Background/aim:' Anecdotally, occupational therapists have identified problems of lack of professional recognition. This situation can mean that health service users' occupational needs are unmet and it can also cause difficulties for the profession of occupational therapy. Therefore, the study described in this paper aimed to better understand the issues of describing occupational therapy in a hospital setting and use this understanding to improve representations of occupational therapy. Methods:' Fifteen occupational therapists engaged in two action research cycles of reflection'action'evaluation over an 18-month period in 2004 and 2005. Transcriptions of individual interviews and group discussions of the participating therapists formed the main dataset. Data were qualitatively analysed. Results:' Participating therapists discovered that the occupational therapy profession is not accorded the regard that it deserves and that the profession is not well understood by others. In addition, occupational therapists may be contributing to this lack of awareness and regard through their own unconscious overly conformist behaviour that contributes to the presence of hegemony and professional image problems. Conclusion:' Therapists are encouraged to engage in questioning of the taken-for-granted dominance of medical discourses upon their practice. Furthermore, ongoing reflection upon their own attitudes and behaviours may enable occupational therapists to improve professional recognition, representation and autonomy.