Hard Complexities – Soft Complexities: An Exploration of Philosophical Positions Related to Evidence in Occupational Therapy

The practice of occupational therapy rests upon the ontological assumption that there is a relationship between engagement in occupation and health. Different traditions of knowing about and investigating this relationship are evident within the literature. The professional link with biomedicine has led to an adherence to positivistic methodologies but, as the profession has begun to generate discipline-specific knowledge, inquiry approaches consistent with interpretative and critical theory have become evident. This paper explores the nature of inquiry underpinning current practice. It suggests that contemporary developments have been a reaction to a climate of uncertainty, generated by rapid political, fiscal, technological and ideological change in the delivery of health and social care in the last four decades. From these rapid changes, different views of ‘best practice’ have developed: evidence-based, reflective and reflexive practice, each with its own source of knowledge and method of inquiry. It is postulated that each of these views has implications for education, practice and research.