Though there is a gradual increase in research evidence supporting the benefit of occupation-based care in the general rehabilitative setting, little is available in the hand therapy literature. Hand therapy, much of which is based in the biomechanical approach of the medical model, poses particular difficulty for the occupational therapist (OT) to incorporate occupation into patient care. However, when looking at the patient holistically, the greatest need and opportunity for an occupation-based approach occurs during the first encounter with the patient.