Working with a Client
Sam’s client, John, had suffered a traumatic brain injury. Today, he is meeting John to learn about his transition back to school. Sam decides to open their session with an assessment of how John is coping.
Running through the different OT models, he decides that the Kawa Model, which makes use of visual imagery, would help his young client better express his thoughts
​Let's imagine John’s life as a river...
​
![Kawa Wide View.png](https://static.wixstatic.com/media/8d32cf_ab50535c15404c469d1ea29202d076bb~mv2.png/v1/fill/w_490,h_378,al_c,q_85,usm_0.66_1.00_0.01,enc_auto/8d32cf_ab50535c15404c469d1ea29202d076bb~mv2.png)
As Sam draws a cross-sectional river, he explains how the flow of a river can be affected by its shape and objects in the river. Similarly, John’s life can be interpreted the same way, with each of these components influencing the flow of his health:
![](https://static.wixstatic.com/media/8d32cf_58560dcf5b3447bbaefa017c09b4be7e~mv2.png/v1/fill/w_138,h_98,al_c,q_85,enc_auto/8d32cf_58560dcf5b3447bbaefa017c09b4be7e~mv2.png)
Rocks block and slow the river flow, representing difficulties John faces in school.
![](https://static.wixstatic.com/media/8d32cf_df4238c2ebe741febed0564875021aa2~mv2.png/v1/fill/w_186,h_82,al_c,q_85,usm_0.66_1.00_0.01,enc_auto/8d32cf_df4238c2ebe741febed0564875021aa2~mv2.png)
Driftwoods represent John’s personality, beliefs and resources. These can either block the river flow or enhance it by bumping rocks away.
![](https://static.wixstatic.com/media/8d32cf_31de5de6c21e4cd6ac4078b4196b4c34~mv2.png/v1/fill/w_136,h_31,al_c,lg_1,q_85,enc_auto/8d32cf_31de5de6c21e4cd6ac4078b4196b4c34~mv2.png)
Spaces enhance water flow, suggesting the opportunities for improving John’s life.
![](https://static.wixstatic.com/media/8d32cf_1422b03d9f144bf99e403fa537d59bec~mv2.jpg/v1/fill/w_194,h_109,al_c,q_80,usm_0.66_1.00_0.01,enc_auto/8d32cf_1422b03d9f144bf99e403fa537d59bec~mv2.jpg)
River walls and bed shape the river and flow, representing John’s environment and how it affects him.
(Duncan, 2011)
As they categorise John’s struggles into the diagram, potential intervention areas are identified by Sam:
![Kawa_Cross_Section_John_v2.png](https://static.wixstatic.com/media/8d32cf_0e651f074e3e4647b5090120221c8219~mv2.png/v1/fill/w_918,h_514,al_c,q_90,usm_0.66_1.00_0.01,enc_auto/Kawa_Cross_Section_John_v2.png)
Once completed, they decide the areas to focus on and work together to improve John’s situation.