The Tidal model as a Specialist field of enquiry on the provision of Mental Health Care

Introduction

There’s a saying that states that there “is more than one way to skin a cat.” This is well demonstrated in the realm of provision of mental health care because there are several unique approaches to treating mental illnesses (Martin and Henderson, 2011). The tidal model is one of the more recent ways of handling these conditions and the key factor that sets it apart from the other fields of enquiry is the fact that it was developed through a collaborative process between nurses and individuals who had previously used mental care facilities. Its key feature is the empowerment of the patient in terms of taking action that will lead to a full recovery (Barker et al, 2005).

Like other fields of enquiry, this approach is based on and dependent on information that the healthcare provider is receiving from the mental patient. The tidal model is a pioneer approach and is the first of its kind to be internationally acclaimed as a mid-range theory of nursing (Barkway and Patricia, 2009). This model is also the first one to be employed as a basis for initiatives in interdisciplinary mental health care programs. This model, unlike other existing approaches is the only one that takes into account the recovery journey of a mental patient including the time when the patient is at ‘rock bottom.’

The key innovative practice that is used in the Tidal Model is through the patient narrating his or her story. This is known as “story telling’ or ‘telling my story’ and it borrows heavily from the modus operandi at the Alcoholics Anonymous movement. What happens is that the patient is given an opportunity to narrate his or her version of events regarding the possibly traumatic life event that has led them to have a mental disorder. The mentality behind this practice is that what the patient needs is to come face to face with his or her inner truths and thus reclaim control that they have lost. This is in stark contrast with conventional psychiatric practice that applies complex theoretical information that is highly objective to a patient’s condition yet each mental illness is a subjective matter that changes from patient to patient (Sullivan and Garland, 2010).

The narrations that take place are not merely organized story telling sessions but actually a process that enables the patient to discuss his or her issues and correlates them with the effects that they have had on the life of the individual. This may be in the form of an undue burden or a case of being deprived something valuable, say love or deserved status. The more the patient narrates, the closer he or she will draw towards making a decision regarding what action needs to be taken concerning the matter. The sooner the patient makes this realization, the quicker the recovery becomes. A key element of these sessions is the reclamation process (Cotrell, 2003).

Reclamation is tantamount to recovery and this happens once a patient comes to terms with their true identity and decides to take back the elements of this identity that have been lost. In making a decision about what needs to be done, the patient is placed in a position to isolate what he or she can do on their own and also the things that the patient cannot regain unaided. With respect to the second category things, the patient then has to seek help from other people. At this stage, a prerequisite for recovery is the patient’s acceptance of external guidance and help (Barker, 2003; Holland and Reese, 2010).

Given the fact that the tidal model requires a mental patient to be in a lucid state of mind and also that it targets mental conditions that have been caused by a life event, it is ideal for people who suffer from Post-Traumatic Stress Disorder or PTSD in short. As the name suggests, Post Traumatic Stress Disorder is a mental conditions that results from an event that the patient experiences in the course of his or her life. Common causes of this mental illness include bad experiences in war, terror attacks, the loss of a loved one in a violent manner and even physical or psychological abuse such as rape or torture. These events replay themselves over and over again in the mind of the patient thus traumatizing them each time. Narration of their ordeal can be of tremendous help to the patient’s recovery process (Barker and Barker, 2008).

With a high number of war veterans suffering the effects of PTSD, it is essential that the army’s medical department, specifically the one that deals with counselling to adapt the tidal model into the already existing support programs that have been instituted to offer aid the recovery of army officers who have developed mental disorders following nasty experiences at the battlefield (Chambers et al, 2004). The beauty of this is that the model will ensure that the intervention of nurses working with these patients is only doing what is absolutely necessary for the patient’s recovery (Stevenson et al, 2002; Thompson and Dowding, 2002).

References

Barker P.; Barker, PJ 2008. “The Tidal Commitments: extending the value base of mental health recovery”. Journal of Psychiatric and Mental Health Nursing 15 (2): 93–100

Barker, P 2003 Assessment in Psychiatric and Mental Health Nursing – In Search of the Whole Person Nelson Thornes London

Barker, P.; Buchanan-Barker P. (2005). The Tidal Model: A Guide for Mental Health Professionals. London: Brunner-Routledge. ISBN 1-58391-801-9.

Barkway, Patricia (2009). “Theories on Mental Health and Nursing”. In Elder, R.; Evans, K. & Nizette, D. Psychiatric and Mental Health Nursing (2 ed.). Mosby. pp. 119–134
Chambers R, Boath E, Rogers D. 2004. Clinical Effectiveness and Clinical Governance Made Easy Radcliffe Medical Press. Oxford

Cottrell S. 2003. Skills for Success. Palgrave McMillan. Basingstoke

Holland K and Rees C 2010 Nursing: Evidence Based Practice Skills. Oxford University Press Oxford
Martin V, Henderson E (eds) 2011 Managing in Health and Social Care Routledge, London

Sullivan. E.J. and Garland G. 2010 Practical Leadership and Management in Nursing New Jersey
Thompson C, Dowding D. (eds) 2002 Clinical Decision Making and Judgements in Nursing Churchill Livingstone. London

Stevenson, C.; Barker, P. & Fletcher, E. 2002. “Judgement days: developing an evaluation for an innovative nursing model”. Journal of Psychiatric and Mental Health Nursing 9 (3): 271–276.