What is the Tidal Model?

An overview

 

1. The Tidal Model is an internationally accepted theory for the practice of mental health recovery.


The Tidal Model has developed a specific theory of personhood.  This is based around the 'storytelling' process involved where people talk to themselves (Self Domain), share something of the story of their lives with others (World Domain) and enact the living of their lives, influencing others and being influenced in turn by them (Others Domain). (See Theory for more details)

These three
Domains also provide the theoretical basis for the key individual and group-based processes of the Tidal Model: the Holistic Assessment; the One-to-One Sessions; the Personal Security Plan; and the three forms of Group Work - Discovery, Solutions and Information-Sharing.

Since its launch in the mid 1990’s the
Tidal Model has generated  projects in the UK, Ireland, Canada, Japan, Australia, New Zealand, Germany, Singapore, Switzerland, Sweden, Denmark, Brazil and several states in the USA.

These projects range across the complete mental health care spectrum: from home-based care and outpatient addictions, through acute, rehabilitation and forensic units, to the care of older people with early stage dementia. Beyond the mental health field, practitioners in palliative care have explored the Tidal Model as an alternative philosophy for the care of people who are dying.



2. The Tidal Model is a philosophical approach to the discovery of mental health.


Tidal is a philosophical approach. It is a way of thinking about what people might need in the way of help. Tidal asks: What might need to be done to help people reclaim the story, and eventually recover their lives?

Tidal emphasises the
discovery of mental health, as its meaning varies from one person to another. We hope that people will discover what mental health means for them – as unique persons.

Tidal assumes that recovery must begin when the person is at their 'lowest ebb'. In practice, this usually means beginning the work as soon as possible after people have been admitted to any form of psychiatric care, continuing and developing the recovery-focused care as the person moves through the care system, and eventually carrying this over into everyday life back in the community.

 

3. The Tidal Model helps people reclaim their story as a first step towards recovering the story of their lives.


Tidal aims to help people reclaim the personal story of their distress and difficulty by recovering their voice. By using their own language, metaphors and personal stories people begin to express something of the meaning of their lives. This is the first step towards helping people recover control over their lives.

As people, all we have is our story. All we can ever be is framed by the story of our lives – the events that have occurred, and how we responded to them. This story charts not only the changes that have occurred on our voyage from birth, through childhood and adulthood and eventually into death but also the growth and development that has taken place within us.

4. The Tidal Model focuses on helping people deal with their problems of human living.


When people experience problems of human living they are described as being ‘mentally ill’ or affected by some ‘psychiatric disorder’ or ‘psychological dysfunction’. Frequently, the person’s story is overshadowed by stories of ‘illness’ or ‘psychological disorder’. People often talk less about the ‘person’ and talk more about the ‘patient’, ‘client’, ‘service user’ or ‘consumer’.

Tidal focuses explicitly on the person’s story. This is where the person’s problems first appeared. This is where any growth, benefit, or recovery will be found. Tidal also focuses on the problems that are affecting the person in living an ordinary, meaningful and fulfilling life.

The key Tidal question is :

What needs to be done to help the person begin to address, resolve or come to terms with this problem, and so begin to recover her or his life?

 

5. The Tidal Model was developed through the unique collaboration of mental health nurses and people with experience of mental health services.

Most ideas around recovery were developed either by mental health professionals or by former users/consumers of psychiatric services. All the processes within the Tidal Model were developed conjointly with people who either had been 'psychiatric patients', or who were defined as 'service users'. These people acted as 'user consultants' to the field testing of the original model and we continue to seek support and guidance from similar 'consultants' in the further refinement of the Model.

6. The Tidal Model is a person-friendly approach to mental health recovery.


Tidal has no age, class or cultural boundaries and at present is being used to facilitate recovery as easily with younger people, as with adults, or with the older person, across a wide range of societies and cultures.

Tidal actively avoids the use of professional or technical jargon, focusing instead on the use of the natural language of the person.

Originally developed as an alternative model of mental health nursing, the Tidal Model continues to be practised mainly by nurses, but also finds support within psychiatric medicine, social work, occupational therapy and psychotherapy. Increasingly, Tidal is viewed as an important alternative approach to helping people use their natural voices as the key instruments for charting their recovery.


7. The Tidal Model helps people navigate their own voyage of recovery.


The concept of ‘recovery’ means many different things to different people. Tidal aims to help people clarify what is distressing or disabling about their problems of human living, as the first step towards clarifying what needs to be done to begin to move away from, or overcome those problems.

We make no assumptions about what is - or is not - a 'problem in living'. Nor do we assume that we know what might be 'good' for a person; or what might represent a destination that might be called 'recovery'. All such meaning must be defined by the persons themselves.

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

 

The Tidal Model uses a dsiscrete value base - the Ten Commitments - to guide all the practical process of individual and group work within the Model. These values emphasise the importance of genuine person-centred care that is respectful of culture and creed, and which recognise that belonging and membership are vital to our personal identity as social beings.


9. The Tidal Model is a philosophical and theoretical template for the development of mental health recovery.



From Tidal theory we have developed a range of ways of working with people - individually and in groups - that can be adapted to fit the person's changing circumstances. We have developed ‘examples’ of how practitioners might work with people individually or in groups. These are examples or illustrations —not rules. “The golden rule is that there are no golden rules”.

Nurses, and other practitioners, around the world are using the philosophical and theoretical principles of the Tidal Model to develop their own practice to suit the unique needs of the many individuals within their service

 

10. The Tidal Model does not work - people do.

 

There now exists a substantial body of research that illustrates the usefulness of working with the Tidal Model, across a range of populations. From a research perspective this is interesting - but no more than that.

Ultimately, the Tidal Model represents a theory of personhood and some processes, drawn from this theory. these processes provide a means by which professionals might help shape their practice in working with people experiencing problems in living.

However, like all other theories, the Tidal Model does not -cannot - work. It involves only ideas on paper. Ultimately, what 'works' (or does not work) is the person, or team of persons, who might help make a difference. We do not undervalue the possible helpfulness of  the Tidal  Model in helping people develop their practice to become more recovery and person-focused. However, ultimately any success belongs to the persons delivery the Tidal Model.