However, her situation is unique and her mind set may be impacted by a
recently suffered head injury which often allows for less reflection. At the time of the
interview, which was approximately six months after the head injury, Olivia blamed the
college for her first administration imposed stop out period. This period came after a
hospitalization for an exacerbation of her bipolar symptoms. She stated, “I think it
[having to wait a year] made things even worse during my recovery.” Olivia
acknowledged that she was not taking her prescribed medication for her condition at that
time, but did not connect that with the flare up of her bipolar symptoms. She thought that
making the transition from a job to school was stressful, and that change had caused her
condition to return. Olivia also did not understand why the college was having her wait to
go on her internships at the time of the interview. She was very frustrated with the
university because of the delay and did not take responsibility for the fact that she might
not be ready to work with patients. She was not yet allowed to drive and was still getting
therapy for the cognitive problems she was experiencing from the head injury.
Summary
In conclusion, the voices of the participants mentioned a mindset that could be
described in three ways. First, the majority spoke of a determination that helped them
persist through their most challenging obstacles; in other words when all else failed.
Secondly, some described a determination fueled by harmful words from others or hurtful
events. For example, participants explained they had this fierce determination because
they were proving to someone that they could complete this goal or because they needed
to prove it to themselves. Lastly, mindset was also expressed as a way that people framed

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their struggles; what McAdams (1993) referred to as how people “story their lives.”
There was certainly evidence of this in the voices of the participants. “While some stories
exude[d] optimism and hope, others [were] couched in the language of mistrust and
resignation” (McAdams, 1993, p. 47).
Conclusion
These four themes, which were identified in the analysis of the data provided by
participants, all showed a connection to persistence. The first theme, the desire to become
who they wanted to be by becoming an occupational therapist, seemed to be the most
significant in their narratives. This desire to be someone different or better was enacted
when they enrolled in occupational therapy academic programs. This desire also helped
facilitate their persistence. The only time this desire to be someone different or better was
not the primary factor facilitating their persistence was when they felt overwhelmed or
defeated. Then they resorted to what they called their mindset, the last theme discussed,
to keep them moving forward.
Students also moved forward by learning to be adept at finding strategies to
persist when they encountered obstacles. The students who were willing to make changes
in themselves and adaptations in their life progressed with more ease. They sometimes
did not like the adaptations they had to make, but most were relatively philosophical
about the changes; as Nicole stated, “this is only for a season.” Those students who held
on to old patterns of behavior and resisted suggestions for change encountered more
struggles. Participants’ perseverance was also facilitated by support from others, but a
lack of support did not cause them to stop persisting. However, it did make the quality of
their experience in the academic program more negative than for those who had support.

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Those without support were generally more at risk academically. The next chapter will
discuss these themes, which were illuminated by the participants, in another manner. The
discussion chapter will attempt to connect the themes to theory, in order to further
understand the experience of these non-traditional students.

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Chapter Six
Discussion
Introduction
The purpose of this study was to explore persistence of non-traditional aged
occupational therapy students. This current study seeks to understand the experience of
these students because we “have little insight into the forces that shape graduate
persistence” in the professions (Tinto, 1993, p. 230). Gaining an understanding of the
experience of students in combined Bachelor’s/Master’s level occupational therapy
programs offered an opportunity to learn how to support persistence in this program, as
well as other related professions.
The lack of literature on adult learners in professional programs of any type (e.g.,
law, medicine, engineering, health professions) represents a significant gap in the
retention literature. This gap is especially salient because “the highest percentages of
adult students typically chose specialized professional programs (often 60-75%)”
(Kasworm et al., 2002, p.4). It is crucial to determine if established theories and models
of retention (or attrition) are “a good fit” for non-traditional aged students in the health
professions. In this discussion, I will argue that adults in the health professions represent
a group with a unique set of characteristics and needs that set them off from the larger
aggregate of non-traditional students. This current study demonstrated that nontraditional aged students majoring in a health profession, occupational therapy, do have
some commonalities with non-traditional aged students majoring in unspecified majors.
However, it also identified distinguishing factors that suggest modifications are needed in

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established retention theories and strategies used for non-traditional aged students
majoring in the allied health professions.
This chapter first provides an overview of what was learned about non-traditional
aged students in a professional level allied health program. It identifies findings which
reflect what we already know about non-traditional aged students. I will then highlight
new concepts generated from the data that offers insight on how adult students majoring
in a health profession differ in their motivations from the larger aggregate of students
studying non-specified majors. These key findings will then be discussed relevant to the
conceptual framework developed in Chapter Two, the literature review. In other words, I
will discuss how some findings resonated with the theoretical perspectives which were
presented, and also suggest where the perspectives in the literature review fell short of
explaining the findings. Lastly, direction for further scholarship will be proposed, along
with implications for practice.
An Overview of What was Learned
The results of the current study suggest that non-traditional aged students in
occupational therapy programs had difficulty balancing competing priorities such as
employment, family, and school work. For example, Paula, Ellen, Nicole, and Fiona all
emphasized that they had a shortage of time for all their roles in life. They experienced
significant amounts of stress, which they thought sometimes caused health problems.
With only a few exceptions, the participants also experienced increased financial stress
while in school. These findings were congruent with the literature on the non-traditional
student in higher education (Bean, 1985; Bean & Metzner, 1985; Cabrera, Castaneda, et
al., 1992; Cabrera, Nora, et al., 1992; Ozga & Sukhnandan, 1998). The results of this

