Metaphors are powerful devices for eliciting images of practice. Exploring the metaphors of occupational therapy students provides educators with insight into students’ prior knowledge and the constraints their ideas may present in practice. Metaphorical images of helping held by newly enrolled and Level II fieldwork students were examined. Responses to a structured, open-format questionnaire revealed that the two groups were in agreement about conceptualizations of helping. The findings suggest two overarching themes: (1) the importance of client-centered practice and (2) the inevitability of client autonomy and responsibility. These results imply that educators must prepare students to face the realities of practice: working with unmotivated clients and engaging them in meaningful occupations. Thus, a continued emphasis on client-centered practice and the requisite listening skills for a therapeutic alliance are needed. Research should build on the insufficient knowledge of what happens to identity development in the transition from curricula to practice.