Key Concepts

The emerging concept of recovery in mental health is often only loosely defined, but appears to be influenced more by specific human values and beliefs, than scientific research and ‘evidence’. Below is an examination of the Model’s value base - the Engagement Process, the 10 Commitments and the 20 Tidal Competencies, which aim to generate practice-based evidences for the process of recovery. 

The Tidal Model uses specific human values to guide the helping and enabling practice of health recovery.

Listed are some key concepts that are vital in the integration of the tidal model:

1. The primary therapeutic focus lies in the community. People live on an “ocean of experience”, and whenever a crisis threatens to drown them, they need to return to the ocean of experience to continue their voyage of life.

 2. Change is a constant, ongoing, process. The main aim for the Tidal Model, is to help people develop their awareness of the small changes, that may cause big impact in their lives. 

 3. Empowerment lies at the heart of the caring process- how they can take control of their lives.

 4. The nurse and the person are united, albeit temporarily. Nursing involves caring with people, rather than caring for them. This has an impact not only on the relationship of the patient, but also for the kind of support nurses might need from others, to maintain the integrity of the caring process.

The Ten Commitments

The Twenty Tidal Competencies

EMOTIONAL RESCUE AND

 THE TIDAL MODEL 

When people are acutely distressed, under threat – whether physical, psychological or spiritual - or presenting a risk to themselves or others, the high drama of the situation requires an equally dramatic nursing response. Here, the nurse might need to make the person and the environment as physically safe and emotionally secure as possible. This requires great skill and composure on the nurse’s part. Such dramatic help is akin to the work of the lifesaver rescuing someone from drowning. When people are suicidal or tormented by ‘voices’, they require just this kind of ‘emotional rescue’. In such a situation: The nurse provides the kind of supportive conditions that will reduce the experience of distress and prepare the way for a more detailed examination of what needs to be done next. When nurses respond to people’s distress by helping to contain it, delimit it, or otherwise fix it, they are practising psychiatric nursing. Both the nurse and the person are locked in the present. The emphasis is on stemming the flow of distress, or keeping a watchful eye out for any signs of exacerbation of the original problem of living. 

GROWTH AND THE TIDAL MODEL 

As soon as the ‘crisis’ has passed, and the person or their circumstances appears to have calmed down, the focus turns to something more constructive and developmental. Once the ‘drowning’ person has been dragged ashore and is judged to be ‘safe’, the emphasis switches to ‘rehabilitation’- what needs to happen now to help the person return to normal living. If the person appears to have played a part in their own crisis – whether by accidentally falling or intentionally jumping into the river – the focus turns to an examination of the person’s motives, or understanding of the risks involved. Of necessity, this will involve a more detailed, longer-term inquiry, which aims to ensure the person’s safety and well-being in the future. In such a situation: The nurse tries to foster active collaboration – ‘caring with’ the person developing an active alliance, so that together they might develop an understanding of the problem- its personal meanings and relationship to the overall life of the person. Such a careful and paced developmental approach in clarifying the person’s understanding of the function and meaning of his or her problem of living, and their possible solutions, lies at the heart of the Tidal Model and illustrates, in our view, the essence of mental health care.

References:

1. Tidal Model Publications - visit at http://www.tidal-model.com/Publications.htm
2. The Tidal Model: Psychiatric colonisation, recovery and the need for a paradigm shift in mental health care retrieved from http://www.tidal-model.com/New%20Colonisation.htm