As the number of therapists in mental health settings continues to decline, research is needed to explore the scope, satisfaction, and efficacy of services. In this study, we used Patton’s (1997) Utilization-Focused Program Evaluation to explore scope of services, therapist and client satisfaction, and perceived efficacy of services in a free-standing community-based mental health occupational therapy clinic. Surveys were administered to 36 clients and 9 therapists and followed up by qualitative interviews with 6 therapists. We identified characteristics unique to a free-standing psychiatric occupational therapy clinic, along with factors contributing to satisfaction and perceived efficacy of services. The importance of a supportive therapeutic environment and emphasis on the therapist–client relationship were cited as key factors influencing both satisfaction and effectiveness of service. Results are presented and compared with the existing literature.