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The title of this chapter is inspired by Australian penal history, in that one of the punishments used by prison officers in early Australia was calleda labour in vain'. The precise nature of the punishment varied, but essentially it involved the prisoner engaging in a futile activity. One form of labour in vain was for prisoners to be given a metal bucket and told to polish it until the bucket shined. As the buckets were used as toilets or to clean out the prison cells there was no need for them to gleam, given that soon after the bucket had been polished it would once again be dirty: the task was futile and meaningless. At first thought, a labour in vain may seem nothing more than an interesting historical anecdote. It is my contention, however, that this early form of punishment is a useful way to consider modern occupational therapy practice. In particular, it is worth considering three key questions: do the people who receive occupational therapy as clients labour in vain, do individual occupational therapists labour in vain in their attempts to address the occupational needs of clients, and finally is the profession of occupational therapy labouring in vain in its attempts to raise awareness of the occupational needs of humans?

It is my suggestion that the answer to the first of these questions is yes, sometimes, but not always, occupational therapists do subject their clients to the clinical equivalent of a labour in vain. The answers to the remaining two questions are more complex. It is probably true that many, but not all, occupational therapists work in systems and environments which make it difficult to address the occupational needs of their clients. This is most often due …