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What is a model?

Conceptual models are a very fundamental part of occupational therapy.

They help occupational therapists make sense of their therapy, i.e.

  • when therapists meet a client, how would they know what kind of information to elicit from their client that would be helpful towards therapy planning?
  • clients usually come with a multitude of issues to be addressed, and they usually can’t be addressed all in one go, how would the therapist know how to prioritise which issues to address first?

In summary, models are like lenses from which occupational therapists look through to get a picture of what their clients’ lives and the worlds their clients’ live in look like. They also answer the question “What is occupational therapy to the occupational therapist?”


cultural lenses

The Kawa Model was developed by Dr Michael Iwama when he realised that in certain parts of the world, occupational therapists weren’t able to comprehend the concepts of “occupation” and “occupational engagement” which are found in all the other occupational therapy models, and therefore confusing “occupation” with “activity” and “function”. This is typically a phenomenon found among occupational therapists in countries where English is not the native language and the concept behind the word “occupation” (as understood by occupational therapists in the English-speaking world) doesn’t originally exist in the languages that the therapists are most proficient in.
The therapists’ inability to comprehend “occupation” as it was originally intended (not by any fault of their own, but due to incompatibility in language) can result in the concept of “client-centeredness” being negated in their therapy.
So the Kawa approach is a very pragmatic and practical way of addressing the language incompatibility – in essence the Kawa Model allows the occupational therapist to put the concept of “occupation” aside and just ask the client how they want to live their lives so that it is more meaningful to them, and look together with them at what we can do to achieve that.
The beauty of the Kawa Model is that the client is the one who ascribes the meanings to their life components. Sometimes we don’t have to fix the disability (remove the rocks), sometimes what they need more is to come to terms with it and be able to live with it (river continues to flow beyond the spaces in the rocks).
Example: in developing countries it is common to come across parents of physically disabled children very preoccupied with “fixing” the child’s disability. If you were to ask them, “Do you ever read stories to your child?” chances are that they wouldn’t have thought of it and the intellectual and social development of the child is often regarded as unimportant.
Sometimes people just need to realise that even though their children are not born physically perfect, they’re still human and they still need to be stimulated and guided through various parts of development like just about any other child – however, it is very difficult to do so when they don’t see a child, they only see a condition, something “wrong” that needs to be “fixed”. As a result of that, they’re transfixed, stuck where they are and unable to move on. The Kawa Model can help them get over that in a very natural, easy to understand way, by taking the focus away from the “rocks” (disability), and focusing on other methods to “widen the spaces for the river to flow”. The same principle could apply to any individual who is too transfixed and stuck in the “I must fix my problem” mode.
*Adapted and updated in 2015 from “Why the Kawa Model?” (Teoh, 2010).