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current study suggest that the students who were willing to make changes in themselves
and adaptations in their life when they faced challenges progressed through the academic
program with more ease. They sometimes did not like the adaptations they had to make,
but most were relatively philosophical about the changes; as Nicole stated, “this is only
for a season.” Students such as Ivan, Fiona, and Donna who held on to old patterns of
behavior and resisted suggestions for change encountered more personal and academic
struggles.
There was an additional area in which findings from the current study were
similar to what is found in the literature on adult students; participants were affected by
the amount of emotional and practical support they had from other people (Bean &
Metzner, 1985; Grosset, 1991). The perseverance of the participants in the current study
was affected by the support of others, but a lack of support did not cause them to stop
being motivated to persist. For example, Barb and Julie had little emotional or practical
support but they drew on personal determination, both citing “stubbornness,” as helpful
for volition. In addition, they both sought out support, Barb with her cohort peers and
Julie with her old friends. However, it did make the quality of their academic experience
in their program more negative than for those who had extensive support. Those who had
no support at all or made no effort to seek support were generally more at risk
academically. Ivan, Fiona, and Donna fell into this category. They described either being
on academic probation or fearing they would fail classes. Carey’s story exemplified how
support from others made a difference in her academic achievement. Carey said she
experienced academic failure twice until she started to reach out to faculty and her peers

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for support. It did not seem to matter where support came from according to the
participants.
These findings about competing priorities and the value of support reflect what is
already known about the persistence of non-traditional aged students. The participants in
this study had these characteristics and needs in common with the larger aggregate of
adult learners. However, there was one very significant situational factor identified in the
findings of this study which is not typically discussed in the literature. A surprising
number of participants, 12 out of 16, had to cope with a medical condition in themselves
or a close family member while they were in their programs. These medical obstacles
were often identified by participants as “a large boulder,” and were more likely to be
cited as reasons for stopping out of the academic program or at a minimum increasing
absences and academic struggles. The data showed that other situational and institutional
barriers impacted students’ persistence, but not as much as this surprising finding.
The current study also revealed two additional areas not emphasized in the
literature on non-traditional students. These findings shed light on the dispositional traits
of students in an occupational therapy program and may also be relevant for other
students. The participants described their motivation for both initiating and persevering in
the program as related to a desire to become something different or something better.
This vision of who they wanted to become was often intertwined in the majority of
participants with a desire to help others. The data collected from the participants
indicated that this idea of re-developing who they were was critical to their motivation to
persist. When their vision of this new possible self was influenced by altruistic tendencies
they were quite passionate when speaking of their motivation. Their impassioned

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statements suggested that they had a specific world view; one in which helping others and
making a contribution to society was primary. This finding suggests a critical way in
which occupational therapy students and perhaps other students in allied health care
majors differ from the general population of non-traditional students; their reasons or
motivations for persisting are different.
There was another dispositional factor which may be unique to students in allied
health care majors at the professional level. The occupational therapy students in this
study repeatedly spoke of a mindset that helped them persist through their long and
challenging programs. The literature does speak of the influence of non-cognitive
variables (McGaha & Fitzpatrick, 2005; Sedlacek, 2004), but the participants were
speaking of something different when they used the term “mindset.” The participants
emphasized the fierce determination they needed to have to persist, which some called
stubbornness. Participants also had different “mindsets” on how they framed their
challenges, although they did not use this term explicitly for what the data suggested on
this topic. It was noticed that some participants blamed others for their struggles, while
other participants took responsibility for the changes they needed to make in order not to
fail in the pursuit of their goal. Those who made changes, such as Ellen, Barb, and Karen,
often went further and framed coping with adverse circumstances as a growth or
maturing experience. Those participants who blamed others for their struggles used less
effective coping methods, and viewed their college experience and the individuals within
that context with more negativity. This pattern was especially apparent in the narratives
of Fiona, Ivan, Olivia, and Donna.

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Congruence with the Conceptual Framework
Perspectives from the body of knowledge on adult education and theories of
retention and attrition helped explain some of the research findings about the nature of
persistence in this sample of students. However, these studies did not go deep enough
into the underpinnings of why and how people are motivated to persevere. This need was
filled by theories on the motivation for learning. These theories enhanced the
interpretation of findings because this body of knowledge focuses on the details of why
individuals persist in their motivation towards a goal. However, theories on the
motivation for learning are rarely discussed in any type of context, including the college
environment (Perry et al., 2006). Thus, the collaborative use of theory from both areas
was effective in explaining many of the research findings, although some aspects of the
findings also involved consideration of additional concepts which will also be discussed.
Higher Education and the Adult Learner
The voices of the participants clearly identified barriers that could be described
as being in the categories of situational, dispositional, and institutional factors. The
students’ experiences with obstacles such as illness, marital strife, childcare issues, the
rigor and length of the program, as well as occurrences such as faculty changing class
times or expecting extensive group work outside of classes all spoke to challenges which
could be described as either situational or institutional in nature (Cross, 1981;
Darkenwald & Valentine, 1985). Dispositional factors are evident in poor self efficacy
for the work, as was expressed by a few participants. In some cases there was a tendency
to blame others for academic struggles. The work of Quigley (1998) explains the
importance of dispositional factors in the adult learner. The work on the adult learner,

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which used a perspective to look at persistence by incorporating these internal and
external factors, resonated with the content of the narratives from the participants
(Johnstone & Rivera, 1965). The work of these scholars illuminated an inter-play of these
internal and external factors in the lives of the non-traditional aged students in this study.
In other words, internal dispositional traits affected whether a student such as Ivan
utilized support from others which is considered an external, situational factor.
Aspects of retention and attrition theories developed in the higher education
literature also helped explain why participants had common experiences concerning the
role of support and the challenge of balancing multiple priorities in their life. This
congruence was seen in the work of researchers studying the non-traditional student
(Allen; 1986; Bean & Metzner, 1985; Cabrera, Castaneda, et al.1992; Cabrera, Nora, et
al., 1992; Ozga & Sukhnandan, 1998). The conceptual model of Bean and Metzner
(1985) theorizes that a student’s experiences with the faculty, peers in their academic
program, and the course work itself all shape the belief system of students which in turn
influences their behaviors. This model also included the importance of encouragement
from family and the influence of external situational factors such as employment and
finances (Bean & Metzner, 1985). The conceptual model developed by Bean and Metzner
(1985) was found to be exemplary at explaining findings of this study that related to the
themes of balance and support. However, it fell short explaining the unique motivations
and mindset of the participants in this study.
Motivation for Learning
There are different ways to think about what motivates people, but the learning
motivation theories from the social cognitive perspective of psychology provided an

