‘Go with the Flow’Can you imagine your life is like a river? It may begin as a small stream highup in the mountains and trickle downhill with the force of gravity. Later, it maygather speed, flowing fast as it tumbles downhill, collecting and carryingrocks, stones and driftwood along with it, or it may meander slowly as the landbecomes flatter. The water flow eventually reduces, causing the river to dropits stones and pebbles onto the river bed and eventually meets the sea. Whenthe ‘self’ is visualised as a ‘river’, all of the elements including ‘self’,circumstances and society as formed as elements of one, indivisible wholeare difficult to understand in isolation (Turpin and Nelson, 2007).Recently, my ‘river’ has taken me on a surprising and exciting journey since Iwas introduced to the Kawa (Japanese for ‘river’) Model (Iwama, 2006) atuniversity. The distinct concept and simplicity of this recently developed;Eastern influenced occupational therapy Model inspired me to investigatefurther. I discovered that the Kawa metaphor allows therapists to gain furtherinsight into an individual’s life flow and health (river water), personal assetsand liabilities (driftwood), life circumstances/problems (rocks) andenvironment (river banks/bed). These combine to form a unique picture oftheir life at a certain point in time. Using the Kawa Model, the purpose ofoccupational therapy is to gain an understanding of an individual’smetaphorical representations and their occupational circumstances, clarifyingtheir meaning and aiming to facilitate life flow.
I decided to put my newfound knowledge into practice by introducing theKawa Model to a client during my mental health practice placement. I foundthat the Kawa metaphor facilitated communication and building of thetherapeutic relationship and promoted collaborative, person-centered practice.Sharing the client’s Kawa diagrams enabled me to identify his personal assetsand liabilities, problems and challenges, issues and environmental factors(physical, social, political and institutional) which were effecting his ‘life flow’and areas for occupational therapy intervention.Following this experience, I attended a keynote lecture delivered by the KawaModel’s founder, Professor Michael Iwama. I embraced the opportunity toshare my personal experience of using the Kawa with him. I consequentlydeveloped a presentation based on my research findings and shared this withmy colleagues during in-service training. As someone who always fearedgiving presentations, I feel that the Kawa Model has helped me to push mypersonal boundaries and I have gained valuable skills for my future career asan occupational therapist. Commitment to our Continuous ProfessionalDevelopment and life-long learning should be at the heart of our futurepractice to help us to grow and fulfil our personal potential at all stages of ourprofessional lives (Alsop, 2000; Driscoll, 2007).Supervision and Continuous Professional DevelopmentAs health professionals, we have a professional and statutory responsibility toachieve and continuously maintain high standards of professional knowledge,behaviour and skills, demonstrating on-going professional development (COT,2010a; HPC, 2008). With this in mind, I decided to use the Kawa metaphor toreflect upon and represent my feelings prior to starting my final practice
placement and at the end, drawing together my experiences and overallprofessional knowledge gained (Cheng, 2010; Iwama, 2006). Use of the KawaModel in this alternative way facilitated communication during supervision,which enabled the planning of appropriate learning outcomes to meet myneeds and establish areas of focus during this transitional period (Buchan,2010; Fieldhouse, 2008).Social MediaFacebook has become a popular means of communication for many of us.The Kawa Model team have embraced this opportunity to reach out tooccupational therapy personnel worldwide, welcoming our contribution to ourprofession’s development and offering support and encouragement. Why not‘go with the flow’ and give the Kawa ‘river’ Model a go?Rebecca Dellow is a recently qualified occupational therapist andstudied at York St John University (in-service).ReferencesAlsop A (2000) Continuing Professional Development: A Guide for TherapistsOxford: Blackwell Publishing CompanyBuchan T (2010) Implementing Appropriate Support Systems OTnews 18 (7),26 – 27Cheng IKS (2010) Transforming Practice: Reflections on the use of Art toDevelop Professional Knowledge and Reflective Practice Reflective Practice11 (4), 489 - 498College of Occupational Therapists (2010a) Code of Ethics and ProfessionalConduct (Revised Edition) London: College of Occupational Therapists LtdDriscoll J (2007) Practicing Clinical Supervision: A Reflective Approach forHealthcare Professionals (2nd Ed) Philadelphia: Bailliere Tindall Elsevier
Fieldhouse J (2008) Using the Kawa Model in Practice and in EducationMental Health Occupational Therapy 13 (3), 101 – 106Health Professions Council (2008) Standards of Conduct, Performance andEthics London: Health Professions CouncilIwama MK (2006) The Kawa Model: Culturally Relevant OccupationalTherapy Philadelphia: Churchill Livingstone ElsevierTurpin M, Nelson A (2007) The Kawa Model: Culturally Relevant OccupationalTherapy Australian Occupational Therapy Journal (54), 323-324Linkshttp://www.facebook.com/KawaModelhttp://twitter.com/#!/KawaModelhttp://www.kawamodel.com/http://www.slideshare.net/KawaModel/introduction-to-the-kawa-model-beki-dellow