The importance of embracing complexity in rehabilitation

Abstract

In practice, clinicians recognize that the effectiveness of a rehabilitative intervention will be influenced by a range of uncontrollable, interrelated factors.1 For at least 40 years, a holistic, ‘whole person’ approach has acknowledged, albeit implicitly, that many factors will affect the success of an intervention.2 These influences are numerous and relate to social, personal, political and cultural variables: the very elements which together form the complex context in which rehabilitation occurs.3, 4 The term ‘complexity’ is often used throughout rehabilitation; notions such as complexity in practice, complex patients and complex problems are all familiar enough.1, 5, 6 To understand what we mean by complexity, a contrast may be helpful: a system we think of as complicated has many intricate elements that, whilst they can interact with one another in several ways, do so in a linear and predictable fashion; within a complex system, however, these intricate elements interact in ways that cannot be easily understood or predicted.4 Consequently, it is simple enough to foretell the behaviour of a complicated system, but impossible to perform the same feat with a complex one.