This research examines the lived experiences of six novice occupational therapists (0–2 years experience) and eight career occupational therapists (≥ 5 years in the everyday practice in adult rehabilitation. The study focused specifically on therapists’ experiences of working together with patients and the ways in which these experiences unfolded over the course of therapy. Data were generated using a combination of phenomenological interviews with all 14 therapist-participants (Phase I) and participant observation of four therapist-patient dyads throughout the course of rehabilitation therapy (Phase II). Verbatim transcriptions of all interviews from Phase I and Phase II and field notes from Phase II were analyzed using a narrative approach. The analysis revealed that Finding Common Ground was a shared meaning of working together with patients regarding therapy goals and expectations. Findings suggest that occupational therapists may resist negotiating differences with patients over therapy goals and expectations and instead rely primarily on compatibility as the basis of finding common ground. Findings reveal the importance for occupational therapists to be (1) open to negotiating differences with patients over goals and expectations, (2) aware of the ideologies that may influence their practices, and (3) adequately prepared to deal effectively with the challenging interpersonal aspects of practice.