Practice placement is an essential part of occupational therapy education. However, many students report feeling insufficiently prepared to work independently, which can contribute to feelings of stress and low professional confidence. The aim of our study was to explore the students’ experiences before and after their placement. We are interested for how theirs professional occupational therapy competencies were developed. Focus group interviews conducted before and after the placement with final-year occupational therapy students. We used the qualitative analysis to analyze the research material, aided by the computer program Atlas.ti. Seven main categories emerged from the qualitative analysis: (1) student preparation; (2) positive expectations regarding the placement; (3) worries regarding the placement; (4) self-evaluation of competencies before the placement; (5) fulfilm- -ent of expectations; (6) problems and fears during the placement; and (7) self-evaluation of competencies and skills after the placement. Occupational therapy students often experience anxiety related to their professional confidence and abilities. Our findings suggest that the following factors are important for competence building: managing student expectations, the ability to link theory with practice, observing progress in clients, building good rapport, recognizing the client as the most important part of the occupational therapy process, and availability of educators. The findings could be useful as the basic knowledge for future home based occupational therapy fieldwork.