Dr. Anne MacRae designed this Fourth Edition to meet practice challenges as the occupational therapy profession continues to evolve to meet the current needs of our communities. It includes specific examples of programs, groups, assessments, activities, techniques, approaches, and outcomes. Inside Cara and MacRae’s Psychosocial Occupational Therapy: An Evolving Practice, Fourth Edition:•All new chapters on philosophical worldviews, psychiatric institutions and hospitals, community behavioral health services, and direct service provision, as well as consultation and program development.•Reorganized and expanded chapters on built, virtual and natural environments, as well as cultural identity and context. •A new chapter on personal and social identity discusses the aspects of identity that are linked to mental wellness/illness including personal choice, family, roles and habits, spirituality, rituals and traditions, as well as the profound effects of trauma, stigma, poverty, and violence. •Trauma, stigma, poverty and violence are also identified throughout the text, especially in the case illustrations.•Revised chapters on mental health of infants, children, adolescents and older adults. •New chapters on mental health of emerging adults and mid-life adults.