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Empower psychiatric fieldwork students in Taiwan:using KAWA model experience

Hsin Hsiu, Yeh¹ & Michael, K., Iwama²

Dept. of Psychiatric OT, Taipei City Hospital¹&

Graduate Dept. of Rehabilitation Sciences, University of Toronto²

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BackgroundBackground

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Background

• Taiwan OT fieldwork training

• Challenges

– Self-identity & uncertainty future

– Stress Management

• interpersonal & time management

• Empower way: KAWA & Narrative

– self reflection↑

– meaningfulness↑

• Common desires:

– Harmony/ “Yin & Yang” state

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MethodsMethods

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Methods

• Case Study Design

– 6 Students

• Process:

– 2.5 hours/student

– 4 open-ended questions after 7 days

– KAWA model with Narrative Therapy skills

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Methods

• KAWA Model (Iwama, 2006)

– Eastern view

– Metaphor for conversation base

• Narrative therapy(White,2007)

– Re-Authoring conversation map

– Externalizing

– Re-Membering

– Scaffolding

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ResultsResults

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Results: Common Issues

• Confucian Relationalism (Hwang, 2000,2001)

– Care about “Persons-in-Relation”

– “Persons-in-Relation” was represented as ”support” & “obstacle”.

– Conflict between “Being Themselves” & “The Expectation of Significant Others”

– The sense of belongings to their “Systems of Social Relationships”

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Fellow-up Questions

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Results: Results:

After ConversationAfter Conversation((ⅠⅠ))

What did they learn by What did they learn by

painting their KAWA?painting their KAWA?

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The InspiresThe Inspires

•• Empower themselvesEmpower themselves

–– SelfSelf--reflectionreflection

–– Redefine with a positive viewRedefine with a positive view

–– Being themselvesBeing themselves

–– Manage resources Manage resources

•• ““The Chains of AssociationThe Chains of Association””

–– Result meaningfulnessResult meaningfulness↑↑↑↑↑↑↑↑

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Results: Results:

After ConversationAfter Conversation((ⅡⅡ))

WhatWhat’’s the difficulties s the difficulties

in the process in the process

of using KAWA model?of using KAWA model?

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The difficultiesThe difficulties

•• Poor reflective ability before Poor reflective ability before

this processthis process

•• The crossThe cross--sectional view of sectional view of

KAWA isnKAWA isn’’t commont common

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Results: Results:

After ConversationAfter Conversation((ⅢⅢ))

What are the influences What are the influences after using after using

KAWA model?KAWA model?

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The InfluencesThe Influences

•• SelfSelf--Reflection and SelfReflection and Self--

AwarenessAwareness↑↑↑↑↑↑↑↑

–– Find Find ““the chains of the chains of

associationassociation”” and its valueand its value→→→→→→→→meaningfulness meaningfulness ((AntonovskyAntonovsky, ,

1987)1987)

–– Help to find more Help to find more

resourcesresources→→→→→→→→ manageability manageability ((AntonovskyAntonovsky, 1987), 1987)

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Results: Results:

After ConversationAfter Conversation((ⅣⅣ))

What are the thoughts rising What are the thoughts rising

after looking at the KAWA after looking at the KAWA

again?again?

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TThe Effectshe Effects

•• ““Everything continue Everything continue

flowing in their life riverflowing in their life river””

–– Even positive or negative thingsEven positive or negative things

•• Being themselves with a Being themselves with a

positive viewpositive view

–– Using more flexible way to Using more flexible way to

resolve or find resourcesresolve or find resources

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DiscussionsDiscussions

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DiscussionsDiscussions

•• ““How to find How to find harmonyharmony state state

in life?in life?””

–– The Confucian The Confucian RelationalismRelationalism

V.S. Western cultureV.S. Western culture

•• Balance between Balance between ““the expectation the expectation

of significant othersof significant others”” and and ““being being

themselvesthemselves””

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DiscussionsDiscussions

•• KAWA model with KAWA model with

narrative therapynarrative therapy

–– ReRe--construct powerful life construct powerful life

riverriver

–– Help to find Help to find ““meaning in meaning in

lifelife””

–– Appreciate both Appreciate both ““Yin & Yin &

YangYang”” of selfof self

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References• Antonovsky, A. (1987). Unraveling the Mastery of Health. How

People Manage Stress and Stay Well. Jossey-Bass, San

Francisco.

• Hwang, K.K. (2000). Chinese Relationalism: Theoretical construction and methodological considerations. Journal for the Theory of Social Behavior, 30(2), 155-178.

• Hwang, K.K. (2001). The deep structure of Confucianism: A social psychological approach. Asian Philosophy, 11(3), 179-204.

• Iwama, M. (2006). The Kawa Model: Culturally Relevant Occupational Therapy. Edinburgh : Churchill Livingstone-Elsevier.

• White, M. (2007). Maps of Narrative Therapy. New York: W. W. Norton.

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Thank you forThank you for

your attention~your attention~

HsinHsin HsiuHsiu, , YehYeh

Email: Email: essentialyeh@gmail.comessentialyeh@gmail.com