A differentiated model of self-esteem, based on William James’s (1890), C. H. Cooley’s (1902/1968), and G. H. Mead’s (1925/1968) works and developed by Dr. Susan Harter (1983), is presented as a valuable tool for the occupational therapist to use in evaluation and intervention. Competence and social support are considered important components, and discounting is presented as a mechanism for the maintenance or improvement of self-esteem. Social comparison, social desirability, and defensiveness are discussed as important considerations, particularly regarding children with disabilities.