This paper provides a review of the literature on three common treatment approaches used with individuals with Alzheimer's disease: reality orientation, validation therapy, and reminiscence therapy. An operational definition is provided for the three modalities, all of which will be evaluated according to their theoretical rationale, intended therapeutic population, cost of training and implementation, effects of intervention on staff, intensity of interven-, tion, and observed behavioural, cognitive, psychosocial, and functional changes as a result of intervention. It was found that reality orientation and validation therapy fail to provide adequate observable changes in clients to support the cost of implementation, and that more research has to be done into reminiscence therapy prior to its wide-spread implementation. It is suggested that occupational therapists can provide activity groups and specific skills training which will elicit the same, or better, outcomes at a diminished cost.