Environmental disasters cause deaths, injuries, and destruction of familiar surroundings. Social networks and routines that structure daily life are often left in disarray. To surmount subsequent crises, survivors must master painful feelings, solve problems, and accomplish important tasks, even while they are confused, bereaved, and displaced. Otherwise, coping failure leads to a vicious spiral of loss of self-esteem, distrust of the environment, and abandonment of social roles. Both crisis intervention and disaster literature advocate concrete and practical treatment measures. Activity intervention can prevent and reverse the destructive downward spiral by facilitating victims’ most effective coping responses. This paper reviews the pertinent literature and sets forth a theoretical model for occupational therapy in post-disaster settings.