Kawa model
[1][2] Iwama aimed to develop an occupational therapy model that could be easily understood by clients, not just practitioners and scholars.
[3] The Kawa model is the first in occupational therapy "developed from clinical practice outside of the Western English-speaking world through qualitative research.
"[1]: 1 Because "Eastern culture emphasizes the harmony between the person and environmental factors, which is believed to enhance health and well-being[,] ... the model focuses heavily on the client's environmental contexts and how that impacts the flow of harmony in life, rather than mainly focusing on the individual client.
[4] Because "water is fluid and ever changing,"[5]: 373 it reflects the dynamic nature of occupation and the constant interaction between individuals and their environment.
[6] According to the model, if the river has a "strong, deep, unimpeded flow,"[7]: 1129 the individual should experience optimal well-being.
"[4]: 1 The concept of "rocks" represents obstacles, challenges, and life events that may disrupt or impact a person's occupational well-being.
[4][5] The concept of "spaces" represents "opportunities for expanding flow and well-being in accordance with the client's perspective and priorities.
OTs can work with their clients to decrease the size of rocks, widen the river banks, and/or better utilize driftwood.
To widen the metaphorical river banks, OTs may work with clients to implement universal design methods into their daily lives and/or find other ways to alter the physical environment to make it less of a barrier.
Lastly, OTs can work with clients to better utilize existing skill sets and attributes and/or develop new ones to help address barriers.
[8]: 10 When utilizing the Kawa model, OTs often begin by requesting their clients create a visual representation of their life using the river metaphor.
Participants in the study found that using the model provided new opportunities for collaboration across the care team; they determined the tool could be effectively used within their profession.
The greatest finding across all use cases "was that the Kawa model provides a unique platform for open communication and deeper perspective.
"[1] Other strengths include its ability to be culturally responsive and client-centered, as well as how it helps develop partnerships and collaboration.
[10]: 222 That is, instead of deciding upon a set of practices considered universally beneficial, OTs focus on what clients personally find valuable in their life.
[2][21] Some researchers have also noted that the model doesn't focus on the individual's inner self, that is, the unique and independent part of them that is separate from their surroundings.
However, OTs with proficient interviewing skills may be "more confident in facilitating and guiding the participants to complete their drawings without fear of errors.
