Kawa model

The Kawa model (kawa (かわ)), named after the Japanese word for river, is a culturally responsive conceptual framework used in occupational therapy to understand and guide the therapeutic process.^[1] Developed by Japanese occupational therapists (OTs), the model draws upon the metaphor of a river to describe human occupation, which according to OTs refers to individuals' daily activities that make life meaningful. The overarching goal of the model is to "provide a culturally flexible model to aid occupational therapists to improve communication with clients, to better understand what a client finds meaningful and important, and to design optimal client-centered interventions."^[2]: 17

In the model, the river represents the dynamic and ever-changing nature of life; it incorporates five main elements: water, river banks and space, rocks, and driftwood. In the model, "water (mizu) represents life flow and health, driftwood (ryuboku) represents personal assets and liabilities, rocks (iwa) represent life circumstances and problems, and the river walls (torimaki) represent physical and social environmental factors."^[1]: 1 The model emphasizes that each person's river is unique and influenced by cultural, social, and personal factors.