Despite its prominent place in the Occupational Therapy Guidelines for client-centred practice, the exact role of spirituality in clinical practice has been difficult to delineate. In this paper current concepts of spirituality are outlined and ways in which these concepts have been applied in health care are described. To illustrate these spiritual concepts, the experiences of individuals whom the authors have met in their clinical practice are outlined in a series of vignettes. Finally, a revision of the model of occupational performance which enhances consideration of spirituality in occupational therapy practice is proposed, and some guidelines for occupational therapists wishing to incorporate spiritual concerns in therapy are suggested.