Gavin, aged 43 years has a diagnosis of Asperger syndrome and lived with his father all his life until his father’s death. Although very independent, Gavin had difficulty adjusting to life without the support and guidance his father had provided. He was referred to an Occupational Therapist, Annabel, who worked regularly with Gavin to teach him some practical aspects of daily life. As they got to know one another, Gavin felt gradually able to share his anxieties, which enabled Annabel to identify some unexpected areas of vulnerability. For instance, she discovered one day that Gavin had fallen down the stairs in the night and cut his head very badly. He did not seek medical help because he knew his local surgery would be closed and could not judge whether his injury constituted an emergency. From the blood loss and concussion symptoms he described, it clearly had. Gavin needed guidance in this area to keep him safe.