Adjustment challenges can be further complicated by cul- tural contrasts between home and school settings and a change in the type and frequency of contact with primary caregivers.4,16,17,19 Moreover, first-year students may be in- troduced to unhealthy behaviors, some of which may be mal- adaptively adopted as coping mechanisms (eg, binge drink- ing, drug use).20 The university environment also stirs nearly every student’s innate desire to belong, to feel socially ac- cepted.5 When that need is not easily or immediately met, intense homesickness can result.21