Behavioral System Model  “Theory

How?”
Development: What, Why,

Dorothy E. Johnson  “Barriers and Hazards in Counseling”

(1919 - 1999) Overview of the Theory

 Johnson’s model for nursing presents a

view of the client as a living open system.
Backgrounds and History
 Characterized by repetitive,
 Born on August 21, 1919, in Savannah, regular,predictable, and goal-directed
Georgia. behaviors that always strive toward
 Received her associate’s degree from balance (Johnson, 1968).
Armstrong Junior College in Savannah,
Georgia (1938).  (1992) Johnson’s model was heavily
 B.S.N. from Vanderbilt University in influenced by Florence Nightingale’s book
Nashville, Tennessee (1942). “Notes on Nursing”.
 Her professional experiences involved
mostly teaching, although she was a staff  She accepted with Nightingale’s belief
nurse at the Chatham-Savannah Health that the first concern of nursing is the
Council (1943-1944). relationship between the person who is ill
 Serve as chairperson on the committee of and their environment, not the illness
the California Nurses Association. (1977).
 She published 4 books; more than 30  She used the work of behavioral scientists
articles in periodicals; and many papers, in psychology, sociology, and ethnology
reports, proceedings, and monographs to develop her theory which influenced the
(Johnson,1980). identification and the content of her seven
 She died in February 1999 at 80 years of system.
age.
 Talcott Parsons’ (1951,1964) social action
Awards theory stressed a structural-functional
 Faculty Award from graduate students approach.
(1975).  One of his major contributions was to
 Lulu Hassenplug Distinguished reconcile functional and structuralism.
Achievement Award from the California
Nurses Association (1977).  Functional - the idea that every observable
 Vanderbilt University School of Nursing social behavior has a function to perform.
Award for Excellence in Nursing (1981).
 Structuralism - the idea that social
Works behaviors, rather than being directly
functional, are expressions of deep
 She proposed her model of nursing care as underlying structures in social system.
fostering of “the efficient and affective
behavioral functioning in the patient to  The components of the structure of a
prevent illness.” social system - goal, set, choice, and
behavior.
 She also started that nursing was
“concerned with man as an integrated  It is the focus on what the individual does
whole and this is specific knowledge of and why.
order we require.”
 Nursing contributes by facilitating
 Johnson published her conceptualization effective behavioral functioning in the
of “Behavioral System Model for patient before, during, and after illness.
Nursing” (1980) - first work of Johnson
Major Concepts and Definitions
that explicates her definition of the
behavioral system model.  Behavior - the output of intraorganismic
structures and processes as they are
 coordinated and articulated by and 6. Achievement Subsystem - ability to
responsive to changes in sensory progress and thrive, functions to control or
stimulation. master self or the environment. Include
 Johnson (1980) focused on behavior intellectual, physical, creative,
affected by the actual or implied presence mechanical, and social skills (Johnson,
of other social beings that has been shown 1980).
to have major adaptive significance.
 System - is a whole that function as a 7. Aggressive- Protective Subsystem - the
whole by virtue of the interdependence of ability to assert, function in self and social
its parts (p.208). perseverance.
- organization, interaction, Additional Subsystems
interdependency, and integration of the
parts and elements (Johnson, 1980, p.208). 8. Restorative Subsystem - concerned with
 Behavioral System - the ways of behaving rest, sleep, comfort/freedom from pain.
(patterned, repetitive, and purposeful)
Functional Requirements for Each Subsystem
form an organized and integrated
functional unit that determines and limits  Protection - safety and well being of the
the interaction between the person and his individual.
or her environment and establishes the
relationship of the person to the objects,  Nurturance - affection and assistance from
events, and situations within his or her others.
environment.
 Stimulation - internal and external stimuli
 Subsystems - a minisystem with its own
including advancement and growth.
particular goal and function that can be
maintained as long as its relationship to  Equilibrium - is a key concept in nursing’s
the other subsystems or the environment is specific goal (Johnson, 1961b).
not disturbed (Johnson,1980, p. 221).
- a stabilized but more or less transitory,
Seven Subsystems resting state in which the individual is in
harmony with himself and with his
1. Attachment-Affiliative Subsystem - most
environment (p. 65).
critical, the need for social organization:
social inclusion, intimacy. Ability to -the biological and psychological forces
create a relationship . are in balance with each other and with
impinging social forces (Johnson, 1961a,
2. Dependency Subsystem - promotes
p. 11).
helping behavior, need of approval,
recognition, and physical assistance. -not synonymous with a state of health,
Ability to maintain a relationship. since it may be found either in health or
illness (Johnson, 1961a, p.11)
3. Ingestive Subsystem - has to do with
when, how, what, how much, and under MAINTAINING EQUILIBRIUM IS
what conditions we eat (Johnson,
1980,p.213). Fulfills biological  Regulation/Control - implies that
requirements. The ability to consume and deviations will be detected and corrected.
“appetite satisfaction”.
 Tension - defined as a state of being
4. Eliminative Subsystems - addresses to stretched or strained and can be viewed
when, how, and under what conditions we as an end-product of a disturbance in
eliminate (Johnson, 1980, p. 213). equilibrium (Johnson,1961b, p. 10)
Functions to eliminate waste and maintain
 Stressor - internal or external stimuli that
bodily functions.
produce tension and result in a degree of
5. Sexual Subsystem - gender role and instability.
identity. The ability to procreate and
express sexual gratification.
 1. Preparatory Set - what a person usually
attends to.

