The Tidal Model
 
WHAT IS THE TIDAL MODEL? The Tidal Model ® is a focused and sustained joint enquiry into the discovery of mental health and its meaning. It is an approach that centres on people’s lived experience and thus on the story of people’s lives as told by them rather than as told by helping professionals. The Model is about people (not merely clients, or psychiatric patients or service users). It it reflects the conviction that at the core of every person, is a unique personal life-story. “The voice of the person is the beginning and end point” There are two distinctive features to this approach. The first distinctive is the way in which it encourages people to tell and write their own life-story and the value placed on that as a core component of recovery and the discovery of mental health. The second distinctive is the insistence that all professional assessments and care planning should be done collaboratively with people in care and documented in their own words. Experienced mental health professionals say that this is just common sense and is what should be done as a matter of course. However the testimonies of mental health service users and research into mental health services indicate that, although such an approach may be sensible, it is not that common. RECOVERY AND RECLAMATION The Tidal Model aims to help people to reclaim their life story, which has often been colonised by mental professional professionals, doctors, nurses, social workers, and sometimes by family and friends. The simple but brave act of reclamation is the first step on the voyage of recovery. Having reclaimed the story of breakdown into madness or severe psychological distress, the person can then begin to map out a new course for themselves – one small step at a time, one day at a time. The Tidal Model assumes that the best that we can become and offer is to be genuine supporters of the person who suffers. The task is to provide, as best we can, the conditions under which people can find and access the resources (very broadly defined) they need to undertake the journey out of madness and mental breakdown along a pathway towards mental health and/or spiritual recovery which is most meaningful to them. The person is the world expert on their life story and we should apply ourselves to learning, from that person. METAPHORS Like the ocean, our experience of the human condition ebbs and flows, as if in response to invisible tidal influences. This tidal metaphor holds the key to the model's unique set of assessment and intervention methods, all of which emphasises the need to adapt care, constantly, to fit the changes regularly occurring in the person's presentation day by day and week by week. The central task of care is to help people develop and increased awareness of how their own experience ebbs and flows; how distress comes and goes and - most importantly - what the person, or others, are doing right now that appear to influence this and to help the person recover from their distress and so get on with their lives. Each of our lives is a journey, or a sea voyage if you will, passing through the various stages of life from birth, through infancy, childhood, adolescence, young adult hood, adulthood, middle-age, retirement, old age and passing on through death to realms unknown.  The Tidal Model assumes that here and now, within the person's everyday lived experience, lays the possibility as well as the inner resources necessary for that person to find a good resolution to their present problems and the beginning of recovery journey and thus an opportunity to carry on this journey through life with a full sail and renewed hope.
Text: The person is the world expert on their own life story and we should apply ourselves to learning from that person.


A very significant time for me ‘on the road’ has been my collaboration with Phil and Poppy Barker, founding father and mother of a model of mental health care called the Tidal Model. 


We worked closely together over a number of years (2002-2008) developing the Tidal Model within the Birmingham and Solihull Mental Health NHS Foundation Trust.

It was also a great privilege and pleasure for me to work with Maureen Smojkis and a team of mental health service users in support of the Tidal Model at the Centre of Excellence in Interdisciplinary Mental Health (CEIMH) University of Birmingham.


I spent many stimulating and challenging hours with Jo Barber and other service users producing some poignant  and powerful teaching materials.


These including a DVD and handbook on the use of the Tidal Model within acute psychiatric inpatient settings. You can access our handbook here: Turning the Tide Handbook.pdf 


My experience with the Tidal Model over those years continues to actively shape my coaching  practice today.

 

If you would like to see a more detailed and scholarly account of the Tidal Model project feel free to download two of my papers.


The first is an extensive and detailed piece of the research we did arguing the case for implementing the Tidal Model within the Birmingham and Solihull Mental Health NHS Foundation Trust.... 


Chapters One and Two of that paper give a full overview of current issues within NHS mental health acute inpatient services. To download the first two chapters click here.... Chapters one and two.pdf.

