ABSTRACT
This chapter proposes a new way of developing the nursing and multidisciplinary therapeutic relationship with the service user who has an eating disorder, in order to establish a working alliance in all treatment settings. In the UK eating disorders are treated mainly in psychiatric services: in specialist psychiatric eating disorder services, or generic psychiatric services for people of all ages. There is a shift in treatment focus at the age of 18, when people move from child and adolescent mental health services to adult psychiatric services. A nurse-generated model of care which promotes and outlines the idea of nursing care as a ‘craft’ is the Tidal Model. Self-determination theory explains why people change and Motivation interviewing explains how to establish the therapeutic conditions needed to elicit and direct changes in health behaviour. The Tidal Model outlines a philosophical stance of respectful caring that underlines the necessary qualities of the nursing therapeutic alliance.
