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Use of the Kawa Model for Occupation-based Culturally Responsive Occupational Therapy in India

Use of the Kawa Model for Occupation-based Culturally Responsive Occupational Therapy in India

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Authors: Neha S. Tripathi, Melissa M. Sweetman, & Susan A. Zapf.

Neha S. Tripathi, OTD, OTR/L is a licensed occupational therapist in Washington, D. C. She earned her Bachelor of Occupational Therapy degree in India, and her Master of Science in Health & Rehabilitation Sciences as well as Doctor of Occupational Therapy degrees in the United States.

Melissa M. Sweetman, PhD, OTD, OTR/L is the Founding Director and Associate Professor at the Doctor of Occupational Therapy program at Wingate University, NC, USA.

Susan A. Zapf, PhD, OTR/L, BCP, ATP is the Director of the Pediatric Track and Assistant Professor in the Doctor of Occupational Therapy program at Rocky Mountain University of Health Professions, UT, USA.


Background: Across the globe, occupational therapy practitioners are pushing for a paradigm shift toward occupation-based and client-centered rehabilitation. Evidence supports the adoption of holistic, occupation-focused, performance-oriented, and culturally responsive models of care delivery rather than mechanistic and dysfunction-based biomechanical approaches. However, prevalent Western-centric models of practice are unable to provide a good fit to client-centered practice in Eastern contexts. The Eastern philosophy-based Kawa model may be well-suited to guide evidence-based occupational therapy in India, given the reason for its origins, philosophy, and the potential for varied avenues of application, specific to the practice of occupational therapy in India.

Objective: The purpose of this narrative literature review is to encourage Indian occupational therapy practitioners to align themselves with the profession’s paradigm shift, utilizing a theoretical model relevant to the Indian culture and practice contexts, and join hands in global collaboration for the benefit of the profession and its clients.

Study Design: Narrative literature review.

Methods: Analysis of available qualitative and quantitative literature, published between 2007 and 2017, was conducted to consolidate data in support of the potential of the Kawa model to serve as an effective practice model for the Indian health-care context.

Results: An emerging body of evidence points to the effectiveness of the Kawa model as an occupation-based and culturally responsive model to guide clinical and non-clinical processes in Eastern contexts.

Conclusion: The Kawa model has the inherent potential to facilitate alignment of evidence-based, occupation-focused occupational therapy practices in India with the profession’s paradigm shift. However, qualitative and quantitative research regarding the direct application of this model in the Indian occupational therapy arena is required to test its effectiveness and success as well as to guide the development of more specific culturally responsive theoretical models.” (Tripathi, Sweetman, & Zapf, 2017, p. 148).


Tripathi, N. S., Sweetman, M. M., & Zapf, S. A. (2017). Use of the Kawa model for occupation-based culturally responsive occupational therapy in India. Indian Journal of Occupational Therapy, 49(4), 148-153.

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Alternate Source: Email request for full text to Editor-in-Chief, Indian Journal of Occupational Therapy at

Corresponding Author Information: Neha S. Tripathi (


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