In occupational therapy practice, well designed groups represent social and cultural contexts for occupational performance in everyday life. Group Dynamics in Occupational Therapy: The Theoretical Basis and Practice Application of Group Intervention, the best-selling text for over 25 years by Marilyn B. Cole, has been updated to a Fifth Edition, offering strategies and learning tools to place clients in effective groups for enhanced therapeutic interventions. Updated to meet the AOTA’s Occupational Therapy Practice Framework, Third Edition, this Fifth Edition provides guidelines for occupational therapy group design and leadership and guides application of theory-based groups. The theory section clarifies how occupation based models and frames of reference change the way occupational therapy groups are organized and how theory impacts the selection of group activities, goals, and outcomes. Recent examples and evidence are added in this Fifth Edition to reflect the design and use of groups for evaluation and intervention within the newly evolving paradigm of occupational therapy. The third section focuses on the design of group protocols and outlines a series of group experiences for students. These are intended to provide both personal and professional growth, as well as a format for practice in group leadership, self-reflection, cultural competence, and community service learning. A new chapter focusing on the recovery model and trauma-informed care suggests ways for occupational therapists to design group interventions within these broadly defined approaches. Cole’s 7-step format for occupational therapy group leadership provides a concrete, user-friendly learning experience for students to design and lead theory based groups. The settings for which students can design group interventions has been updated to include current and emerging practice settings.