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The KAWA Model of occupational therapy uses a metaphor of a river to visually depict  someone's life experiences.

River flow represents: One's life priorities
River banks represent: One's environment, and physical and social contexts
Rocks represent: Life obstacles
Driftwood: Life influencing factors
Blank spaces: Room for opportunities to advance life flow

Assumptions: Harmony vs. Mastery and Being vs. Doing

These elements help the occupational therapist to find out what their normal activities/roles/routines/process are and what about their environment can help or hinder them. This allows for determination  of an intervention that will best meet the clients needs/goals to fit their life.

(Teoh & Iwama, 2015)

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After getting the opportunity to meet our interviewee, we decided the KAWA model would be a good fit for her.

She spoke a lot about the importance of family and friends when it came to her participation in activities and overall quality of life. The Kawa model doesn't highlight independence as much as other models, but allows for the family to be a part of decisions.
- Her husband was a huge part of her life until he passed. Now participating in daily activities are harder
-She values seeing her family whenever she can
-Social participation in activities with friends as well as computer games can strengthen her quality of life and engagement in activitites
-Her rocks were represented in her life story during the interview

She also spoke about how certain health issues can be barriers to her doing activities such as going grocery shopping, getting exercise, and can hinder her engagement in social activities in her building.

Connecting KAWA could be a good resource for her to map out and visualize all of the important aspects of her life that may be contributing to or inhibiting her engagement in her preferred occupations.

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The PEO Model of occupational therapy focuses in on:

The Person-
- Intrinsic factors that support or hinder participation in occupations
--> psychological, cognition, sensory, motor, physiological, sense-making, and spiritual

Environment- Extrinsic factors of a persons life including:
- culture
- social factors
- physical
- policy
- technology

Occupation- Biopsychosocial Approach
-client-centered (uses person + environment + occupation to facilitate occupational engagement)
- Ecological model influences
- biological, psychological, and social

(Bass et al., 1985)

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This model incorporates a lot of the aspects of our interviewee's life that we discussed.

In particular, she has trouble walking and moving around because of her COPD and her difficulties that come with her aging.
- This can be looked into by delving into her intrinsic factors that are aiding in her occupational performance
--> She has trouble getting air into her lungs limiting her mobility (physiological/motor)
--> Self-efficacy: she doesn't have much confidence in her ability to carry out certain tasks

Her Environment is also contributing to her success in occupational performance:
- This includes many of her extrinsic factors
--> Grocery stores are hard for her to maneuver around
--> Technology helps aid in her enjoyment of playing the Sims video game
--> Social: Social participation in activities she and her friends set up help her engagement in her preferred activities

Her role as a mother and wife have influenced her life, as well as the changes that have occurred in these roles.

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Comparing these two models, Kawa and PEO both target the same context of clients factor's (physical, emotional, envronmetal, etc), but approach them differently.

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A difference between these two models shows within the end result. In the Kawa model, the goal is to widen the space of flow in the client's life by keeping all components there (even if they are rocks/struggles) but allowing occupation within those, whereas PEO focuses on adapting the environment and bio-psychosocial environment instead of flowing with it. As well as adaption, PEO focuses on how to change the person, environment, and occupations to improve the client's overall occupations. It also involves modifying a client's occupations so it fits their needs. The Kawa model wants to keep all those aspects in tact, but make "room" for occupational improvement.

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Baum, C. M., Christiansen, C. H., & Bass, J. D. (2015). The Person-Environment-Occupation- Performance (PEOP) model. In C. H. Christiansen, C. M. Baum, & J. D. Bass (Eds.), Occupational therapy: Performance, participation, and well-being (4th ed., pp. 49-56). Thorofare, NJ: SLACK Incorporated.

Iwama, M. K., Thomson, N. A., & Macdonald, R. M. (2009). The Kawa model: The power of culturally responsive occupational therapy. Disability and Rehabilitation, 31, 1125-1135.

Teoh, J.Y. & Iwama, M.K. (2015). The Kawa Model Made Easy: a guide to applying the Kawa Model in occupational therapy practice (2nd edition). Retrieved from: www.kawamodel.com