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optimal way to more deeply understand persistence in higher education. This perspective
has developed a body of research solely devoted to the motivation for learning (Bandura,
1991; Brophy, 2004; Corno, 1993; Schunk, 1999; Svinicki, 2004). A more thoughtful
and in-depth interpretation of the data can be obtained when theories from this
perspective are applied to the findings within the context of the higher education
environment for non-traditional aged students. Analysis of the data determined that
possible selves theory provided a powerful lens for understanding the experiences of the
participants. The voices of the participants lead me to agree with Rossiter’s perception
that “the possible selves construct offers a useful and previously untapped framework for
the exploration of how educational relationships influence adult learning” (2007, p. 139).
In addition to possible selves theory, additional perspectives on motivation for learning
were included because they added to the interpretation of the findings and supported the
possible selves concept. These additional perspectives will be explored after a discussion
on the relevance of possible selves theory.
Possible selves theory: the primary theoretical framework for understanding the
participants’ motivation.
The participants’ strongest motivation centered on wanting to become someone
different or someone better. They hoped to achieve this desire, what is called a “new
possible self,” in the context of an academic program educating them to become an
occupational therapist (Oyserman & Markus, 1990). The manner in which participants
spoke of becoming this new self is reflected in possible selves theory. Possible selves
theory speaks of self concept and how we can give form to our desires for achievement or
affiliation (Markus & Nurius, 1986). Possible selves are visions of one’s self in the future

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(Oyserman & Markus, 1990), which is what all of the participants discussed in their
narratives. This desire to be someone new emerged as one of the most prominent factors
that motivated the participants. This concurs with Oyserman and Markus (1990) who
state that visions of oneself in the future “are essential elements in the motivational and
goal setting process” (p. 113).
The participants all spoke of who they would like to become after they explained
why or how they would like to be different in the future. According to Markus and
Nurius (1986), “this type of self-knowledge pertains to how individuals think about their
potential and their future. Possible selves are the ideal selves that we would very much
like to become” (p. 954). Students repeatedly connected both their motivation to initiate
the program, as well as their motivation to persist, with a belief or hope that the
completion of the academic program and the opportunity to be an occupational therapist
would obtain their desired new self. According to Rossiter (2007), academic persistence
has been linked with the ability to picture a positive and detailed view of self in the
future. This type of positive detail was seen in the narratives of most of the participants.
Their belief that a new possible self was achievable functioned as an incentive for their
behaviors which facilitated persistence (Markus & Nurius, 1986). It can be expected that
an individual’s conception of possible selves changes over time as one progresses into
adulthood as a result of experiences (Eccles, 2009). This concept helps explain how the
adults in this study came to make this life changing decision to return to school that
would affect not only their life, but the people that were close to them.
Conversely, possible selves theory also helped explain the maladaptive behaviors
of some participants which did not correlate with effective coping methods. For example,

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when Fiona, Ivan, or Donna realized they might be in danger of failing academically they
exhibited behaviors such as anger and increased isolation from faculty and cohort peers.
They also resisted taking advice and blamed others or circumstances, rather than taking
responsibility for changes that needed to be made. Higgins (1987) describes the intense
negative emotional discomfort that can occur when one’s vision for oneself does not
match with the actual self. In other words, in the case of these students the reality of their
circumstances was so incongruent with their possible self that they were very threatened
which caused them to make poor behavioral choices. Possible selves theory
conceptualizes that we carry with us not just our hoped for possible selves but our
dreaded possible selves, what we fear we may become (Higgins, 1987; Markus & Nurius,
1986; Oyserman & Markus, 1990).
Participants were very emotional when they described who they wanted to be
(their hoped for possible self), or how they did not want to be thought of by others or
themselves (their feared possible self). It is suggested that the displays of emotion were
present because their higher education goal was so intertwined with their self-perception.
When students could not meet the expectations of others such as faculty, cohort peers, or
family they responded with anger when telling their story. If they did not meet their own
“ought to” goals or ideal self expectations they were more likely to express sadness or
guilt. These findings correlated with the work of Higgins (1987) who focused on how
discrepancies between the actual, ideal, and the “ought to” self are related to emotional
vulnerabilities.
In conclusion, these students provided narratives which illustrated that they were
in the process of re-creating themselves, sometimes for others and sometimes for

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themselves. Possible selves theory, along with other aspects from the social cognitive
perspective emphasized the influence others play in the construction of the possible
selves participants carried with them. These perspectives led me to interpret the data with
a deeper level of understanding. It allowed me to understand the phenomenon being
studied at a deep level where I was not just cognizant of their behavioral choices, but why
they made these choices.
Social cognitive perspectives supporting possible selves theory.
The social cognitive perspective applied to motivation for learning starts with
the assumption that social influences become internalized in learners and become part of
that individual’s view of self (Schunk, 1999), as well as a view of who they could be in
the future. In this way, other individuals can affect a student’s volition to persist in
college both negatively and positively (Grusec & Hastings, 2006). This concept was
clearly apparent in the narratives of the participants as they discussed how family
members or significant others in their past influenced how they interacted in the college
environment in the present. An ongoing inter-play between the internal aspects of an
individual, the environment, and the behaviors of the individual was taking place; this
was originally described by Bandura as triadic reciprocality (Zimmerman, 1989, 1990;
Schunk & Zimmerman, 1997).
This triad helped explain the strong influence participants felt from their past, as
far back as their childhoods, and how this still had an effect on how they negotiated the
challenges of becoming their new possible self. Triadic reciprocality also explained how
participants could in turn impact other people in their environment, as well as change
their own behavioral patterns as a result of the influence of new people in their present

