Career expectations contribute to job satisfaction, which ultimately affects personnel retention. This paper focuses on a current trend in career literature: career self-efficacy, judgments about the efficacy of one’s career choice and adjustment. Career self-efficacy is relevant to occupational therapy in that therapists are leaving the profession because of unmet career expectations. This paper explores Bandura’s self-efficacy theory (the basis of career self-efficacy) and discusses the authors’ experience in clinical practice and education relating the application of career self-efficacy to occupational therapy. Suggested methods for enhancing career self-efficacy include the implementation of a professional development course based on Bandura’s self-efficacy theory; incorporation of self-efficacy content into the professional theory and practice courses; clinical supervision that creates realistic self-perceptions of performance during the fieldwork experience; and transitional programs for entry-level practitioners that identify and explore personal career expectations and support for the experienced practitioner.