Understanding Refugee Adolescents' Occupational Participation Challenges Through the Kawa Model: A Thematic Analysis


SAĞLAMOĞLU E., ABAOĞLU H.

The American journal of occupational therapy : official publication of the American Occupational Therapy Association, vol.80, no.3, 2026 (SSCI, Scopus) identifier identifier

Abstract

IMPORTANCE: Refugee adolescents face significant barriers to daily participation, including economic hardships, health concerns, trauma, and social isolation. OBJECTIVE: To explore occupational performance and the participation challenges of refugee adolescents at a youth center, using the Kawa model. DESIGN: Qualitative, phenomenological study using semistructured interviews and Kawa model-based visual activities. The thematic analysis was guided by Braun and Clarke's framework. SETTING: Ankara Altındağ Youth Center in Ankara, Turkey. PARTICIPANTS: Twelve refugee adolescents (ages 10-18 yr). Participants resided in Turkey for at least 6 mo and were purposively sampled for diversity. OUTCOMES AND MEASURES: Challenges and facilitators to occupational performance and participation were explored. RESULTS: Five main themes emerged: economic hardships and survival struggles, health and safety for a secure future, seeking a new life in the shadow of war, family ties between support and burden, and hopes for the future shaped by the flow of life. CONCLUSIONS AND RELEVANCE: The Kawa model effectively illuminated the complex factors that influence the lives of refugee adolescents. Findings highlight the need for culturally sensitive, holistic occupational therapy interventions addressing both barriers and facilitators to participation. Plain-Language Summary: Using the Kawa model, this study explored the daily life challenges and hopes of refugee adolescents in Turkey. Financial issues, health and safety concerns, and past trauma were identified as major obstacles, or "rocks in their life river." Strong family ties functioned as supportive "river walls," whereas the educational journey and hopes for the future were seen as "driftwood" and "open spaces" for progress. Occupational therapy should address both difficulties and strengths to help these young people thrive. Positionality Statement: At the time of the study, the lead author (Emine Sağlamoğlu) was a research assistant and occupational therapist with experience working with disadvantaged youths. The second author (Hatice Abaoğlu) was an associate professor specializing in mental health and qualitative research. The multidisciplinary research team, possessing expertise in participation problems and occupational performance, conducted all interviews. A researcher with 10 yr of occupational therapy experience finalized the interview questions.