Sylvia docker memorial lecture: Together we go further-Service co-design, knowledge co-production and radical solidarity

Background/aim Occupational therapy can be essentially described as enabling social inclusion through occupational participation. How does this best happen? The answer is through working in deeply collaborative, power and knowledge sharing partnerships with individuals, families, communities and populations of people across contextual boundaries. Methods In this lecture, critical consideration is given to first, ways of working with communities of interest in service co-design, knowledge co-production and as co-researchers and how the philosophical underpinnings of the profession are consistent with such approaches. The second part of the lecture examines epistemic and hegemonic 'blind-spots' of the profession which can act as barriers to such person centred interactions, further reproducing dynamics of exclusion and marginalisation of already vulnerable persons and communities. Finally, the lecture considers the 'next era' in occupational therapy in which, in response to entrenched situations of occupational injustice globally, we may work with people in what has been termed 'radical solidarity' using de-colonising and occupation-centred approaches such as the Participatory Occupational Justice Framework and the Capabilities, Opportunities, Resources and Environments approach. Results Using approaches that represent authentic partnerships between occupational therapists and the people they serve can result in powerful and potentially transformative outcomes. This is because working with people as co-designers of services and as co-researchers in evaluating service effectiveness, means that knowledge is co-produced within specific contexts. This in turn means the traditional evidence/practice gap is closed. Conclusions Working in authentic, power sharing partnerships with diverse people in diverse settings using diverse approaches, will be the way in which occupational therapy can make its strongest societal contribution. Aligning occupational justice with epistemic and hermeneutic justice is fundamental to this vision, providing a platform in which members of the profession can work collaboratively with people and go further together towards societal change.