Dorothy E.

Johnson’s
Behavioral System Model
Dorothy E. Johnson is well-known for her “Behavioral System Model,” which
was first proposed in 1968. Her model was greatly influenced by Florence
Nightingale’s book, Notes on Nursing. It advocates the fostering of efficient and
effective behavioral functioning in the patient to prevent illness and stresses the
importance of research-based knowledge about the effect of nursing care on
patients.

Contents [hide]
 1 Description
 2 Goals
 3 Assumptions
 4 Major Concepts
o 4.1 Human Beings
o 4.2 Environment
o 4.3 Health
o 4.4 Nursing
o 4.5 Behavioral system
o 4.6 System
o 4.7 Subsystem
 5 Subconcepts
o 5.1 Structure
o 5.2 Variables
o 5.3 Boundaries
o 5.4 Homeostasis
o 5.5 Stability
o 5.6 Stressor
o 5.7 Tension
 o 5.8 Instability
o 5.9 Set
o 5.10 Function
 6 7 Subsystems
o 6.1 Attachment or affiliative subsystem
o 6.2 Dependency subsystem
o 6.3 Ingestive subsystem
o 6.4 Eliminative subsystem
o 6.5 Sexual subsystem
o 6.6 Aggressive subsystem
o 6.7 Achievement subsystem
 7 Behavioral System Model and The Nursing Process
 8 Strengths
 9 Weaknesses
 10 Conclusion
 11 See Also
 12 References
 13 External Links

Description

Johnson’s theory defined Nursing as “an external regulatory force which acts to
preserve the organization and integration of the patients behaviors at an
optimum level under those conditions in which the behavior constitutes a threat
to the physical or social health, or in which illness is found.”

It also states that “each individual has patterned, purposeful, repetitive ways of
acting that comprises a behavioral system specific to that individual.”

Goals
Johnson began her work on the model with the premise that nursing was a
profession that made a distinctive contribution to the welfare of society. Thus,
nursing had an explicit goal of action in patient welfare.

The goals of nursing are fourfold, according to the Behavior System Model: (1)
To assist the patient whose behavior is proportional to social demands. (2) To
assist the patient who is able to modify his behavior in ways that it supports
biological imperatives. (3) To assist the patient who is able to benefit to the
fullest extent during illness from the physician’s knowledge and skill. And (4) To
assist the patient whose behavior does not give evidence of unnecessary
trauma as a consequence of illness.

Assumptions

The assumptions made by Johnson’s theory are in three

categories: assumptions about system, assumptions about structure,
and assumptions about functions.

Johnson identified several assumptions that are critical to understanding the

nature and operation of the person as a behavioral system: (1) There is
“organization, interaction, interdependency and integration of the parts and
elements of behaviors that go to make up the system.” (2) A system “tends to
achieve a balance among the various forces operating within and upon it, and
that man strive continually to maintain a behavioral system balance and steady
state by more or less automatic adjustments and adaptations to the natural
forces occurring on him.” (3) A behavioral system, which requires and results in
some degree of regularity and constancy in behavior, is essential to man. It is
functionally significant because it serves a useful purpose in social life as well as
for the individual. And (4) “System balance reflects adjustments and
adaptations that are successful in some way and to some degree.”
The four assumptions about structure and function are that: (1) “From the
form the behavior takes and the consequences it achieves can be inferred what
‘drive’ has been stimulated or what ‘goal’ is being sought.” (2) Each individual
person has a “predisposition to act with reference to the goal, in certain ways
rather than the other ways.” This predisposition is called a “set.” (3) Each
subsystem has a repertoire of choices called a “scope of action.” And (4) The
individual patient’s behavior produces an outcome that can be observed.

And lastly, there are three functional requirements for the subsystems.: (1)
The system must be protected from toxic influences with which the system
cannot cope. (2) Each system has to be nurtured through the input of
appropriate supplies from the environment. And (3) The system must be
stimulated for use to enhance growth and prevent stagnation.

Major Concepts

Human Beings

Johnson views human beings as having two major systems: the biological
system and the behavioral system. It is the role of medicine to focus on the
biological system, whereas nursing’s focus is the behavioral system.

The concept of human being was defined as a behavioral system that strives to
make continual adjustments to achieve, maintain, or regain balance to the
steady-state that is adaptation.

Environment

Environment is not directly defined, but it is implied to include all elements of

the surroundings of the human system and includes interior stressors.
Health

Health is seen as the opposite of illness, and Johnson defines it as “some degree
of regularity and constancy in behavior, the behavioral system reflects
adjustments and adaptations that are successful in some way and to some
degree… adaptation is functionally efficient and effective.”

Nursing

Nursing is seen as “an external regulatory force which acts to preserve the
organization and integration of the patient’s behavior at an optimal level under
those conditions in which the behavior constitutes a threat to physical or social
health, or in which illness is found.”

Behavioral system

Man is a system that indicates the state of the system through behaviors.

System

That which functions as a whole by virtue of organized independent interaction

of its parts.

Subsystem

A mini system maintained in relationship to the entire system when it or the

environment is not disturbed.

Subconcepts

Structure

The parts of the system that make up the whole.

Variables

Factors outside the system that influence the system’s behavior, but which the
system lacks power to change.

Boundaries

The point that differentiates the interior of the system from the exterior.

Homeostasis

Process of maintaining stability.

Stability

Balance or steady-state in maintaining balance of behavior within an acceptable

range.

