This article in Occupational Therapy International journal describes a three-phase project to identify and develop an occupational therapy response to the challenges experienced by caregivers of middle-aged and older adults with MS. In Phase 1, 302 caregivers of middle-aged and older adults with MS were interviewed by telephone to identify the caregiving challenges they experienced. A total of eight challenges were identifi ed, with the four most prevalent ones including fi nding and using formal support services, managing the emotional aspects of caregiving, doing the physical aspects of care-giving and dealing with informal supports. In Phase 2, a comprehensive literature review was conducted to identify existing caregiver education programs that could be used to address these challenges. None of the 21 programs that were located addressed all of the challenges identified through the Phase 1 interviews. In response, a new fi ve-session psycho-educational group program titled “Meeting the Challenges of MS” was developed in Phase 3. The program was empirically grounded in Phase 1 findings, and drew on theory to guide group process and sequencing. The fi ndings from Phases 1 and 2 and the resulting program cannot be generalized to caregivers of younger adults with MS, although the steps taken to develop this program have the potential for replication with other populations served by occupational therapists. (Available from: http://www.pubmed.gov PMID: 18203107)