A randomized controlled trial investigated the effect of client-centered Occupational Therapy on individuals with spinal cord injuries (SCI). Twenty-one subjects, 4 to 6 months post acute rehabilitation, received eight in-home, client-centered Occupational Therapy sessions or eight visits from social visitors. The Functional Independence Measure (FIM), the Craig Handicap Reporting and Assessment Technique (CHART), the Role Checklist and the Life Satisfaction Inventory-A (LSIA) were administered pre and post interventions. Analyses showed no differences between groups on the CHART and the FIM; the Role Checklist showed the Occupational Therapy group took on a limited number of new life roles; however, a statistically significant difference was found between groups post intervention for LSIA (p < 0.05).