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circumstances (Schunk & Zimmerman, 1997; Zimmerman, 1989, 1990). For example,
some participants described how people such as faculty, cohort peers, and family
members in their current life as a student were changing their attitudes and behavioral
choices so that it was possible for them to reach their goal of “re-selfing.”
All of the participants had at least one person, at one point in time, who helped
them believe they could be who they envisioned. Participants did seem to develop a
belief that they could master the challenges of the program, even if they were not sure
they could initially. This self-efficacy for the work was crucial and is supported by theory
which emphasizes the importance of having a strong image of oneself mastering the
challenges (Bandura, 1991). In fact, the findings of the research suggest that the selfefficacy the participants developed may be in part what kept them persisting through
major obstacles with their strong mindset of determination or stubbornness. Bandura
(1991) states that people’s belief in their self-efficacy influences…how much effort they
mobilize in a given endeavor and how long they persevere in the face of difficulties and
setbacks…” (p. 257). Self- efficacy for their goal to become an occupational therapist
seemed to be stronger in participants such as Nicole and Ellen, who were starting to use
the language and the methods of the profession. It is suggested that they had a more
internalized “picture” of themselves as their new possible self which improved their selfefficacy and motivation (Waterman, 1990, 2004).
As stated previously, these professional level health care academic programs are
long, usually six to seven years, and often have more rigor and challenge than expected
by students. In order to make the successful transition to college as an adult student and
show volition until graduation a student needs to have what the motivation literature

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describes as self-regulation (Lindner & Harris, 1992). The participants in this study who
are non-traditional aged students balancing multiple priorities definitely needed to have
the ability to self-regulate both cognition and motivation to persist. This resonates with
the work of Wolters (2003) who said that it takes regulation of both of these factors to
have the volition to persist on a long term goal. These students needed continued selfefficacy and metacognition. Metacognition allowed them to be aware of how they learned
best and problem solved. It also allowed them to have “contextual sensitivity” in order to
use the environment effectively (Lindner and Harris, 1992). This aspect of learning
motivation theory was congruent with the experiences described by participants. Those
participants who made use of input from their cohort peers and faculty made the
necessary changes to succeed academically and described a more positive experience on
their path to becoming their new possible self. This was reflected in the narratives of
Barb, Carey, Ellen, Lindsay, and Anne. Participants like Fiona, Ivan, and Donna who did
not make use of resources in their environment and chose to stay with ingrained patterns
of behavior described academic situations where they were currently at risk for failure at
the end of their academic program.
This latter group of participants, who did not take advantage of opportunities for
positive interaction in the college environment with cohort peers or faculty, struggled
more academically and described feelings of isolation. This was very apparent and
consistent throughout the narratives of Fiona, Ivan, and Donna. Karen and Carey initially
kept themselves isolated but learned that becoming involved with others made their
academic progress “less rocky.” The social cognitive perspective, highlighted in
belongingness theory, explains this phenomenon. Associating with others who are similar

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to oneself and have similar goals has been shown to be important in the motivation to
pursue a goal (Baumeister & Leary, 1995). Relatedness has been shown to be a basic
psychological need for the motivation to learn (Osterman, 2000), whether it is gained
from relationships with faculty, cohort peers, or friends with college degrees. This
concept was supported by the data in this current study. It appeared that self-efficacy for
the academic work was gained through vicarious learning from being with others who
were similar to one’s self (Brophy, 2004), such as cohort peers. Interaction with cohort
peers and faculty within their institutions also helped them achieve their new possible self
because this engagement can help them acclimate to a new professional culture (Hooper,
2007).
This new professional enculturation was apparent in some of the narrative of the
participants. I recognized that some of the language they used was from a worldview
common to the occupational therapy profession. Additionally, when some of the students
spoke of changes they needed to make in order to be successful, they described “using
OT on themselves.” This enculturation was especially noted in students like Ellen, Paula,
Helen, and Nicole. These students were the closest to actualizing their new possible
selves as occupational therapists; they were speaking and looking at their lives with
changed metacognition. Despite multiple roles in their lives, the professional identity
formation of this group of students was the most evolved toward the possible self they
envisioned. Because these students were closer to actualizing their new possible self, they
placed a strong value on their goal. Other participants, such as Fiona and Karen, held on
to their current stronger identities with little identification as an occupational therapy
student. Fiona’s primary identity was as an employee and Karen’s was as a parent. Going

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to school was something they did “on the side.” These students wanted to obtain their
degree, but the value they placed on the goal was less. Other aspects of their life were
declared as much more important.
In order to have the volition to work maximally towards a goal students must not
only believe the goal is possible, they must also value it very strongly (Brophy, 2004;
Svinicki, 2004). In the work on the value and expectation sides of motivation, a student
needs to either keep valuing the reasons that motivated them to initiate the degree or
develop new reasons to value the goal in order to have the volition to persist (Svinicki,
2004). In a long and rigorous program such as the professional level occupational
therapy degree, students in this study were sometimes noted to rely not only on their
initial motivation but on a secondary reason for continuing to persist. For example, they
reminded themselves they only had a short time until completion, or that they had too
many loans to pay back to quit. It was very apparent in the narratives of the participants
that they were passionate about reaching their goal, despite falling back sometimes on
these secondary reasons because of frustration or fatigue. They expressed absolute
certainty about becoming a professional level occupational therapy practitioner in order
to actualize their vision of a new possible self.
Extending Beyond the Possible Selves Perspective: Implications for Theory
Possible selves theory explains the motivation and the volition for the
participants, but it falls short in explaining what set their desire in motion. Literature on
identity development that focuses on the socially constructed nature of identity offers
additional insight. Possible selves theory also did not explain the predominance of an
altruistic sub-theme in their desire to be a more ideal self. Relatively new ideas in the

