Purpose: We explored how occupational therapy (OT) is practiced, and how the nation's long-term care (LTC) policies affect therapists' motivation to practice OT in indigenous townships. Methods: We conducted an ethnographic study with 2 therapists who provided OT services in 2 indigenous townships in southern Taiwan. We used in-depth interviews and participant observation to study therapists' working conditions and therapeutic processes with 2 therapists and 4 treatments. In addition, we held one focus group for each indigenous townships. For each focus group, we had members of the Council of Indigenous Peoples, LTC management centers, city health bureaus, regional hospitals, and township health centers. Results: Therapists' healing programs incorporated indigenous cultural elements, such as language, important interpersonal relationships, and material creations (e.g., homemade furniture); they incorporated culture into LTC. However, there exist individual (i.e., therapists'career goals, occupational achievements, occupational status, and social identities), institutional (i.e., professional goals and supports, cultural boundaries, and tribal political ecology), and political (i.e., national LTC policies, and salary structure) factors demotivate therapists to practice OT in indigenous townships. Conclusions: To encourage occupational therapists to engage in cultural care of indigenous townships, the government should actively remove all individual, institutional, and political obstacles.