Objectives. Occupational therapy literature has long recognized meaning as central to therapy. By focusing almost exclusively on how the therapy process influences the experience of meaning, the literature has neglected to examine how the patient's experiences before therapy influence the creation of meaning in therapy. Method. Building on a previous study of how patients discover and recount the meaning of their own lives in volitional narratives, we investigated the effect of those narratives on the experience of therapy. Results and Conclusion. Our examination of the therapeutic experiences of two patients enrolled in a psychiatric day hospital program reveals how they assigned meaning to therapy as an episode within their larger volitional narrative.