Challenges for occupational therapists working with clients who choose illicit, immoral or health-compromising occupations

Understanding how people derive meaning and purpose from illicit, immoral, and health-compromising occupations is of great interest to occupational scientists. For occupational therapists, who predominantly work to attain healthy outcomes for their clients, the issue is a vexed one. There is no universal way of managing the challenges involved in supporting clients to attain occupational therapy goals that are not necessarily aligned with health, morality, or law. This chapter presents a way of approaching those challenges using a structured professional reasoning approach that embraces multiple ways of thinking and encourages clinicians to balance a range of perspectives before drawing conclusions about the best way to proceed.