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What is the Kawa Model?

The Kawa Model is a therapeutic method developed in Japan by occupational therapists.

Kawa is the Japanese word for ‘river’.

The Kawa Model uses the natural metaphor of a river to depict one’s life journey. The varying and chronological experience of life is like a river, flowing from the high lands down to the ocean. Along its meandering path, the quality and character of its flow will vary from place to place, from instance to instance. Occupational therapists try to enable, assist, restore and maximize their clients’ life flows.

The Kawa Model can be used as a conceptual model of practice, frame of reference, assessment tool and modality.

The Kawa Model can be used metaphorically in its original form of a river or it can be applied using other metaphors as well (see links for the AutoBahn metaphor or the mountain metaphor), whichever is appropriate for the context, e.g. using traffic as a metaphor: Life is like traffic on the road. When traffic is smooth and you’re able to get to your destination on time you’re happy. But when you’re stuck in a traffic jam – what can you do about it? Take another road, inch your way through the jam, lobby for the government to build a wider road with traffic lights, not travel during rush hour, etc. Same principle, different way of framing the circumstances to make sense to different people.

When using the Kawa Model, occupational therapists do not always have to sit down and draw the river if it’s time consuming. They can use also it in its underlying form of four interrelated constructs:


(i)  life flow and overall occupations (river)
(ii)  environments / contexts, social and physical (river banks)
(iii)  circumstances that block life flow and cause dysfunction / disability (rocks)
(iv)  personal resources that can be assets or liabilities (driftwood)

The key is to have this set of thinking to guide their reasoning. For more ideas about application, download your FREE copy of the Kawa Model Made Easy manual, visit the case studies and videos section, and especially watch Dr Iwama’s Kawa Model FAQ video.

 Like a river where its source represents the beginning of life and its mouth meeting the sea representing the end, the Kawa Model takes into consideration the past, present and future occupational needs of the client.

The  Kawa  Model  (2006)  was  created  by  a  team  of  occupational  therapists  in  Japan led  by  a  Japanese-Canadian occupational therapy scholar to enable occupational therapists everywhere to “just ask the client how they want to live their lives so that it is more meaningful to them, and look together with them what they can do to achieve that.” (Teoh 2010)

The inclusive nature of the Kawa Model allows the occupational therapy client to be considered as a collective, meaning that it can be used on individuals, families, groups and organizations.

Source: The Kawa Model Manual (Teoh & Iwama, 2010) – updated 2015