Little is known about the attitudes of psychiatric patients towards the specific role of occupational therapy within the overall context of hospital-based treatment. The present study examined this issue by asking 102 adult psychiatric inpatients to indicate their reasons for participating in an occupational therapy group programme, and comparing their responses to those of 31 occupational therapists. Both groups gave high ratings to "reasons for participation" that were related to the achievement of positive therapeutic outcomes, although therapists rated these items significantly higher. The patients, on the other hand, gave higher ratings than therapists to items related to escaping the hospital routine (e.g., "to decrease boredom"), and to achieving "secondary gains" (e.g., to get passes to leave the hospital). The results emphasize the importance of preparing patients for participation in therapy groups in order to enhance the therapeutic value of these experiences.