How is the Kawa Model Used in Practice within Occupational Therapy Placement Settings? A Qualitative Phenomenological Study

Abstract

Background: Conceptual models are central to occupational therapy reasoning and support the integration of theory with person-centred practice, yet applying them in practice can be challenging, particularly for students. The Kawa model offers a relational and culturally responsive framework for understanding individuals’ life circumstances, but little empirical research has examined how pre-registration occupational therapy students use it during practice placements. This study explored how students experienced and applied the Kawa model during placements, including the factors that supported or constrained its use.

Methodology: A qualitative phenomenological study, underpinned by an interpretivist epistemology, was conducted with four final-year MSc pre-registration occupational therapy students who had used the Kawa model during practice placements. Participants were recruited using purposive and convenience sampling. Data were generated through a semi-structured online focus group and analysed using Braun and Clarke’s reflexive thematic analysis.

Findings: Four themes were generated: Learning the Kawa Model; Kawa as a Person-Centred Tool; Contextual Barriers to Using the Kawa Model; and Kawa and Emerging Occupational Therapy Identity. The Kawa model supported person-centred reasoning, therapeutic communication and reflection but its use was shaped by uneven learning opportunities, limited modelling in practice and organisational pressures.

Conclusion: The Kawa model can support students’ professional reasoning and identity development; however, its potential is constrained by inconsistent conceptual model teaching and service contexts that prioritise measurable, time-limited, outcome-driven contexts. More coherent conceptual model teaching is needed as well as explicit use of models in placements and supportive organisational conditions to enable students to embed theory within practice across pre-registration occupational therapy education. Implications for occupational therapy education, practice, and future research are discussed.