When children and youth are referred to rehabilitative services, they, along with their families and teachers, often engage in the rehabilitation process with the belief that, with enough effort, the deficits will decrease or even disappear. It is critical that occupational therapists consider the messages they communicate to the children, youth, families, and communities in which they work. Otherwise, they may run the risk that the outcome of therapy is experienced as "unhelpful at best and harmful at worst", with their clients interpreting their drive to fix as a statement of their lesser value, worth, and potential contribution to their communities. Their intervention efforts, rather than help, may then be implicated in the development of serious negative consequences for the children and youth with whom they work when these individuals compare unfavorably to the typical standards of childhood development. Guided by their professional ethics, the author stresses that occupational therapists must push back against the forces that buttress practice troughs, and forge new pathways for making a difference that is positive, just, and respectful of the bigger picture. If they fail to recognize the potentially negative impact they can have on their clients, they run the risk of helping to catalyze the 50% of all adult mental health disorders that begin during adolescence.