The American Occupational Therapy Association’s Centennial Vision advocates for an emphasis on intervention and prevention services for children, young people, the aging, and those with severe and persistent mental illness. This article discusses mental health issues among adolescents in foster care, a population that would greatly benefit from occupational therapy services emphasizing skill development in the areas of independent living, vocation, and health. Additionally, current intervention modalities used by other disciplines with adolescents in foster care are explored. Finally, a pilot study demonstrating the opportunities for occupational therapists to influence the long-term outcomes of adolescents in foster care is described.