Noted OT practitioner, author to speak at TWU Dallas

profile picture of Michael Iwama

Feb. 4, 2025 — DENTON —  Michael Iwama, a professor in the occupational therapy doctorate division in the School of Medicine at Duke University, did not set out to be an agitator in the occupational therapy world. His initial intention was to develop a theory that clinicians in Japan could understand and use during the rehabilitation of their clients.

But instead of being welcomed, his theory was rejected by the Japanese OT community. 

Undeterred, Iwama veered in a different direction. He went international. He presented and wrote about the Kawa model (kawa is Japanese for river) – a method that takes into account factors such as a client’s environment and personal obstacles – and was astonished with how it resonated not just with people in East Asia but all around the world.  

That made Iwama somewhat of a rebel – a label of which he is proud. 

“I have no recourse but to be proud of it,” Iwama said. “That’s what I am.”

The Kawa model is now taught in over 700 health professions education programs internationally and used in practice across six continents.

“So, what was intended to be for Japan, made in Japan for the Japanese, actually became internationally embraced,” Iwama said. “And, the reason behind it is, I believe, that the concepts of the model, everything is based on this metaphor of a river to depict a person’s life journey. And, it’s that metaphor that everybody around the world can relate to, understand and therefore use.”

graphic of Vanderkooi lecture 2025 event

Since his book, The Kawa Model: Culturally Relevant Occupational Therapy, was published in 2006, he has given over 350 national and international lectures and over 100 keynote and plenary addresses at scientific and professional conferences. 

One of his next lectures is Friday, Feb. 7 at Texas Woman’s Dallas campus, where he is the speaker at the 32nd annual Vanderkooi Endowed Lectureship. 

Although Iwama has not collaborated with any Texas Woman’s faculty or students, he has been aware of the TWU School of Occupational Therapy for a long time. 

“It is known as one of the iconic OT programs in the world,” Iwama said. 

Iwama is notable for his occupational therapy background, but he initially went to school for sports physical therapy. He realized that helping people reach elite levels of performance wasn’t his calling. 

“I want to work with ordinary people in society and especially those who are at subnormal levels of performance trying to reach some semblance of normalcy,” Iwama said. “It’s a personal thing, but to me, I thought that was much more fulfilling.” 

Iwama grew up in Japan but moved to Vancouver with his family as a teenager. After establishing his OT career in Canada, he went back to Japan to teach and had challenges readjusting to Japanese society. He also saw confusion on his colleagues’ and students’ faces when he discussed OT theories. 

TWU Dallas exterior

“That’s when I realized that the Japanese people learn a whole different world viewpoint and that is one that comparatively to Western, individualism centralism, it is very collectivistic in nature,” Iwama said.  

Which led to Iwama’s big aha moment. He saw that maybe OT theory was culturally bound and that a new model from a different cultural lens was needed. This led to the creation of the Kawa model, a theory that was made for the Japanese OT community but ended up becoming much more universal.

Iwama grasped later that he had performed a social faux pas with the development of his theory. Having acclimated to Western life, he forgot about the strict hierarchy that exists in Japanese society.

“So, the great big sin that I committed, unwittingly, was that I enabled practitioners,” Iwama said. “I gathered a group of Japanese practitioners to develop the Kawa model. I enabled the people at the bottom of that hierarchy to achieve something that the people at the top of the hierarchy were unable to do in the past half century. So, it was an affront to the occupational therapists of Japan.”

The model is now more than 25 years old, and the demand and interest in the Kawa model has not diminished.

“It's practical,” Iwama said. “It makes sense. It is easy to understand. And, it just seems right for this changing world that we are living in.”

Iwama sees his model as a gift from OT practitioners to OT practitioners. The OT community has the green light from the author to innovate and make changes to the model for the good of OT and its clients. 

“I have faced all kinds of adversity,” Iwama said. “All of the thousands of people that have embraced the Kawa model, they are the wind in my mast, my sail. When I face these accusations of being a rogue, I take comfort in the kind of support and enthusiasm that this next generation of occupational therapists are bringing. I’m so incredibly grateful for that because if it wasn’t for that, I would have abandoned this a long time ago.”

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Page last updated 9:46 AM, February 4, 2025