Family engagement is a central ideology in pediatric occupational therapy; however, the literature indicates that engaging families is challenging in the school- based context. The purpose of this study is to explore occupational therapists' and families' experiences of family engagement in school-based occupational therapy services and to propose stakeholder-informed improvements to service delivery. An interpretive description design was applied. Interviews were the primary method of data collection and were analyzed using inductive thematic analysis. Family engagement was depicted metaphorically as a group dance. The findings outline how therapists' and families' capabilities and expectations, trust, communication, emotional connections, and contextual factors interact to impact family engagement. Important changes to practice are required. Technology might enhance opportunities for connection and communication. The adoption of service delivery models that endorse a needs-based approach to service, rather than a 'one-size-fits-all' approach, are necessary to increase the value families place on this service.