This paper introduces a practice model based on the occupational adaptation frame of reference (Schkade & Schultz, 1992). The occupational adaptation practice model emphasizes the creation of a therapeutic climate, the use of occupational activity, and the importance of relative mastery. Practice based on occupational adaptation differs from treatment that focuses on acquisition of functional skills because the practice model directs occupational therapy interventions toward the patient’s internal processes and how such processes are facilitated to improve occupational functioning. The occupational adaptation practice model is holistic. The patient’s occupational environments (as influenced by physical, social, and cultural properties) are as important as the patient’s sensorimotor, cognitive, and psychosocial functioning and the patient’s experience of personal limitations and potential is validated. The integration of these concepts drives the treatment process. Through a description of treatment with a variety of patients, this paper presents the model’s diversity and illustrates the relationship between the concepts. The occupational adaptation practice model reflects the uniqueness of occupational therapy and integrates the profession’s historical practice with contemporary interventions and methods.