Title and Abstract

Like a River; De-Colonizing Occupational Therapy Theory

How relevant and powerful is occupational therapy in this contemporary age of information? Will occupational therapy continue to be relevant and responsive to the basic human interests for health and well-being in a world that feels like it is flowing in constant change and disruption? Is there still promise in our collective belief that occupational therapy can be one of the greatest ideas for human health and well-being of this century? The questions of relevance are paramount as they are urgent; these questions must be thoughtfully addressed if this great profession is to thrive and flow powerfully into the 21st century. The concern for culturally relevant occupational therapy does not begin with practice. Rather, it starts with the World views, ideas, philosophy, values, knowledge systems and (especially) theory that guide, explain and drive favorable outcomes in our practice. 

Although the World is changing rapidly; our worldviews, theory and methods bear the hallmarks of belief systems rooted in the Modern Era. We have come to unquestionably embrace and even celebrate concepts of rationality, objectivity and assumptions of universal truth. Intertwined in these structures is (social) power – how it is constructed, understood, valued and exercised. The age of information; the faster access to and sharing of information and increasing reliance on technology and artificial intelligence, is hurtling us toward a condition in which rationality, objectivity and previously assumed universal truths and narratives become questioned, challenged and even rejected. The tsunami of digital social media continues to fuel the paradigm shift from modernism into the postmodern condition where the diversity of human experience and the multiplicity of perspectives become paramount. And power that is traditionally held and commandeered by the professional is progressively ceded to the client. How will occupational therapy respond and address this monumental paradigm shift?

The Kawa (Japanese for river) Model (Iwama M, 2006) is an early exemplar of occupational therapy’s flow from the Modern Era into the Postmodern Era. The Kawa model exemplifies how occupational therapy might begin to respond to the massive social shift occurring around us, and in the daily life experiences of the people and communities we serve.