This article will identify beliefs and values held by Certified Occupational Therapy Assistants. These beliefs and values differ from those held by the mainstream culture of the occupational therapy profession and have resulted in the evolution of a subculture among certified occupational therapy assistants. This subculture has the potential to become a force that positively or negatively influences its members as well as the occupational therapy profession. The author will propose strategies to resolve some of these differences, to support certified occupational therapy assistants who will accept responsibility for the challenges which confront them and become a positive force within the mainstream culture of the occupational therapy profession.