Tidal Model of Mental
Phil Barker and Poppy Buchanan-Barker
Life is a journey taken on an
ocean of experience.
- Tidal model is a mental health recovery model which may be
used as the basis for interdisciplinarymental health
- It was developed by Phil Barker and Poppy Buchanan-Barker of
University of Newcastle, UK.
- It is considered as a mid-range theory of nursing.
- The main focus of the model is on helping individual
people, make their own voyage of discovery.
Tidal Model is a philosophical approach
to the discovery of mental health. It
emphasises helping people reclaim the
personal story of mental distress, 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 recover control
over their lives". - Barker
- The Tidal Model provides a practice framework for the
exploration of the patient's need for nursing and the
provision of individually tailored care. (Barker P, 2001)
- Tidal Model draws its core philosophical metaphor from chaos
theory, such that the unpredictable - yet bounded – nature of
human behaviour and experience is compared to the dynamic flow
and power of water and the tides of the sea. (Barker P, 2001)
The tidal model is applied through six key philosophical
- A belief in the virtue of curiosity : the person is the
world authority on their life and its problems. By expressing
genuine curiosity, the professional can learn something of the
‘mystery’ of the person’s story.
- Recognition of the power of resourcefulness, rather than
focusing on problems, deficits or weaknesses
- Respect for the person's wishes, rather than being
- Acceptance of the paradox of crisis as opportunity
- Acknowledging that all goals must belong to the person
- The virtue of pursuing elegance—the simplest possible means
should be sought
- In the Tidal Model, the person, the individual is
represented, theoretically, by three
personal domains: Self, Worldand Others .
- The theory suggests that our mental wellbeing depends on our
individual life experience, including our sense of self,
perceptions, thoughts and actions.
The Ten Commitments
The values of the Tidal Model can be distilled into Ten
- Value the voice – the person's story
- Respect the language – allow people to
use their own language
- Develop genuine curiosity – show
interest in the person's story
- Become the apprentice – learn from the
person you are helping
- Reveal personal wisdom – people are
experts in their own story
- Be transparent – both the person and
the helper, Professionals are in a privileged position and
should model confidence, by at all times being transparent and
helping to ensure the person understand exactly what is being
- Use the available toolkit – the person's
story contains valuable information as to what works and what
- Craft the step beyond – the helper and
the person work together to construct an appreciation of what
needs to be done "now"
- Give the gift of time – time is the
midwife of change. The question that should be asked is, "How
do we use this time?"
- Know that change is constant – this is
a common experience for all people
The Twenty Competencies
- Competency 1: The practitioner
demonstrates a capacity to listen actively to the
- Competency 2: The practitioner shows
commitment to helping the person record her/his story
in her/his own words as an ongoing part of the
process of care.
- Competency 3: The practitioner helps
the person express her/himself at all times in her/his
- Competency 4: The practitioner helps
the person express her/his understanding of
particular experiences through use of personal
stories, anecdotes, similes or metaphors.
- Competency 5: The practitioner shows
interest in the person’s story by asking for
clarification of particular points, and asking for further
examples or details.
- Competency 6: The practitioner shows
a willingness to help the person in unfolding the
story at the person’s own rate.
- Competency 7: The practitioner
develops a care plan based, wherever possible,
on the expressed needs, wants or wishes of the
- Competency 8: The practitioner helps
the person identify specific problems of living, and what
might need to be done to address them.
- Competency 9: The practitioner helps
the person develop awareness of what works for or against
them, in relation to specific problems of living.
- Competency 10: The practitioner
shows interest in identifying what the person thinks specific
people can or might be able to do to help them further in
dealing with specific problems of living.
- Competency 11: The practitioner helps
the person identify what kind of change would represent a step
in the direction of resolving or moving away from a specific
problem of living.
- Competency 12: The practitioner helps
the person identify what needs to happen in the immediate
future, to help the person to begin to experience this
‘positive step’ in the direction of their desired goal.
- Competency 13: The practitioner
helps the person develop their awareness that dedicated time
is being given to addressing their specific needs.
- Competency 14: The practitioner
acknowledges the value of the time the person gives to the
process of assessment and care delivery.
- Competency 15: The practitioner
helps the person identify and develop awareness of personal
strengths and weaknesses.
- Competency 16: The practitioner
helps the person develop self-belief, therefore promoting
their ability to help themselves.
- Competency 17: The practitioner
helps the person develop awareness of the subtlest of changes
– in thoughts, feelings or action.
- Competency 18: The practitioner
helps the person develop awareness of how they, others or
events have influenced these changes.
- Competency 19: The practitioner aims
to ensure that the person is aware, at all times, of the
purpose of all processes of care.
- Competency 20: The
practitioner ensures that the person is provided with copies
of all assessment and care planning documents for their own
- Young BB. Using the tidal model of mental health recovery
to plan primary health care for women in residential substance
abuse recovery. Issues Ment Health Nurs. 2010
- Fletcher E, Stevenson C. Launching the Tidal Model in
an adult mental health programme. Nurs Stand. 2001 Aug
- Official internet site for the Tidal Model available at
- Buchanan-Barker P . Clarifying the Value Base of Recovery:
The 10 Tidal Commitments. Journal of Psychiatric and
Mental Health Nursing 2008: 15, 93-100.
- Barker P. The tidal model: developing a person-centered
approach to psychiatric and mental health nursing. Perspect
Psychiatr Care. 2001 Jul-Sep;37(3):79-87
- Barker P. The Tidal Model: Theory and Practice. University
of Newcastle, 2000.
- 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):
- Tidal Model Publications -
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