Kawa Model Application: Illustration of Compassionate CareKawa Model Application: Illustration of Compassionate Carehttp://www.youtube.com/watch?v=VaWt3tHZL7o

Kari Tracy, OTSKari Tracy, OTSContributing Author: Sandra F. Countee, OTR/L, Ph.D.Contributing Author: Sandra F. Countee, OTR/L, Ph.D.

OverviewOverview Alternate ModelAlternate Model

Occupational ProfileOccupational Profile

RocksRocks

SpacesSpaces

Implementation StepsImplementation Steps

The Kawa Model describes a culturally relevant model of practice, using the metaphor of a river to describe the many issues inherent in people’s lives1. This presentation on the Kawa Model explains its foundational concepts. The model has six steps, four of which are outlined. An alternative metaphor is also illustrated for use in practice.

WaterWater

ReferencesReferences

Kawa Concept

Client Centered Issues

Occupational Therapy Intervention

RocksLife circumstance& Problems

-Pain and decreased mobility from wrist injury

-Divorce: Can’t fulfill family duty as wife -Feels alone and uninspired

-Attend activity group on exercise and education of body mechanics. Learn joint preservation approaches and techniques

-Coordinate with other team members, such as nursing, psychology and counselors to set up a series of family meetings to discuss family duties and roles in order to explore more avenues to deal with disability experience

Kawa Concept

Client Centered Issues

Occupational Therapy Intervention

Driftwood Liabilities

-Aloofness

-Lack of communication and social skills

-Perseveration

-Asperger’s Syndrome

-Encourage interaction with environment and people, teach ways to engage others-Establish communication techniques and teach social roles within community-Prevent perseveration from impacting life by redirecting Julie to engage in new activities-Attend a social skills training support group. Encourage social situations

Kawa Concept

Client Centered Issues

Occupational Therapy Intervention

WaterPurity, spirit, cleansing, renewal

-Water continues to flow around Julie’s wrist injury, divorce and lack of social environment but…

-Water is slowed due to Julie feeling uninspired in the most important occupation of her life and her feelings of aloneness due to her lack of communication and social skills

-Use the clients assets and abilities to work at decreasing problems and liabilities

--Encourage and provide positive feedback

-Involve other members of support network (with client’s consent) as much as possible

The first four steps of the model illustrated in this case include:

1) Appreciating the client in context

2) Clarifying the context

3) Prioritizing issues according to client’s perspective, and

4) Assessing focal points of occupational therapy intervention.

Steps 5 and 6 (Intervention and Evaluation) should follow but are not presented in this case.

Kawa Concept

Client Centered Issues

Occupational Therapy Intervention

SpacesLife flow & Health

-Potential OT treatment approaches and points of interventions are seen in the channels between Asperger’s Syndrome, divorce, pain in wrist, feeling alone and uninspired, art studio, inability to paint while injured, lack of family and friends, financial stability, art supplies, determination, aloofness, lack of communication and social skills and perseveration

-Avenues to explore are increasing social skills as to build up a support by reconnecting with family and making new friends. Finding ways to adapt art to allow for participation in this occupation which will open client up to feeling inspired again

Julie is a young adult who views her primary role as that of an artist and identifies painting as her most significant occupation. Julie has Asperger’s Syndrome and hyper-flexion of the wrist but even though she is divorced, her ex-husband has provided her with financial resources to continue her painting. A lack of family support has created a barrier in her life. In addition, Julie’s deficits in communication have acted as a barrier to forming friendships; Julie feels alone and uninspired.

DriftwoodDriftwood

River Walls and BottomRiver Walls and Bottom

1. Iwama, M. (2006). The Kawa Model: Culturally relevant occupational therapy. Philadelphia: Churchill Livingston Elsevier.

2. Kawa Model Website. (2010). Retrieved June 11, 2012. From http://www.kawamodel.com

3. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed. text rev). Washington, DC: Author

-Metaphors are best understood when they are presently tangible

-The river is an excellent metaphor but in urban settings, they are difficult to come by

-A window is easily accessible in most environmentsKawa- (River), life flow Goal- strong, deep, unimpeded flow

Mado- (Window), enlightened lifeGoal- bright, wide, long, unimpeded shine

River- Fluid, beginning to end (birth to death)

Window- Opening, portal to the soul, two-way interaction between client and environment

Water- Cleansing, purity, spirit, renewal

Light- Cleansing, purity, revelation

Rocks- Problematic, difficult to move

Trees- Solid, difficult to remove, blocks light

Driftwood- Blocks, enhances, or does not impact flow

Curtains- Shutting out light or letting it in

River walls & bottom- Confines river, give it shape

Window frame- Confines window, determines how much light can shine through

Spaces- Channels for water to seep through between barriers

Window pane- Where light can still shine through between barriers

Kawa Concept

Client Centered Issues

Occupational Therapy Intervention

River walls &bottomPhysical &SocialEnvironment

Physical:-Art studio

-Inability to paint with injury

Social:-Lack of family

-Lack of friends

-Establish a plan in which Julie can ensure financial stability to maintain her art studio after funds from her ex-husband dry up-Adapt a way in which Julie will be able to engage in her art to inspire her soul

-Teach social skills and roles in an attempt to reconnect Julie with estrange family and communication skills to boost confidence to make friends

DriftwoodAssets

-Financialstability

-Art supplies

-Determination

-Asperger’s Syndrome

-Establish a plan to budgetmoney to continue financialsituation as long as possible-Learn ways to maintain integrity of art supplies to make them last-Work on maintaining determination to paint and learn ways to shift determination to other aspects of life such as making friends and reconnecting with family-Maintain the unique qualities inherent from this syndrome that have given Julie a talent for art