Putting occupation into practice: occupation as ends, occupation as means.

This article addresses a difficulty that many occupational therapists experience: maintaining occupation as the core of their therapeutic intervention. This difficulty not only results from but also contributes to occupational therapy's struggle with professional identity. Current manifestations of the problem are described as component-driven practice and the narrowing of occupation to basic activities of daily living. The concepts of occupation as ends and occupation as means are proposed as a practical solution to guide treatment planning and merge remediation and adaptation within a single occupational session. Each concept is investigated in terms of its history within the profession and its usefulness for analyzing and solving therapeutic problems. These concepts are discussed as useful guidelines to help occupational therapists not only in their clinical decision making but also in their understanding and expression of the field's unique expertise. A case example, applying occupation as ends and occupation as means to evaluation and treatment, is presented.