Abstract
{\it Objective:} Occupational therapists specializing in hand therapy are challenged to provide care that reflects foundational concepts of occupation and holism. The researchers investigated cost containment influences on occupational therapists specializing in hand therapy to determine how therapists provide holistic care within cost containment constraints.
{\it Method:} Five hand therapists were chosen based on selection criteria of hand therapy and holistic care practice. Using a grounded theory approach, the researchers gathered data via interviews and clinical observations. Data were analyzed through open, axial, and selective coding, and critiqued by an expert panel for emerging theory and concepts.
{\it Results:} Occupational therapists developed new skills or refined existing skill through adapting, educating, and strategizing in response to environmental demands. Tenets of the occupational adaptation model matched the strategies used by the participants.
{\it Conclusion:} Occupational therapists specializing in hand therapy adapted to cost containment constraints by modifying professional settings and skills, educating multiple consumers, and implementing innovative interventions.