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literature discuss how some individuals have more need to do “good work” (Damon,
2008). Literature from both of these areas will be discussed in terms of how it can
contribute to existing possible selves theory.
Identity Development: Evolving in Adulthood
Identity has been traditionally thought of as “one’s choices of values, beliefs and
goals in life” (Archer, 1989). Identity development or formation involves committing to
elements of these values, beliefs, and goals and then taking action to implement progress
towards realization of these desired choices. Identity can also be conceptualized as a
“psychosocially constructed narrative which integrates the reconstructed past, perceived
present, and anticipated future: in short it is a story of the self” (Tennant, 2008, p. 19).
This was apparent in the narratives of the participants who voiced what they valued and
connected this value to their goal of wanting to become an occupational therapist.
Tennant’s comment explains why participants delved into their past, even their
childhoods, although they were only being asked to recount their experiences in the
academic program (2008).
Identity development cannot be discussed without mentioning Erikson who
proposed eight stages of psychosocial development which serve as a foundation for
extensive research on identity development (Roser, Peck & Nasir, 2006). The fifth stage
known as identity versus role confusion is the most relevant to discuss for this sample of
participants even though this stage was proposed to occur during adolescence rather than
adulthood (Roser et al., 2006). However, Erikson did articulate that humans confront and
master new challenges throughout the lifespan. He viewed identity development as an
ongoing process in life, with the challenge of identity and role development as the focus

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of the fifth stage (Roser et al., 2006). This discussion will utilize literature that views
identity development as an ongoing lifelong and dynamic process moving beyond
adolescence and young adulthood.
Theorists have proposed that adults continue to evolve in their concept of who
they are and what is important to them, even though this was traditionally viewed as a
task of adolescence and young adulthood (Marcia, 2002; Waterman, 1982, 1990). It can
be expected that as one ages and lives through a variety of experiences that individuals
might re-assess their values and beliefs, therefore adjusting their goals and purpose
throughout the lifespan (Archer, 1989; Eccles, 2009). The stories of the participants
exemplify the point that identity is not static. The narratives of the participants described
a myriad of life events which seemed to have changed their values and goals which in
part make up their identity. It is also possible that their experience as a research
participant in this study allowed them to re-define aspects of their sense of identity
(McAdams, 1993).
Waterman (1982) proposed that not all individuals go through identity formation
in adolescence and young adulthood as suggested in Erikson’s stage model. He proposed
that identity formation can be delayed because of prevailing societal or historical
conditions (Waterman, 1982), and sometimes as is the case of the participants in this
study because of personal history. For example, early marriages and pregnancies in some
of the participants established identities as a spouse and parent, but seem to have delayed
identity in terms of vocation. This was apparent in the narratives of Barb, Fiona, Donna,
Anne, and Julie. In the case of other participants, certain precipitating life events may
have prompted participants to re-conceptualize who they wanted to be or bring forward

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possible selves they had been carrying with them, but had not yet enacted. For example,
Julie initiated college full-time in pursuit of a professional degree as she had always
envisioned after a divorce. Donna’s impending thirtieth birthday prompted her to realize
she had not yet started college in pursuit of a professional level degree which had always
been her dream. Marcia (2002) refers to these as disequilibrating circumstances which
facilitate re- construction of an individual’s identity. The individual takes steps, such as
enrolling in an occupational therapy higher education program, in hopes of becoming
“more and more who she or he truly is, as previously undeveloped elements of
personality become realized and new aspects are added” (Marcia, 2002, p. 17).
William James (as cited in Waterman, 1982) proposed that some individuals are
“once born,” but others “go through a second birth or growth crisis in the shaping of their
identity” (p. 342). The findings of the current study suggest that when a specific set of
situational factors intersected for a participant they were triggered to make a change. In
this study, they took steps to enroll in an academic program that they felt would allow
them to achieve the possible self they envisioned.
Once in their programs the voices of the participants illuminated that the college
process itself was facilitating deep changes in themselves. Although these students were
not traditional college age, it is reasonable to assume that the college experience can still
offer them a “time for the greatest gains in identity formation to occur” (Waterman, 1982,
p. 346). The concept of identity being discussed here delves into how one’s identity is
wrapped up in constructing meaning or purpose in life (Damon, Menon, & Bronk, 2003;
Eccles, 2009; Tennant, 2008). Discussions of identity in the literature show the
“motivational properties of identity…identity specifies that which one wishes to become”

171

(Waterman, 1990). When participants enrolled in their programs, they made major
adaptations in their life. They “were acting in such a way as to further the development of
their highest potentials and/or further their purposes in living” (Waterman, 1990). It is
possible that participants were acting in ways that were congruent with the stories they
had created about themselves in their conscious or unconscious mind, what McAdams
calls our personal myth (2008).
McAdams (1993) would state that there are many ways in which people construct
meaning in their life. He feels that adults construct or “re-story” the events in their life to
make meaning, to help them make sense of their experiences. Mc Adams refers to
identity development work as “selfing” and recognizes this as ongoing work in the adult
years (1993). McAdam’s views are an excellent explanatory model for what appeared to
be “in-between the lines” of the participants’ interview, what was not explicitly voiced. It
helped explain the differences in how participants framed their struggles; some with a
more positive lens as they reflected and told their stories, and other participants blaming
others for their struggles. McAdams posits that those with a more optimistic worldview
take more positive steps to confront challenges in their life which was seen in the
narratives of those participants who felt they had grown or matured from handling
obstacles.
Conversely, McAdams work also illuminates what may have been going on in the
narratives of students who consistently blamed others. It is suggested that these
participants grew up with worldviews that came from not feeling they were safe and
taken care of by others. They learned not to trust and they didn’t seem to realize how this
belief has been carried forward in their disposition or mindset (McAdams, 1993; Tennant,

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2008). This phenomenon echoes the work of Erikson. Erikson described trust versus
mistrust as a central feature of the first stage of psychosocial development in his
framework (Roser et al., 2006). Erikson suggested that issues not resolved from an early
stage could affect an individual later in life (Roser et. Al., 2006). For some participants
the opportunity to reflect and recount their experiences in the academic program may
have been the first time they pieced together events of their life into what McAdams
describes as one’s own personal myth. This is essentially a story that embodies their
identity; that makes sense and is psychologically comfortable for the individual (1993).
Altruism: The Importance of Having Purpose
The majority of participants in this study described that it was important for them
to be helping others or to contribute to society. They described this desire as a trait in
themselves. From McAdams’ perspective, they had constructed an identity in which this
characteristic of helping others was a key theme. Waterman (1990) has a slightly
different way of discussing how we all desire to have meaning in life. He states that we
all share potentialities as members of the human race but that we have unique potentials
distinguishing us from others (Waterman, 1990). He says these potentialities or the
daimon in each of us is what we are striving for; a perfection that gives purpose and
meaning to ones life. It is suggested that participants were speaking of being one’s true
self or daimon as it is referred to in eudaimonistic philosophy (Norton as cited in
Waterman, 2004). Participants were in search of a more ideal self, desiring to have more
meaning and purpose in life by helping others and contributing to society.
A study done by Waterman in 2004 showed that altruistic expressiveness was
unique to some students and not present in all undergraduates; some students were

