Running Head: CURTIS AND THE TIDAL MODEL

Curtis and the Tidal Model

Natasha Singh
Humber College

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INTRODUCTION
Stated in Health Canada (2012), mental health disorder is classified as a
disturbance in thinking, mood and behaviour that impacts a persons ability
to function effectively over a long period of time. In the movie Take Shelter,
Micheal Shannon played the character Curtis who was suffering from
schizophrenia. Phil Barker introduced the tidal model which is a framework to
the process of recovery based on ten commitments from a philosophical
approach that is tailored to fit an individuals specific needs and is developed
from practice based evidence in mental health referring back to the persons
own story and their unique experience (Barker, 2008). Mental health
professionals use Barkers tidal model and the ten commitments to help treat
patients with mental illnesses to recover. The purpose of this paper is to
analyze how two of the ten tidal commitments aid in Curtis recovery from
schizophrenia. This paper will also discuss the mental health disorder
schizophrenia, signs and symptoms that affect his behaviour, feelings, and
thinking how it is exhibited in Curtis. Then it will define and discuss two
commitments from the Barkers Tidal Model and how it can be applied to
Curtis and his recovery process including a nursing intervention that
supports the commitments.
FIRST PARAGRAPH
Schizophrenia is a complex and major mental disorder characterized by
disturbances of thought, perception, mood and behaviour (Rigby and

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Alexander, 2008, p.49). There is no known cause to schizophrenia although

biological theories include: genetic factors, biochemical factors, and
neurodevelopmental theories (Rigby and Alexander, 2008). Signs and
symptoms of this mental health disorder include: delusions, hallucinations,
disorganized speech, disorganized or catatonic behaviour, and dysfunction in
work, school, interpersonal relations, and self-care (Schizophrenia Society
Canada, 2013). There are two main types of symptoms; Positive symptoms
and negative symptoms and within the negative symptoms there are
cognitive symptoms. Negative symptoms refer to the absence of or a
reduction in a persons normal behaviour (Rigby and Alexander, 2008, p.
50). Negative symptoms usually refer to lack of motivation, social
withdrawal, and anhedonia (the loss of interest in things that were once
pleasurable). Curtis exhibited signs of his negative symptoms when he
refused the invitation to the community dinner that his wife made him
attend. His refusal of the dinner was due to his social withdrawal that he had
with his peers decreasing his motivation to be a part of the dinner. This is an
example of Curtis causing isolation upon himself and his social life began to
decline. A common cognitive deficit associated with this condition is
anosognosia; when someone is not aware of having an illness (Schizophrenia
Society Canada, 2013). Curtis expresses this type of cognitive symptom
when he visited his mother and she asked if he was okay and he replied
with saying he was fine. Curtis knew his mother was a schizophrenic but
denied himself of suffering from the symptoms of schizophrenia.

The most

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common characteristic of schizophrenia are delusions and hallucinations

which are also known as positive symptoms. Hallucinations cause a person
to hear voices inside or outside their heads or, less commonly, see things
that do not exist, whereas delusions occur when someone believes ideas that
are clearly false, such as that people are reading their thoughts or that they
can control other people's minds (Schizophrenia Society Canada, 2013).
Curtis exhibited delusions as he so strongly believed there was a terrible
storm coming and felt the need to make an underground shelter in the
backyard. Curtis experienced hallucinations when he vividly believed people
broke through his truck windows and took his daughter Hannah. He also had
hallucinations when he was holding Hannah in the street and he thought
there were hundreds of birds attacking him and dropping dead from the sky.
All of these signs and symptoms support the cardinal signs and symptoms of
schizophrenia.

SECOND PARAGRAPH
The Tidal Model focuses on helping people who have experienced some
metaphorical breakdown recover their lives as fully as possible, by
reclaiming the personal story of their distress and difficulty (Barker, 2010,
p.171). In other words, it is focused to the recovery process of mental
illnesses by using the clients own experiences, values and voice through 10

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commitments. To be transparent is a commitment that values an open

relationship between the client and the care-giver. The professional helper
should be transparent and let the client know what is being done and why at
all times during their recovery process (Brookes, 2008). During the movie,
Curtis initial professional helper suddenly stopped working with him without
him knowing. This could be seen as a setback in Curtis recovery process
because she was not being completely transparent. If Curtis had a
professional helper that included him in everything they were doing as part
of his treatment and recovery process, Curtis would had been more likely to
continue working with them to reach his goal of functioning normally again.
In nursing, this commitment can be looked at as developing a therapeutic
relationship. An appropriate nursing intervention for this commitment would
be to set up many check-in appointments to allow the client to voice his
experiences and to document and share with the client what is being said,
what the steps of care will be, and how they will be executed (Barker, 2008).
Collaboration between the client and the professional is key.
THIRD PARAGRAPH
Any time spent in constructive interpersonal communion, is a gift for both
parties (Barker, 2008, p.97). With that being said, the gift of time is the
second tidal model commitment that will be discussed. The gift of time is
aimed to make the individual aware that there is a dedicated period of time
to them to address their needs and aid them in recovering. It is important for

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both parties to understand the importance and the value of the time they
have to work together in this process. Nothing is more valuable than time
itself. It is important to remember that the recovery process can go forward
as well as backwards before reaching the end goal and in the end the
successfulness will ultimately depend on time. It is crucial for the
professional helper to allot as much time as needed to fit Curtis individual
and specific needs as the recovery process is different between all clients.
This commitment can work in combination with being transparent because
the more time spent working with Curtis can greatly influence his
relationship with his professional helper in a positive way. The more time
Curtis spends working in collaboration with his professional helper will
encourage him to complete the recovery process. An appropriate nursing
intervention for this tidal model commitment would be to monitor Curtis
progression as the treatment takes place and to allow Curtis to move forward
by understanding his situation and developing coping mechanisms tailored
to him during this process. Since professionals often complain about not
having enough time to work with the person (Barker, 2008, p.97), an
important intervention is to use the time spent with Curtis creatively and
constructively. Professional helpers need to remember that all interventions
will take time.
CONCLUSION

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Overall, to help Curtis in his recovery process, the professional helper must
first understand schizophrenia and how schizophrenia affects Curtis life in a
holistic view. Although there is no permanent cure for schizophrenia, early
diagnosis and immediate treatment aids in allowing the individual to live a
full and satisfying life which is the ultimate goal for both the professional
health care team and the individual. The tidal model helps with the recovery
process for individuals with schizophrenia by using the commitments
provided within the tidal model and the use of therapeutic approach, nurses
can enhance the recovery process for the client and increase the
successfulness of reaching the individuals goal on their journey to recovery.
It is important to remember that with time comes change.