Objective: Researchers explored the knowledge, attitudes, and use of shared decision making (SDM), involving occupational therapists and their clients discussing the available evidence and client’s preferences throughout occupational therapy (OT). Methods: Researchers analyzed surveys using binomial logistic regressions to identify if age, education, years as an occupational therapist, average hours worked per week, average length of intervention sessions, clients treated, and work setting were predictors of SDM knowledge, attitude, and use. Results: Participants (N = 462) were predominantly female licensed occupational therapists with past or current work experience. Participants most commonly worked in hospitals, skilled nursing, or outpatient facilities, and treated client groups were clients with musculoskeletal and neurological conditions. The models predicting SDM knowledge (χ2 (17) = 49.375, p < .0005), SDM attitude (χ2(17) = 100.739, p < .0005), and SDM use (χ2(17) = 120.020, p < .0005) were significant. Occupational therapists treating geriatric clients and clients with developmental disorders had 10.139 and 2.5 times the odds, respectively, to have SDM knowledge. Occupational therapists treating clients with musculoskeletal or developmental disorders, and geriatric clients had 15.358, 14.373, and 14.872 the odds, respectively, to have positive SDM attitudes.SDM use was more likely (19.412 times) during longer treatment sessions and sessions that involved clients with learning disabilities (3.873 times). Conclusion: Researchers found that therapy session length and client condition contributes to the use of SDM. Therapists were more likely to use SDM when they had greater knowledge of and a positive attitude toward SDM.