Dorothy Johnson: Behavioral System Model

Get to know the nurse theorist Dorothy Johnson and her nursing theory “Behavioral System Model” in
this study guide.

Biography of Dorothy E. Johnson

Dorothy E. Johnson (August 21, 1919 – February 1999) was one of the greatest nursing theorists who
developed the “Behavioral System Model.” Her theory of nursing defines 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.”

Early Life

Dorothy Johnson was born on August 21, 1919, in Savannah, Georgia. She was the youngest of seven
children. Her father was the superintendent of a shrimp and oyster factory, and her mother was very
involved and enjoyed reading. In 1938, she finished her associate’s degree at Armstrong Junior College
in Savannah, Georgia. Due to the Great Depression, she took a year off from school to be a governess, or
teacher, for two children in Miami, Florida. This was when she began to realize her love for children,
nursing, and education.

Behavioral System Model

Dorothy Johnson is known for her “Behavioral System Model of Nursing,” which was first proposed in
1968. Her nursing model states that “each individual has patterned, purposeful, repetitive ways of acting
that comprises a behavioral system specific to that individual.”

It advocates the fostering of efficient and effective behavioral functioning in the patient to prevent
illness. The patient is defined as a behavioral system composed of seven behavioral subsystems:
affiliative, dependency, ingestive, eliminative, sexual, aggressive, and achievement.

Works

Dorothy Johnson was a prolific writer on the subject of nursing theory. Her many publications on this
subject profoundly influenced theoretical thinking in nursing during the second half of the twentieth
century. Johnson’s publications include four books, more than 30 articles in periodicals, and many
papers, reports, proceedings, and monographs.

She held a strong conviction that continuous improvement of care was the ultimate goal of nursing. Her
1968 paper, entitled, One Conceptual Model of Nursing, is a classic contribution to Nursing literature.
Two of Johnson’s many works include Theory Development: What, Why, How? and Barriers and Hazards
in Counseling.

Awards and Honors

Of the many honors she received, Dorothy Johnson was proudest of the 1975 Faculty Award from
graduate students, the 1977 Lulu Hassenplug Distinguished Achievement Award from the California
Nurses Association, and the 1981 Vanderbilt University School of Nursing Award for Excellence in
Nursing.

Death

Dorothy Johnson died in February 1999 at the age of 80.

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
fostering 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.

What is Behavioral System Model?

Dorothy Johnson’s theory defined Nursing as “an external regulatory force which acts to preserve the
organization and integration of the patient’s 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.”

Major Concepts

The following are the major concepts and definitions of Johnson’s nursing model, including the
definition for its nursing metaparadigm:

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 focuses on the
behavioral system.

Environment
The environment is not directly defined, but it is implied to include all elements of the human system’s
surroundings 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
somehow, and to some degree… adaptation is functionally efficient and effective.”

Nursing

Nursing is seen as “an external regulatory force that acts to preserve the organization and integrate 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 under organized independent interaction of its parts.

Subsystem

A mini system is maintained concerning 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 influence the system’s behavior, but the system lacks the 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 a 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 to select a behavioral
response, the individual will rank those options and choose the option considered most desirable.

7 Subsystems of the Behavior System Model

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

Johnson’s Behavioral System Model

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
organizations. On a general level, it provides survival and security. Its consequences are social inclusion,
intimacy, and the formation and maintenance of a strong social bond.

Dependency subsystem

The 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

An 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 influence the biological aspects of this subsystem and may conflict with
the eliminative subsystem.

Sexual subsystem
A 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 a broad range of sex-role behaviors.

Aggressive subsystem

The aggressive subsystem relates to 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 self-protection modes and that people and their property be respected and
protected.

Achievement subsystem

The achievement subsystem provokes behavior that tries to control the environment. It attempts to
manipulate the environment. Its function is to control or mastery 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 assessing and diagnosing 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,
they have been successful in the role.

Strengths

Dorothy Johnson’s theory guides nursing practice, education, and research, generate 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 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 cultures. The theory also
has the potential for continued utility in nursing to achieve valued nursing goals.

Weaknesses

The theory is potentially complex because there are several 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, making it difficult to view the entire behavioral
system as an entity. The problem involving the interrelationships among the concepts also creates
difficulty 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 behavioral system’s integrity.

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

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 subsystems’ relationship or the internal and external environments.

See Also

References
Alligood, M., & Tomey, A. (2010). Nursing theorists and their work, seventh edition. Maryland Heights:
Mosby-Elsevier.

Dorothy E. Johnson Biographical File. (n.d.). Retrieved August 7, 2014, from

https://www.mc.vanderbilt.edu/diglib/sc_diglib/archColl/1014.html

Johnson, D. E. (1959a). A philosophy of nursing. Nursing Outlook, 7(4), 198–200.

Johnson, D.E. (1968). One conceptual model of nursing. Unpublished lecture, Vanderbilt University,
Nashville, TN.

Johnson, D. E. (1980). The behavioral system model for nursing. In McEwen, M. and Wills, E. (Ed.).
Theoretical basis for nursing. USA: Lippincott Williams & Wilkins.

External Links

Theory Development: What, Why, How?

Barriers and Hazards in Counseling

One Conceptual Model of Nursing

The Nurse Theorists – Dorothy Johnson Promo – YouTube video of an interview with Dorothy Johnson
herself.

With contributions by Wayne, G. (for Biography), Ramirez, Q.

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Angelo Gonzalo, BSN, RN

Angelo Gonzalo earned his Nursing degree in the year 2010 and continued his studies at St. Paul
University Manila taking up Masters of Arts in Nursing Major in Clinical Management. He worked as an
intensive care nurse for more than six years. He advocates for proper training and development of new
nurses, quality assurance and compassionate care. He has also been involved in community
development for 10 years steering programs on good governance, health, sports, and education. Angelo
aims to build a good foundation for aspiring nurses. He would like to impart the importance of
understanding nursing theories that he hopes to be translated successfully to practice.

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