Abstract Objective: to investigate (1) whether differences in occupational therapy practice exist between general and psychiatric care and (2) whether differences in occupational therapy practice exist between general care settings. The four most common settings where occupational therapists work in the Netherlands (nursing homes, rehabilitation centres, general hospitals and psychiatric hospitals) were studied. Method: a total of 143 therapists, working in 49 occupational therapy departments, participated in this study. They collected data on 1051 patients. For each patient a standard registration form, based on the International Classification of Impairments Disabilities and Handicaps (ICIDH) was filled out. This form contained information about (i) patient characteristics (ii) occupational therapy diagnosis and treatment goals in terms of ICIDH and (iii) treatment characteristics. Results and conclusions: occupational therapy treatment goals and interventions showed clear differences between psychiatric and general care settings. The differences in occupational therapy practice across general care settings were small. Copyright © 1996 Whurr Publishers Ltd.