Recent literature has changed the ways in which occupational therapy is delivered in mainstream schools, but consideration of practice in specialist schools, where all students have special educational needs or disabilities, is limited. This study aimed to address this gap by exploring occupational therapy practice in specialist schools in England. This qualitative study used a phenomenological approach. Data were collected via semistructured interviews and analyzed using thematic analysis. The study had 6 occupational therapist participants. Three themes emerged from the data: Theme 1: "I'm going to be really honest with you, we're not doing therapy;" Theme 2: "We are not entirely part of the school community;" and Theme 3: "You shouldn't have to try and make someone else the therapist." The findings echo studies of occupational therapy in mainstream schools but offer new insights into the focus and delivery of occupational therapy in specialist schools. It is recommended that in England a new model of service provision is developed that integrates occupational therapists into specialist schools, creates more time in the classroom, facilitates therapist-teacher collaboration, and enables a broader scope of practice.