Abstract
Service user involvement in the delivery of health care is now a government priority yet, with some exceptions, it does not seem that the occupational therapy profession is meeting the challenges that this poses. In the light of the profession's emphasis on client-centred practice and individual empowerment, this is surprising. The authors argue that professional insecurity and role uncertainty are inhibiting the vigorous development of advocacy in occupational therapy. They propose that a preoccupation with establishing professional demarcations prevents the openness necessary for the lively and genuine involvement of service users.
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