TIDAL MODEL

Tidal Model

Tidal Model

Introduction

The Tidal Model recognizes that the life experiences associated with mental ill health are invariably described in metaphorical terms. People who experience life crises are (metaphorically) in deep water and risk drowning, or they feel as if they have been thrown onto the rocks. People who have experienced trauma (such as injury or abuse), or those with more enduring life problems often report loss of their "sense of self," akin to the trauma associated with piracy. In all these instances, people need a sophisticated form of lifesaving (psychiatric rescue), followed at an appropriate interval by the kind of development work necessary to facilitate true recovery. This may take the form of crisis intervention in the community or the "safe haven" of inpatient settings. Once the rescue is complete (psychiatric nursing), the emphasis switches to the kind of help needed to get the person "back on course," returning to a meaningful life in the community (mental health nursing) (Barker, 2000). The model assumes that the practical focus of psychiatric and of mental health nursing differ: the former requiring more direct interventions, involving a highly vulnerable and potentially dependent person; the latter emphasizing a more egalitarian relationship, which involves an even more collaborative approach to education, personal growth and discovery.

Tidal Model: A Discussion

The Tidal Model recognizes that people's need for nursing cannot lie in some either/or world of community or hospital, general or specialist service, acute or continuing care, but rather flows across these artificial boundaries, as the nature of the person's needs shift, often imperceptibly. This focus on the care continuum aims to promote the kind of seamless care that risks becoming mere rhetoric. The caring response, expressed by nursing, needs to flow with the person, adapting itself to the person's changing needs. Regrettably, the worlds of community and residential care have suffered from artificial distinctions. If we maintain a focus on the needs of the person--for critical, transitional (Szasz, 2000), or developmental care--the interdependence of different services, to meet different needs, becomes apparent.

The Tidal Model is represented by a range of holistic (exploratory) and focused (risk) assessments, which generate person-centered interventions that emphasize the person's extant resources and capacity for solution finding. These various assessment and. intervention processes are intended to support rather than restrict practice. The various methods that have been defined in the training program for the model (Szasz, 2000) help the nurse gain a ...