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motivated by instrumental choices in values and goals. In a study done on undergraduate
college students, Waterman (2004) distinguished intrinsically motivated choices from
what he termed instrumental choices. The latter were choices that were more extrinsically
motivated, choices that led to goals which allowed someone to make their way through
the world successfully. Conversely, intrinsically motivated choices were viewed as more
personally expressive; students in this group “had found someone to be” (Waterman,
2004, p. 210). This statement strongly echoed the comments of the participants in this
current study who described how they either wanted to be someone better or someone
different. Although a few spoke of wanting to have more financial security in life, none
of the participants discussed specific extrinsic motivating factors such as a better salary,
house, or car.
Eccles (2009) concurs with the scholarship of Waterman and McAdams when she
states “those parts of an individual’s self-image that are central or critical to selfdefinition should influence the value an individual attaches to various educational and
vocational options” (p. 83). She seems to be describing the participants in this study when
she states “if helping other people is a central part of an individual or collective identity
than this individual should place higher value on ‘helping’ occupations than on nonhelping occupations” (Eccles, 2009, p. 83). The majority of participants in this study
were at a certain point in their lives or had dispositional traits which helped them
recognize “that there is no meaning in life except the meaning man gives his life by the
unfolding of his powers by living productively” (Fromm, 1947, p. 53).
Eccles connects an individual’s identity with career choice stating that career
choice does not just depend on self-efficacy for the occupation but on the congruence of a

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persons’ values with the values inherent in the occupation (2009). Damon‘s (2008) focus
has been studying the idea of purpose in life relative to career choices. In his work he has
discovered that those individuals who are clear about their purpose in life have clearly
defined goals and their purpose “gave them persistence when they ran into obstacles”
(Damon, 2008, p.x). Perhaps the fierce determination expressed consistently by
participants was present because they were very clear, not vague as some students can be,
about why they were pursuing their degree. This hypothesis correlates with a statement
by Waterman who states determination is “commitment that involves making a firm,
unwavering decision…to engage in appropriate implementing activities” (1982, p. 342).
Purpose is not just an internal personal search for meaning, but “it also has an
external component, the desire to make a difference in the world, to contribute to matters
larger than oneself (Damon et al., 2003, p. 121). The body of work on “purpose” supports
the idea that some fields of study and career choices provide more opportunity for
meaning and purpose (Damon et al., 2003). Conceptual work that addresses these ideas
suggests that students who are studying a health profession such as occupational therapy,
which has always been considered a “helping profession,” are unique and worthy of
study.
In summary, the inclusion of perspectives from the identity development
literature, which focuses on the dynamic evolvement of identity during adulthood,
contributes to possible selves theory, and makes this theory increasingly relevant to the
adult learner. In addition, the inclusion of perspectives which speak of the need to find
meaning and purpose in life by living altruistically are especially beneficial to incorporate

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when conceptualizing why learners of any age persist in academic programs which center
on helping others or society at large.
Implications for Further Research
As is often the case, research can find answers; while at the same time pose more
questions. This study found that non-traditional aged occupational therapy students have
unique motivations grounded in altruism and a re-formulation of their adult identity. This
study also confirmed that these students have some things in common with the nontraditional aged student population: the challenge of competing priorities and financial
stress along with the importance of emotional and practical support.
It seems obvious, based on the strength of the first theme that illuminated the
strength of identity reformation, that there should be additional lines of inquiry which
explore persistence with possible selves theory used as a theoretical framework. For
example, how do relationships with others influence our goals in higher education? There
is some indication in the literature that adults re-entering higher education may be
grappling with identity re-structuring (Rossiter, 2007). Given that approximately 50
percent of the student population are adult learners, the research is sparse on the deep
transitions adult learners are making while enrolled (Sissel, Hansman, & Kasworm,
2001). Rossiter continues, “given the centrality of possible selves construction in the
transition to new roles and in motivating goal related behavior, it is clear that the possible
selves perspective may offer insights into adult learning and transformation (2007, p.
141).
It is suggested that more studies be undertaken to determine if possible selves
theory is a relevant framework for additional sub-groups of non-traditional students

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studying in other professions, such as engineering or law. Do these students in other
majors also have unique characteristics? Also, there are many definitions of the term
“non-traditional student.” The current study only focused on students who were nontraditional in terms of age. For example, do students who are non-traditional in terms of
socioeconomic class, race, or gender identification grapple with identity issues and
envision their academic curriculum as a path to a new possible self? Additionally,
students who are not successful could also be studied to understand if a discrepancy in
possible selves caused poor academic performance. In other words, did the student
perceive that there was too large a gap between their actual and idealized self? As
Higgins (1987) suggests did the perceived or actual gap deter them from being
determined enough to make the behavioral choices necessary to succeed? Inclusion of
possible selves theory into the study of persistence in adult learners will assure that all
relevant factors are explored.
The literature on persistence from the fields of higher education and adult
learning does not explicitly discuss the mindset of students, whether one is describing
degree of determination or the mindset of blame versus taking responsibility. Roser and
Peck (2009) make the case that education should help students “develop healthy
mindsets” to prevent “curtailed educational attainment, chronic stress, depressed mood,
substance abuse, ill health and family difficulties” (p. 128). Inquiry in this area may be
especially important in programs that are long and have more rigor than expected by
students. It may also be important to discover if certain programs exacerbate emotional
issues. The findings of this current study suggest that it may be beneficial to explore these
concepts further in relationship to retention and attrition. It would also be beneficial to

177

explore if the pre-dominance of medical issues is common in students who stop out or
leave higher education; or was this a unique situational barrier for this sample of
students?
Also, the role of purpose in life, which includes altruism, would benefit from
being explored in more depth in the professions because as Damon (2006) states:
Professional schools need to find ways to balance the intellectual rigors of the
domain with its fundamental missions, which serve for many students as the
inspiration for entering the profession. This is an essential tension that is not
easily resolved; professional education can err on the side of the balance between
intellectual rigor and the connection with the underlying social mission of the
profession (p. 14).

