This article describes the development of the Occupational Performance History Interview, an instrument designed to gather an accurate and clinically useful history of an individual’s work, play, and self-care performance from psychosocially and/or physically disabled adolescents, adults, and older persons. Following the identification and validation of content and the development of format, the instrument was field-tested and revised. An examination of reliability across time and raters indicated that although part of the instrument ratings met or exceeded levels of acceptable stability, further development and testing is indicated.