Research and Evaluation
How does change 'happen' for people?
How does change impact on people's lives?
How do people respond to the experience of change, whether they are staff members or people in the care of a service?
What do people make of the experience of change - what does it mean to them?
Evaluation of all aspects of the Tidal Model is very important. We need to make sense of the changes that might occur following the implementation of the Tidal Model within a service. That said, this can be be difficult to study. One of the obvious features of all such studies is that the results will vary from one setting and team to the next.
People often ask us: "Does the Tidal Model work?" This is a very interesting question. Our answer may, however, not be exactly what the questioner was hoping for.
We do not believe that the Tidal Model can be shown to 'work' any more than the sheet music for a Mozart Concerto can be said to 'work'. Both involve nothing more than the representation of ideas on paper.
To make great music we need great musicians, who can interpret the musical notation. To provide quality care we need quality practitioners - people who 'know' what they are doing and are 'motivated' to do this, come what may. Poor or careless musicians will make a travesty of Mozart's Concerto. Unmotivated or unskilled care staff will make a travesty of the practice of the Tidal Model.
This is not an 'escape clause'. It is obvious: good quality care is primarily a function of the carers' skills. They may well have been influenced by thoeries or models of practice but, in the final analysis, it is their actions that make a difference.
Any realistic study of the Tidal Model in practice must focus on the 'workings' of the team - both individually and collectively. It must also take account of the organisational context, the support available to the team, the quality of the environment and a range of other physical, social and interpersonal factors. Any such study will be as complex as it is interesting. Through such a multidimensional study it might be possible to say that this team, working in this way, doing these kinds of things, with this kind of support, achieved these sorts of results.
Such studies will be more focused on 'evaluating' what happens within a specific service setting, rather than 'researching' a concept at a more global level. If we are really interested in promoting change, we must focus on 'how change happens' in specific settings, rather than talk about 'change' as a general concept.
The kind of 'change' hoped for through the use of the Tidal Model bears no relation to the kind of change hoped fo through the administration of a specific drug. In general, it does not matter how the person dispensing the drug acts towards the person taking it. Indeed, if the drug was dispensed by a machine -as in intravenous therapy. The drug will 'work' (or not) despite the presence or absence of human contact.
Published Research and Evaluation
A wide range of evaluations of the Tidal Model in practice have been conducted as part of 'clinical audit' or other 'ongoing evaluations' of care within health or social service settings. Almost all of these evaluations were planned and conducted as part of routine professional or clinical auidt. As a result, few of them have been published.
These represent some of the important pieces of research and evaluation that have been subject to peer-review and been published.
Brookes, N., Murata, L., & Tansey, M. (2008). Tidal Waves: Implementing a new model of mental health recovery and reclamation. Canadian Nurse, 104(8), 22
Cook NR, Phillips BN and Sadler D (2005) The tidal model as experienced by patients and nurses in a regional forensic unit. Journal of Psychiatric and Mental Health Nursing 12 (5) 536-40
Gordon W, Morton T and Brooks G (2005) Launching the Tidal Model : Evaluating the evidence. Journal of Psychiatric and Mental Health Nursing 12 (6) 703-12
Lafferty S and Davidson R (2006) Person-Centred Care in Practice: An account of the implementation of the Tidal Model in an adult acute admission ward in Glasgow. Mental Health Today (March) 31-34
Stevenson C and Fletcher E (2002) The Tidal Model: The questions answered. Mental Health Practice 5(8) 29-37
Stevenson C, Barker P and Fletcher E (2002) Judgement days: developing an evaluation for an innovative nursing model. J Psychiatric and Mental Health Nursing 9(3) 271-6