Stressor

A stimulus from the internal or external world that results in stress or

instability.

Tension

The system’s adjustment to demands, change or growth, or to actual

disruptions.

Instability

State in which the system output of energy depletes the energy needed to
maintain stability.
Set

The predisposition to act. It implies that despite having only a few alternatives
from which to select a behavioral response, the individual will rank those
options and choose the option considered most desirable.

Function

Consequences or purposes of action.

7 Subsystems
Johnson’s Behavioral System Model

Johnson identifies seven subsystems in the Behavioral System Model. They are:

Attachment or affiliative subsystem

Attachment or affiliative subsystem is the “social inclusion intimacy and the

formation and attachment of a strong social bond.” It is probably the most
critical because it forms the basis for all social organization. On a general level,
it provides survival and security. Its consequences are social inclusion, intimacy,
and formation and maintenance of a strong social bond

Dependency subsystem

Dependency subsystem is the “approval, attention or recognition and physical

assistance.” In the broadest sense, it promotes helping behavior that calls for a
nurturing response. Its consequences are approval, attention or recognition,
and physical assistance. Developmentally, dependency behavior evolves from
almost total dependence on others to a greater degree of dependence on self. A
certain amount of interdependence is essential for the survival of social groups.

Ingestive subsystem

Ingestive subsystem is the “emphasis on the meaning and structures of the

social events surrounding the occasion when the food is eaten.” It should not be
seen as the input and output mechanisms of the system. All subsystems are
distinct subsystems with their own input and output mechanisms. The ingestive
subsystem “has to do with when, how, what, how much, and under what
conditions we eat.”

Eliminative subsystem

Eliminative subsystem states that “human cultures have defined different

socially acceptable behaviors for excretion of waste, but the existence of such a
pattern remains different from culture to culture.” It addresses “when, how, and
under what conditions we eliminate.” As with the ingestive subsystem, the
social and psychological factors are viewed as influencing the biological aspects
of this subsystem and may be, at times, in conflict with the eliminative
subsystem.

Sexual subsystem

Sexual subsystem is both a biological and social factor that affects behavior. It
has the dual functions of procreation and gratification. Including, but not limited
to, courting and mating, this response system begins with the development of
gender role identity and includes the broad range of sex-role behaviors.

Aggressive subsystem

Aggressive subsystem relates to the behaviors concerning protection and self-

preservation, generating a defense response when there is a threat to life or
territory. Its function is protection and preservation. Society demands that
limits be placed on modes of self-protection and that people and their property
be respected and protected.

Achievement subsystem

Achievement subsystem provokes behavior that tries to control the

environment. It attempts to manipulate the environment. Its function is control
or mastery of an aspect of self or environment to some standard of excellence.
Areas of achievement behavior include intellectual, physical, creative,
mechanical, and social skills.

Behavioral System Model and The Nursing Process

The nursing process of the Behavior System Model of Nursing begins with an
assessment and diagnosis of the patient. Once a diagnosis is made, the nurse
and other healthcare professionals develop a nursing care plan of interventions
and setting them in motion. The process ends with an evaluation, which is
based on the balance of the subsystems.

Johnson’s Behavioral System Model is best applied in the evaluation phase,

during which time the nurse can determine whether or not there is balance in
the subsystems of the patient. If a nurse helps a patient maintain
an equilibrium of the behavioral system through an illness in the biological
system, he or she has been successful in the role.

Strengths

Johnson’s theory guides nursing practice, education, and research; generates

new ideas about nursing; and differentiates nursing from other health
professions.

It has been used in inpatient, outpatient, and community settings as well as in

nursing administration. It has always been useful to nursing education and has
been used in practice in educational institutions in different parts of the world.

Another advantage of the theory is that Johnson provided a frame of reference

for nurses concerned with specific client behaviors. It can also be generalized
across the lifespan and across cultures.

The theory also has potential for continued utility in nursing to achieve valued
nursing goals.

Weaknesses

The theory is potentially complex because there are a number of possible

interrelationships among the behavioral system, its subsystems, and the
environment. Potential relationships have been explored, but more empirical
work is needed.

Johnson’s work has been used extensively with people who are ill or face the
threat of illness. However, its use with families, groups, and communities is
limited.

Though the seven subsystems identified by Johnson are said to be open, linked,
and interrelated, there is a lack of clear definitions for the interrelationships
among them which makes it difficult to view the entire behavioral system as an
entity.

The problem involving the interrelationships among the concepts also creates
difficulty in following the logic of Johnson’s work.

Conclusion

Johnson’s Behavioral System Model describes the person as a behavioral system

with seven subsystems: the achievement, attachment-affiliative, aggressive
protective, dependency, ingestive, eliminative, and sexual subsystems. Each
subsystem is interrelated with the others and the environment and specific
structural elements and functions that help maintain the integrity of the
behavioral system.

Through these, the focus of her model is with what the behavior the person is
presenting making the concept more attuned with the psychological aspect of
care in.

When the behavioral system has balance and stability, the individual’s behaviors
will be purposeful, organized, and predictable. Imbalance and instability in the
behavioral system occur when tension and stressors affect the relationship of
the subsystems or the internal and external environments.
See Also

 Dorothy E. Johnson – Biography and Works

References

1. Johnson, D. E. (1959a). A philosophy of nursing. Nursing Outlook,

7(4), 198–200.
2. Johnson, D.E. (1968). One conceptual model of nursing. Unpublished
lecture, Vanderbilt University, Nashville, TN.