In summary, possible selves theory and the additional concepts highlighted in this
section can facilitate the development of alternative models of retention or attrition.
Alternative models of retention can offer insight into the nature of persistence in subgroups within the larger aggregate of non-traditional students. Further inquiry in this
direction will assure that retention efforts are maximized for the non-traditional student
population which is at higher risk for attrition (Swail, 2002; Wlodkowski, 2008).
Implications for Practice
One of the most obvious implications for practice is to offer students in the
professions, especially those in the “helping professions,” opportunities for experiential
learning to keep reminding students why they entered their long and rigorous programs.
Experiential learning can help students transform to their envisioned self as an
occupational therapist because they get to think, speak, and act in ways congruent with
the profession. The discrepancy between their current self and their envisioned possible
self becomes less, which in turn promotes positive affect and increased motivation

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(Higgins, 1987). Comments from the participants are congruent with the concept that
experiential learning can be “a valuable pedagogy for promoting both intrinsic motivation
and identity development” (Waterman, 2004, p. 226). Damon refers to this as having the
opportunity to do good work and suggests this should be done in the context of
coursework because developing a professional identity requires that an interest in public
service is required to be a true professional (2006). Therefore, experiential learning is not
only effective for facilitating continued persistence. It is effective at developing the
student to their maximum potential as a professional; a state of being where they are most
likely to be fulfilled and also excel in their profession (Damon et al., 2003).
A related implication for practice is the recognition that adult students in higher
education are not just grappling with financial issues and competing demands on their
time. They are often in the midst of identity re-structuring, which can be an ambiguous
and confusing time for them as well as the people close to them such as spouses, family,
and close personal friends. This fact needs to be recognized by faculty so that they can
incorporate assignments that allow for students to reflect on changes within themselves
and the dynamics that these changes set in motion. The current study showed that nontraditional aged students are often transitioning from their current or “ought to” self to
their desired possible self. There needs to be space in the curriculum for affective
learning about “self.” For example, there could be on-line or in classroom discussion of
the affective learning component, as well as the knowledge based learning that can be
gained from experiential learning activities. Reflective journaling can be made a
requirement in the classes most likely to facilitate deep personal change, such as courses
which involve real world experiences in the community or a health care setting. Assigned

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readings and discussion of topics on the development of professional identity can be
incorporated in the curriculum. Lastly, while expectations need to stay high, empathy for
the turbulence some students may be going through is crucial to support their persistence.
There could also be events or information that allows family members to get
acquainted with and better understand the academic programs that their student family
members are enrolled in. As a result, non-traditional aged students may gain more
understanding from others for the new self they envision and consequently obtain more
support from family members (Kirby, Biever, Martinez, & Gomez, 2004). Kirby et al.
suggest that family members can be included in some campus events so they would feel
less excluded and would better understand the demands on the student family member
(2004). Although it was not mentioned by these authors, there seems to be potential for
this approach to help family members feel they are a part of the student’s new possible
self, hopefully allowing old relationships to stay intact.
Lastly, further study is needed to know if personal health issues or medical crises
are situational barriers common to students who are struggling with persistence, or if this
was a unique finding in the current study. If additional studies show that medical issues
are a factor precipitating academic struggles, then it would be appropriate to offer
students a service to help them navigate the complex health care system in order to
support their persistence. It would also be beneficial to have programs such as Tai Chi,
yoga, and meditation in place on campus which can help support “healthy states of mind”
or “mindsets” which Roeser and Peck (2009) state can decrease the impact of “setbacks
associated with learning new and challenging things” (p. 129).

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Conclusion
This research endeavor has allowed me to learn a great deal about the
persistence of the non-traditional aged student in professional level occupational therapy
programs. However, I also realized while I was writing this dissertation that I had learned
a lot about myself. It dawned on me rather late in the research process that I too am
ingrained with a strong sense of purpose and the need to make a difference in the world,
like the majority of my participants. It helped me understand why I am so uncomfortable
when peers my age retire or speak of retiring. They report the great benefits of leisure
time and their happiness with the changes that came with retirement. Instead of feeling a
desire to join them, I feel a kind of panic at the thought and I have occasionally left the
table to avoid the discussion. This has puzzled me, but no longer. The participants in my
study, along with the literature on purpose, reminded me that for me happiness will
always involve working, being productive in a way that matters, whether it is
employment or volunteer work. For this realization, I thank my participants who helped
me recognize this is not such an unusual way to be in the world; it is a very valid way to
be in the world.

181

Appendices

182

Appendix A

Selected Tables from the:
Academic Programs Annual Report (2008)/2009)
Accreditation and Academic Affairs Division
American Occupational Therapy Association

Table 1
Ethnicity of occupational therapy students:
Total
Caucasian
10,377
Black/African American
741
Asian-American or Pacific Islander
718
Hispanic/Latino/Latina
638
Native American or Alaskan American
45
Multiracial
73
Other
306
Not Available
289
Total
13,187

183

Percentage
78.7
5.6
5.4
4.8
<1
<1
2.3
2.2
100.0

Appendix B

Selected Tables from the:
Academic Programs Annual Report (2008)/2009)
Accreditation and Academic Affairs Division
American Occupational Therapy Association

Table 2
Student Gender:

Male
Female
Missing
Total

Doctoral OT
N (%)
23 (7.6)
280 (92.4)
0
303

Master’s OT
N (%)
1,245 (9.4)
11,846 (89.8)
96 (7.3)
13,091

OTA
N (%)
716 (12.9)
4,731 (85.8)
66 (1.2)
5,513

Table 3
Retention Rates:
Doctoral (n=5)
Masters (n=140)
OTA (n=121)

Minimum
70.0
54.0
43.0

Maximum
99.0
100.0
100.0

184

Average
91.9
93.7
81.3

Appendix C
Figure 1
Pictorial Representation of the
KAWA MODEL
(Iwama, 2006)

Start of OT Program

Near conclusion of OT
Academic Program
For interpretation of the references to color in this and all other figures, the reader is
referred to the electronic version of this dissertation.