Chapter Two: Literature Review

( Pages 10-53)


2.1 The state we're in

2.2 Childhood abuse, psychosis & the dynamics of containment, control and milieu toxicity

2.3 Why don't nurses talk to patients any more?

2.4 The dislocation of appearance and reality on acute wards

2.5 Conflicting perspectives on the appropriate focus of nursing

2.6 Contradictions within current mental health nursing theory

2.7 Impact of the psychiatric medical model on current nursing care

2.8 The starting point of research and the problem of bias

2.9 A commitment to basic principles of action research

2.10 Abductive reasoning

2.11 Qualitative and quantitative (statistical) evidence

2.12 Conclusion: In search of a non-reductive science of care



Click on the picture above for a pdf download of the entire 162 page document


...........which I followed up by a shorter second paper published in the Journal of Psychiatric and Mental Health Nursing.


Here I look more closely at the nature and integrity of the evidence of our research which had come under attack in some quarters.  Click on this picture for a pdf download.

In 2009 I left the NHS to begin a new career in personal life coaching.

Life-Coaching and Mental Health



A radically holistic approach to fostering mental health as evidenced in the Tidal Model, remains  central to my whole approach to coaching.


Put simply, my highest priority is to see (feel, hear) what the person I am coaching is actually experiencing and to get a grip on their map of reality as they define it, whether they have a psychiatric diagnosis or not. Everything else flows from that.


If someone comes to me with a diagnostic ‘label’ it is that much more important for me to seek out, and communicate with the person behind the label and behind the diagnosis and to meet and understand that person on their own terms.


My job is to help people identify their own life-vision along with the specific goals, which will support that, and to help them create an action plan to turn these into reality. I help people manage their ‘transition’ from where they are today to where they want to be tomorrow.


The issue is often this: people with a history of involvement with the psychiatric services often find that their entire life story has been ‘taken over’, and colonised, (documented, diagnosed, re-told) by psychiatrists & well-meaning helping professionals, as well as by family and friends.


Therefor a simple act of  reclamation of that persons’s own life story and version of events can be the first step on a new journey of discovery of the meaning of emotional and spiritual wellness for that person. 


Having reclaimed the story of breakdown and distress, the person can then begin to map out a new course in life for themselves – one small step at a time, and one day at a time.


Helping people become more aware of how specifically change is happening to them is a key coaching skill to be used with every client and this skill is especially important in working with people who are in recovery from mental health issues.


In addition to that, asking the right questions increases  people’s awareness of the areas of choice actually open to them. This enables people to take more responsibility for their experiences and behaviour.


After all it is the person, not the coach, who is the world’s leading authority on that person’s life and guiding life-vision.


Respecting that tends to subvert traditional psychiatric practice and involves giving both responsibility and power ‘back’ to the person in the following ways:


  1. 1.It is the client that makes the phone calls

  2. 2.It is the client who sets the agenda

  3. 3.It is the client who chooses the goals

  4. 4.It is the client who develops the action plan and discovers the  steps which need to be taken

  5. 5.It is the client who is accountable to report back to the coach on the steps they have taken within the agreed time frame

  6. 6.The coach does not tell the client what to do, where to go or how to get there



My Ten Coaching Commitments


One:

I value the voice of the person I am coaching

Two:

I respect  the specific language he or she  uses when talking about themselves and telling me their life story

Three:

I have and maintain genuine curiosity about this person and their present situation

Four:

I become the apprentice to this person

Five:

I facilitating, by means of skilled, strategic questioning, the dawning of new wisdom for both of us in the context of the coaching relationship

Six:

I knowing that change is constant and that no moment is exactly the same as any other

Seven:

I use  this person’s available tool kit of examples of what has worked for them in the past when they have been ‘at their best’

Eight:

I caft the next positive step beyond..... from where this person is today to where they want to be tomorrow

Nine:

I give my full undistracted attention to this person during the time or are together in conversation

Ten:

I am committed  to being personally transparent, congruent and consistently aligned with my highest spiritual values in all my relationships