Direct support workers are a key link in the effort to integrate adults with developmental disabilities into society. Due to low pay, the difficult nature of the work, inconsistent training and the undervalued state of the profession, staff turnover is high and client skill development suffers as a result. Inspired by the author's practicum experience, the following research question was developed: What experiential process of adaption, rejection or acceptance do direct support staff working with developmentally disabled adults in Japan and the United States go through? For the purpose of this study, field interviews were conducted with direct support workers at facilities for adults with developmental dis abilities in Shimane, Japan and Vancouver, Washington. The study results suggest that due to the challenging nature of the work, direct support workers experience repeated stages requiring ongoing adaption to difficult situations and behaviors. These workers will need to overcome and accept challenges if they are to remain in the field. Particularly in the United States, a majority of such workers soon reject the work and leave.