2. Perseverative Set - the habit one maintains

in a situation.
Johnson’s Model Metaparadigm of the Theory

● Nursing - has a primary goal that is to

foster equilibrium within the individual.

-concerned with the organized and

integrated whole, maintaining balance in
the Behavioral System when illness occurs
in an individual.

4 Goals of Nursing

To assist patient:
4 Major Assumptions
1. Whose behavior is commensurate with
1. “Organization, interaction,
social demands
interdependency, integration of the parts
and elements of behavior that make up the 2. Who is able to modify his behavior in
system.” ways that supports biological imperatives
2. A system tends to achieve a balance 3. Who is able to benefit to the fullest extent
among the various forces operating within during illness from the physician’s
and upon it, and that man continually knowledge and skill
strive to maintain a behavioral system
balance and steady state by more or less 4. Whose behavior does not give evidence of
automatic adjustments and adaptations to unnecessary trauma as a consequences of
the natural forces impinging upon him. illness (Johnson, 1980, p.207).

3. A behavioral system, which both requires ● Person - “human being” having the major
and results in some degree of regularity systems, the biological system (medicine’s
and constancy in behavior is essential to focus) and behavioral system (nursing’s
man that is to say, it is functionally focus).
significant in that it serves a useful
● Health - an elusive, dynamic state
purpose, both on social life and for the
influenced by biological, psychological,
individual.
and social factors.
4. A system balance reflects adjustments and
-reflected by the organization, interaction,
adaptations that are successful in some
interdependence, and integration of the
ways and to some degree.
subsystems of behavioral system
Structural Elements Required for Each (Johnson, 1980).
Subsystems
- also the source of the sustenal
1. Drive or Goal - the ultimate consequence imperatives of protection, nurturance, and
of behaviors (Grubbs, 1974, p.226). stimulation that are necessary
prerequisites to maintain health
2. Set - tendency to act a certain way. (behavioral system model balance;
Grubbs, 1980).
3. Choice - behavior the patient sees
themselves using in a situation. Johnson’s Behavioral System Model
4. Action - observable behavior of an
individual

2 Types of Set
  Ingestion

 Achievement

 Restorative

Diagnosis - tends to be general to the system that

is specific to the problem.

1. Insufficiency - a state which exists when a

particular subsystems is not functioning or
developed to its fullest capacity due to
inadequacy of functional requirements…

2. Discrepancy - behavior that does not meet

Acceptance By the Nursing Community the intended goal.
● Practice - used in a variety of clinical 3. Incompatibility - the goals or behaviors of
settings and age groups. the two subsystem in the same situation
- Used in inpatient, outpatient, and conflict with each other to the detriment of
the individual…
community setting, as well as in nursing
department. 4. Dominance - the behavior in one
subsystem is used more than any other
- Assessment, disorders, treatment and
subsystem regardless of the situation or to
evaluation are concepts referred to in a
the detriment of the other subsystems.
variety Johnson’s works.
Outcomes, Planning and Implementation- the
- “Means of management”
plan will be focus on nurses’ actions to modify
 Education - a core curriculum based on aa client’s input into the plan. Have a goal to bring
person as a behavioral system would have about homeostasis in a subsystem, based on nursing
definite goals and clear course planning. assessment of the individual’s drive, set behavior,
The study would center on the client as a repertoire, and observable behavior.
behavioral system and its dysfunction.
Evaluation - based on the attainment of a goal of
Which would necessitate the use of the
balance in the identified subsystems.
nursing process.
Application of the Theory
 Research - vital to explain and identify the
behavioral system disorder which arises in Coco C., a 6-week infant was brought to
relation with illness, and develop good the clinic for a routine check- up. He presents with
reasoning for the means of management no weight gain since his check up at the age of 2
(Johnson). The theory resulting from the weeks. Hiss mother stated she feeds him but he
Behavioral System Model influences the does not seem to eat much. He sleeps 4 to 5 hours
researcher to choose between two options. between the feedings. His mother holds him in her
arms without trunk to trunk contact. As the
Nursing Process and Johnson’s Behavioral
assessment is made the nurse notes that Mrs. C.
System Model
never looks at Coco and never speaks to him. She
 Assessment stated he was a planned baby but she never realize
how much work a baby could be. She says, her
 Affiliation mother told her she was not a good mother because
Coco is not gaining weight like he should. She
 Dependency
states she had not called the nurse when she knew
 Sexuality Coco was not gaining weight because she thought
the nurse would think she was a bad mother just
 Aggression like her own mother thought she was a bad mother.
 Elimination Assessment
 ● Affiliative subsystem between mother and
Coco

● Dependency subsystem between mother

and Coco

● Affiliative subsystem between Mrs. C. and

her mother

● Insufficiency ingestion subsystem

Diagnosis

● Insufficient development of the affiliative

subsystem.

● Insufficient development of the

dependency subsystem

Planning and implementation

● Increasing mother’s awareness of the

baby’s clues

● Assisting her to talk with the baby

● Teach her to bring bond between her and

the body by touching, patting, cuddling,
eye contact, etc.

Evaluation

● Coco’s weight gain or weight loss will be

carefully assessed.

● The mother-infant interaction could be

reassessed, using the nursing child
assessment feeding scale.

● The interaction of Mrs. C. with her

mother.

“All of us, scientists and practicing professionals,

must turn our attention to practice and ask
questions of that practice. We must be inquisitive
and inquiring, seeking the fullest and truest
possible understandings of the theoretical and
practical problems we encounter.” ( Johnson,
1976)