Tidal Model in light of complexity: contributions to clinical nursing care in mental health

Comaru, Natália Rocha Chagas; Monteiro, Ana Ruth Macêdo; Silva, Lucia de Fatima da; Freitas, Maria Célia de; Guedes, Maria Vilani Cavalcante

doi:10.1590/1980-220X-REEUSP-2024-0377en

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THEORETICAL STUDY • Rev. esc. enferm. USP 59 • 2025 • https://doi.org/10.1590/1980-220X-REEUSP-2024-0377en linkcopy

Tidal Model in light of complexity: contributions to clinical nursing care in mental health

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This is a theoretical essay that aims to reflect on the articulations between Phil Barker’s Tidals Model and Edgar Morin’s Complexity Theory, highlighting Tidals Model adequacy for clinical nursing care in mental health according to the psychosocial care model guidelines. The key concepts of Complexity Theory (dialogic, organizational recursion, hologram and tetragram) were used in an articulated manner with Tidals Model, identifying that this framework is aligned with the following guidelines of psychosocial care: respect for human rights, humanized care, promotion of equity, diversification of care strategies, combating stigmas and prejudices, guaranteeing access to services, and offering comprehensive care and multidisciplinary assistance, under an interdisciplinary logic. Tidals Model represents an alternative to traditional care models, with a care proposal aligned with current public health policies. It is suggested that nurses adopt this framework more effectively, expanding its application to the most diverse audiences and contexts of mental healthcare.

DESCRIPTORS
Nursing; Mental Health; Mental Health Assistance; Philosophy, Nursing; Nursing Theory

Complexity principle	Application in Tidal Model	Psychosocial Care Network guidelines(¹)
Dialogic	– Complementary antagonisms are accepted: health x mental illness; nurse x person in psychological distress; whole x parts (domains of the Self, the World and Others); – In its fourth guiding principle, it views the crisis as an opportunity for change.	– “Respect for human rights, guaranteeing people’s autonomy and freedom”; – “Humanized care focused on people’s needs”; – “Promotion of equity, recognizing the social determinants of health”.
Organizational recursion	– Change is a constant process; – Knowledge and discoveries about the person’s relationship with health and illness, constructed and revealed in collaboration with the nurse, help to form new knowledge, which generates new perspectives on the subject.	– “Respect for human rights, guaranteeing people’s autonomy and freedom”; – “Humanized care focused on people’s needs”; – “Diversification of care strategies”.
Hologram	– The person is represented and must be understood in three personal domains: the Self, the World and Others.	– “Promoting equity, recognizing the social determinants of health”.
Tetragram of complexity	– He considers that the unpredictability of nature is similar to human life, comparing it to the flow of water, the ebb and flow of the tides, drawing his central philosophical metaphor from Chaos Theory. – Life and its unpredictability are threatening, and everyday human problems arise from complex interactions between people and them, enabling the installation of chaos.	– “Combating stigmas and prejudices; ensuring access and quality of services, offering comprehensive care and multidisciplinary assistance, under an interdisciplinary logic”.

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[1] Source: prepared by the authors.