The Occupational Therapy Practice Framework: Domain and Process (OTPF) summarizes the interrelated constructs that describe occupational therapy practice. It is intended for a wide audience of occupational therapy practitioners and students, other health care professionals, educators, researchers, payers, and consumers. This 4th edition (the OTPF–4) continues its predecessors’ mission to provide structure and guidance for practitioners to achieve the distinct value of occupational therapy in the clinic and other settings. An American Occupational Therapy Association (AOTA) official document, the OTPF is reviewed on a 5-year cycle. The review period includes the voices of AOTA members, scholars, authors, practitioners, AOTA volunteer leadership and staff, and other stakeholders to ensure that the document maintains its integrity while responding to emerging concepts and advances in occupational therapy. The OTPF–4 includes the following changes: Increased focus on group and population clients Identification of the cornerstones of occupational therapy practice, foundational to the success of occupational therapy practitioners More explicit description and definition of the terms occupational science, occupation, and activity Changes in terminology to accord with the taxonomy from the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) Inclusion of gender identity as a client factor under “experience of self and time” Discussion of transitions and discontinuation as outcomes to occupational therapy services Discussion of patient-reported outcomes Five new tables to expand on and clarify concepts. The OTPF–4 represents the latest articulation of the occupational therapy domain and process, building on a set of values that the profession has held since its founding in 1917. Embedded in this document is the occupational therapy profession’s core belief in the positive relationship between occupation and health and its view of people as occupational beings.

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