Complexity – A Challenge in Occupational Therapy Research


In general, when research involves humans, it is not as simple to study and attribute variables to an intervention compared to other methods and means such as in the laboratory with laboratory mice. As occupational therapists often highlight and value the importance of the individual and use client-centered approaches, research in the field is often not as straightforward. Therefore, research will often attribute improvement in overall function, e.g., in older adult populations due to occupational therapy, but pinpointing the exact intervention may not so easy.

Occupational therapists often use multiple interventions, theories, and approaches. In a systematic review that studied whether occupational impacted functioning in community-dwelling adults, Coninck et al., described how interventions first involve a multidisciplinary team. At the very minimum, it may be a primary care provider and an occupational therapist. Oftentimes, there are physical therapy/physiotherapists, registered nurses, registered dietitian, social workers, general practitioners, geriatricians, and/or case managers.


Occupational therapy approaches include client-centeredness, empowerment, education/information, embedding within meaningful activities, and collaboration. “This is inherent to OT because a high-quality OT intervention takes into account a number of characteristics of which “client-centered” and “tailored made” are two. For this reason OT interventions will vary because they are tailored to the personal and environmental characteristics and will therefore rarely be rigidly prescribed.”


One way to simplify the complexities of human behavior and the effect that occupational therapy interventions may have is by using theories and a frame of reference. Many theories and FORs take into account variables such as the environment, social circles, habits, routines, personal motivation, etc. Examples include PEO-P and MOHO.

In my master’s capstone, we were able to use MOHO to organize the rich amount of data in our qualitative research using 1:1 interviews with clients while addressing components of human nature, interactions, and their occupations. A good place to begin when framing a research question is to use a particular model or frame a reference that is appropriate for your study population. For example, if you are aiming to study an Asian population, the KAWA model may be better for cultural-based and aware OT research. After this, you may reframe your research question and use a model to guide your research design. We used MOHO to guide how we framed our specific interview questions for our participants.


De Coninck, L., Bekkering, G. E., Bouckaert, L., Declercq, A., Graff, M. J., & Aertgeerts, B. (2017). Home‐and community‐based occupational therapy improves functioning in frail older people: A systematic review. Journal of the American Geriatrics Society65(8), 1863-1869.