185

Appendix D
Figure 2
Pictorial Representation of the
KAWA MODEL
(Iwama, 2006)

Drift wood = personal factors which are assets and/or liabilities
Rocks or boulders = problems, barriers or challenges
River bank = micro-environment such as family and friends and macro-environment such as
political and institutional factors
Water = life flow or life energy

186

Appendix E

Invitation to Participate in Research with the
Potential to Assist Non-Traditional Age OT Students
My name is Susan Tons and I am an associate professor teaching in a combined
Bachelor’s/Master’s level occupational therapy program in Flint, MI. The majority of
students I work with are non-traditional in age and juggle many roles while they pursue
their goal of becoming an occupational therapist. I have loved watching them achieve this
goal, but wonder how they successfully achieved their goal despite obstacles, while
others in their program were less successful. I admire their persistence and hope that the
insight of students near the end of their academic program can help faculty and
institutions of higher education know how to support struggling students in their
persistence, since the number of non-traditional students is increasing.
I am initiating a research study as part of the requirements for a PhD in Education at
Michigan State University. This endeavour gives me the opportunity to pursue this topic
of interest and explore the following research questions:
How do non-traditional age students who have successfully completed (the majority of)
their academic program perceive their experience?
a. What helped them successfully complete the program?
b. What challenges did they encounter and how did they navigate difficulties or
barriers?

I am looking for participants who are willing to be interviewed at a time
and location of their convenience at Weekend College. Participant
requirements:
1. older than 24 years when the OT academic program was initiated
2. ability to be available for a one hour “in person” interview
and a brief follow up interview
3. participants need to be near the end of their academic course work
(have one or two more semesters to complete); Level II Fieldwork
does not have to be initiated yet.
*I would prefer students who have faced challenges of any type,
considered leaving the academic program or “stopped out” for a period
of time.
I am planning on being at Weekend College the weekend of Sept. 17th
and 18th . Please contact me at 517-881-2675 or susan.tons@baker.edu
to set up a time to participate. Other dates are also a possibility.

187

Appendix F
Guidelines for Interviews
*The purpose of the study will be explained and the participant will have the opportunity
to ask questions of the researcher. They will then be asked to read the consent form and
sign it if they are in agreement.
*The participant will be asked how they first heard of the occupational therapy
profession; this will be followed by asking how they became interested in pursuing a
degree in the field.
*The participant will be asked about their educational and employment background, as
well as their family’s background in these two areas. The researcher will also obtain other
demographic background such as age, marital status, family situation etc. by asking the
participant to tell me about themselves.
*Once the participant appears to be at ease with the researcher, the focus of the interview
will move to exploring the phenomenon addressed in the research questions. The
participant will be shown one ore or two different pictorial representations of the Kawa
Model (See appendixes C and D) and the symbols will be explained. I might need to give
an example from a period in my life to demonstrate how someone might use the Kawa
Model to tell their story.
*Participants will be encouraged to tell me what it was like for them in the occupational
therapy academic program from the time they decided to major in occupational therapy
until they completed the academic course work. They will be prompted to draw using the
Kawa Model symbols in order to facilitate their reflection on the topic and verbally
describe in depth what helped them make it through the program. They would also be

188

asked to use this same format to explain and demonstrate what obstacles they faced and
how they overcame them.
*Participants may end up drawing one model that shows their experiences over time, or
they may end up explaining their experiences by showing a contrast between two or more
cross-sections of a river (e.g. the first cross section might show a blockage of life flow
because of so many “rocks”, but then they draw a subsequent river cross section with
more “flow” after the problems were resolved). It is also possible that a drawing will
never be completed by the participant; this is quite acceptable since the purpose of using
the Kawa model is to prompt reflection in order to gain a “data rich” story.
*It will be important for the researcher to make sure no emotional harm is done to the
participant by asking them to reflect back on their experiences. Every effort will be made
to close the interview session on a positive note for the participant.
Guidelines for the Follow-Up Telephone Interview
*Participants will be asked to be available for a follow up phone interview approximately
one to two weeks after the initial in-depth interview. I will have reviewed their data and
made handwritten transcriptions by the time I contact them. I will be ready to ask
additional questions for clarification. The phone interview will also be used to ask the
participants if they thought of anything else they would like me to know or that they
wanted to emphasize.

189

Appendix G: Participant Drawings
Figure 3

This figure was hand-drawn by: Ellen

190

Figure 4

This figure was hand-drawn by: Helen

191

Figure 5

This figure was hand-drawn by: Ivan

192

Figure 6

This figure was hand-drawn by: Fiona

193

Figure 7

This figure was hand-drawn by: Gale

194

Figure 8

This figure was hand-drawn by: Barb

195

Figure 9

This figure was hand-drawn by: Carey
196

Figure 10

This figure was hand-drawn by: Anne
197

Figure 11

This figure was hand-drawn by: Donna
198

Figure 12

This figure was hand-drawn by: Julie

199

Figure 13

This figure was hand-drawn by: Karen

200

Figure 14

This figure was hand-drawn by: Lindsay

201

Figure 15

This figure was hand-drawn by: Nicole

202

Figure 16

This figure was hand-drawn by: Paula

203

Figure 17

This figure was hand-drawn by: Olivia

204

Figure 18

This figure was hand-drawn by: Marie

205

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206

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