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CHAPTER 32 Phil Barker 635

MAJOR CONCEPTS & DEFINITIONS —cont’d
health crisis, possibly entering the mental health include liaising with colleagues and ensuring
system for the first time or with people familiar the person’s participation in the transfer of care.
with the system when a crisis occurs. Transitional The other end of the continuum is developmental
care addresses the smooth passage from one setting care, where the focus is on more intensive and
to another, when the person is moving from one longer-term support or therapeutic intervention
form of care to another. Here, nursing responsibilities (See Figure 32–4).
*Barker, P. J., & Buchanan-Barker, P. (2007a). The Tidal Model: Mental health recovery and reclamation. Newport-on-Tay, Scotland: Clan Unity
International.
† From Barker, P. J. (2000d). The Tidal Model—Humility in mental health care. Retrieved from http://www.tidal-model.com/Humility%20in%20mental%20
health%20care.htm
‡ Retrieved from www.tidal-model.com/Clarifying%20the%20value%20base%20of%20the%20Tidal%29Model.htm
§ Barker, P. J. & Buchanan-Barker, P. (2004). Beyond empowerment: Revering the storyteller. . Mental Health Practice, 7(5), 18–20.
|| From Barker, P. J., & Buchanan-Barker, P. (2007a). The Tidal Model: Mental health recovery and reclamation. (pp. 30–31). Newport-on-Tay, Scotland: Clan
Unity International.
¶ From Barker, P. J. (2000e). The Tidal Model Theory and practice. (pp. 22–24). Newcastle, UK: University of Newcastle.

in the early 1960s and Peplau’s paradigm of inter-
Use of Empirical Evidence personal relationships contribute to the empirical
Barker’s long-standing curiosity about the nature and base of the Tidal Model. Altschul’s study of nurse-
focus of psychiatric nursing and the stories of per- patient interaction in the 1960s provides empirical
sons-in-care led to the development of a theoretical support for the complex, yet paradoxically “ordi-
construction of psychiatric nursing, or a metatheory, nary” nature of the relationship (Barker, 2002a).
that could be further explored through empirical in- Altschul’s study of community teams in the 1980s
quiry (Barker, Reynolds, & Stevenson, 1997, p. 663). raised questions about the “proper focus of nursing”
Over 5 years, from 1995, the Newcastle and North and the “need for nursing,” and both Altschul and
Tyneside research team developed an understanding Peplau provided evidence related to interprofes-
of what people experiencing problems in living might sional teamwork.
need from nurses and began using their emergent Two of Barker’s theory-generating studies pro-
findings in 1997 as the basis for development of the vided the empirical base for the Tidal Model. The
Tidal Model. “need for nursing” studies (Barker, Jackson, &
Barker supports learning from, using, and inte- Stevenson, 1999a, 1999b) examined the perceptions
grating extant theory and research, as well as the ex- of service users, significant others, members of mul-
perience of reality—”evidence from the most ‘real’ of tidisciplinary teams, and nurses, and it sought to
real worlds” (Barker & Jackson, 1997). An example is clarify discrete roles and functions of nursing within
the “need adapted” approach to caring with people a multidisciplinary care and treatment process and
living with schizophrenia developed from Alanen’s to learn what people value in nurses (Barker, 2001c,
studies in Finland. One understanding that underpins p. 215). They demonstrated that professionals and
Alanen’s work and flows through the Tidal Model is persons-in-care wanted nurses to relate to people
that people and their families need to think of admis- in ordinary, everyday ways. There was universal
sion to a psychiatric facility as a result of problems of acceptance of special interpersonal relationships
living they have encountered and not as a mysterious between nurses and persons, echoing Peplau’s (1952)
illness that is within the patient (Alanen, Lehtinen, & work. “Knowing you, knowing me” emerged as the
Aaltonen, 1997). core concept in these studies. The nurse is expected
The power of the nurse-patient relationship dem- to know what the person wants even if it is not
onstrated through Altschul’s pioneering research verbalized or is not clear, and needs are constantly