Evidence-based practice is one of several emerging 'hot' topics in the field of health care, with occupational therapy being no exception. Indeed, it is only right to take the time to assess the evidence for and against new and/or established treatments to ensure that our clients are receiving the best possible care. Randomised controlled trials are considered the gold standard of providing the evidence on effectiveness of therapeutic intervention. In the field of occupational therapy, we argue that it is not always possible or appropriate to use randomised control trials as either a source of evidence, or a means to establish evidence to support the everyday practice of occupational therapy. High quality observational studies and single system research studies are proposed as viable alternatives to provide evidence on effectiveness of occupational therapy intervention.