Occupational therapy is a related service when provided within the public schools, which means that services must enhance or support educational goals. Three service provision models have been described for school therapists: direct service, monitoring, and consultation. Direct service addresses individualized needs that require specialized intervention strategies which can safely be performed only by the occupational therapist. Monitoring, which is sometimes referred to as integrated programming, uses therapeutic expertise within functional tasks to maximize opportunities for practice and generalization. Consultation addresses problems by enabling others to work more effectively on the educational goals they have set for the students. Evidence is accumulating to demonstrate that each model is effective when chosen and applied appropriately. This paper reviews each model, provides examples of studies that have been conducted, and suggests directions for future research.