SUPPORT THEORY systems and subsystems that joined together to form
o The intent of this chapter is to introduce you to
several essential theories from the arts, sciences, and
humanities that have had, and still have, a significant
influence on nursing theory, knowledge, practice and
research
o Why support theory? Because these people are
not nurses, they are primarily psycho analysts or
psychologists by profession but their theories are very
helpful with the nursing practice and some nurses
actually use their theories to come up with their own
theory.
VON BERTALANFFY
~ Von Bertalanffy (1968) wrote that a system is a
complex of interacting elements and that they
are open to, and interact with their environments. In
addition, they can acquire qualitatively new properties
through emergence, thus they are in a continual
evolution. When referring to systems, it also generally
means that they are self-regulation.
~ General Systems Theory is based on the
assumption that there are universal principles of
organization, which hold for all systems, be they
physical, chemical, biological, mental or social.
~ Systems management is the combination of four
key elements: processes, data, tools, and
organization, which are all needed to manage a
system efficiently and effectively.
Characteristics of system theory
~ Open system: a system keeps evolving and its
properties keep emerging through its interaction with
the environment.
~ Holistic view: systems theory focuses on the
arrangement of and relations between the parts
that connects them into a whole.
GENERAL AND OPEN SYSTEMS
THEORIES
o Two of the most globally influential theories ever
developed are:
● General System Theory (GST)
● Open System Theory (OST)
o GST was framed in the 1920’s by Ludwig Von
Bertalanffy, a biologist from Vienna. OST, which was
generated from GST, was framed in the 1930s and
presented to the scientific community at a meeting at
the University of Chicago in 1937
GENERAL SYSTEMS THEORY
o Was based in the biological sciences and
suggested that there was structure, organization and
interdependent function among living things based on
“wholes”
o The General System Theory of Von Bertalanffy
talks about the subsystems and a system that forms a
whole.
Example:
- Our body is composed of different systems,
we have the cardiovascular system, the
neurological system, digestive system, etc.
and per system, we have another subsystem.
In our nervous system, we have the brain, the
spinal cord, and the nerves. As a whole,
these compose the human body.
SYSTEM
○ Operationally defined as connected,
interdependent, interacting elements that are
hierarchically organized for the purpose of
maintaining homeostasis and achieving
common goals.
SUBSYSTEM
○ Is defined as connected, interdependent
interacting elements that are part of a larger
system.
Example:
- Mitochondria, golgi apparatus, cytoplasms,
and so on are separate microscopic systems
that joined together to form a larger system
called an organ then organs to systems,
systems to human body
WHOLENESS
○ Indicates that although systems and
subsystems may be separate in nature,
together they constitute a whole that is
greater than the sum of the part. For example
some may view the human body wholistically
like the integration of mind body and spirit
and some view it as a compilation of different
organs and systems
o As GST evolved, Bertalanffy made additional
observations that gave it a new and more global
dimension and ultimately formed a new theory. This
second theory was OST. Whereas GST focuses on
the physical aspect of systems, subsystems and
environments, OST focuses on their interaction.
o The GST focuses or describes just the system
within the body. Now, he came up with another theory
which is the OST which focuses on the interaction of
each system, subsystems, and the environment.

OPEN SYSTEMS THEORY
INTERACTION
○ Self regulation is composed of input, output
and feedback
○ Defined as exchange of energy, information,
or matter across system, subsystem and
environmental boundaries. He contended that
these interactions were designed to help the
whole system to be self regulating.
Example:
- Your body is dehydrated, you're lacking fluids
and if you are lacking fluids, you are lacking
electrolytes as well. So if you think about it,
when you say ‘dehydrated’ the system that is
involved is the digestive system because
when we drink water, we drink the fluid by
mouth that will pass through the esophagus
down to the digestive system and into the
intestines and then it will be absorbed by the
body. Since there is an interaction within this
system, if your body is dehydrated, your renal
system and endocrine system will try to
regulate the fluid balance to try and conserve
the function of the body.
INPUT
○ Anything that enters the system.
OUTPUT
○ Is energy information or matter that leaves
the system in response to input and either
goes.
FEEDBACK
○ Is energy, information, or matter that is
received back by the system from the
environment or another system
ENVIRONMENT
○ Defined as the surroundings or conditions in
which something exists or operates, it is an
essential concept within the OST.
○ Aside from the interaction within the systems,
environment is also an important factor in the
OST because it affects our body.
Example:
- Internal and external environment of cell,
organs and human body
○ Environments can also be non physical in
nature and include qualitative factors that
influence relationship between systems and
subsystems, such as beliefs, philosophies,
behaviors and attitudes.
○ Because these greatly affect your beliefs, it
greatly affects how you act, etc.
Example:
- Organization can be useful or not useful
BOUNDARIES
○ Are somewhat like a protection.
○ Are traditionally defined as lines, real or
imaginary, that separate or enclose.
Boundaries sometimes act as stopping
points.
○ In our body we have different types of
boundaries. A good example of this is
Example:
- Semi permeable membranes like the blood
brain barriers
SUMMARY OF THE OPEN SYSTEM
THEORY
PHENOMENON
o Systems, subsystems and environments interact
and influence each other.
IDEA
o Interactions among systems subsystems and their
environments are self regulating and goal directed.
o Goal Directed: that is for a person to become more
physically fit and healthy.
KEY CONCEPTS / INTERNAL VARIABLES
SYSTEM
o Connected, interdependent, interacting elements.
SUBSYSTEM
o A system within a larger system.
ENVIRONMENT
o Internal and external surroundings of systems and
their subsystems
 HIERARCHY 3. The system has the resources for entropy
and equifinality if needed.
o The ordering or ranking of systems and their
subsystems.
❖ This theory was very helpful for Betty
o In our body, we also have hierarchy, the most
Newman’s System Model Theory.
important systems and the least important
subsystems.

WHOLENESS
o Systems, subsystems and environments working as
one to preserve the human body.

INTERACTION
o The exchange of energy, influence, and matter
across a boundary (in the form of input, output and
feedback).

TELEOLOGY
o Goal directed interaction.
o This is like trying to maintain the balance or
homeostasis of the body.

ENTROPY
o Adaptive interaction.

EQUIFINALITY
o Goals accomplished in different ways.
o When you already achieve your goals. It can be
achieved in different ways, but when you achieve the
goal, that is equifinality. And all of us have different
goals to achieve.

Examples of Propositions:
1. Systems, subsystems and their environments
from hierarchical wholes that maintain
homeostasis and work toward a common
goal.
- And that is for the body to conserve and to be
more healthy and prevent illnesses and
diseases.
2. Systems, subsystems and their environments
self-regulate based on their interactions.
- That we be your feedback mechanisms or the
response of the body to stressors.
3. Teleology, entropy and equifinality are
achieved through interactions.

Examples of Assumptions:
1. Everyone knows what the goal is.
2. The hierarchical order is actually facilitating
the achievement of the goal.
 ABRAHAM MASLOW Physiological Needs > Safety Needs >
belongingness and Love Needs > Esteem Needs >
~ In 1954, Abraham Maslow developed a grand Self-actualization
theory called Theory of Human Motivation and
Hierarchy of Basic Human Needs that are the
motivation behind people’s behavior.
~ Maslow's hierarchy of needs is a motivational
theory in psychology comprising a five-tier model of
human needs, often depicted as hierarchical levels
within a pyramid.
~ Maslow's hierarchy is most often displayed as a
pyramid. The lowest levels of the pyramid are made
up of the most basic needs, while the most complex
needs are at the top of the pyramid.
~ Needs at the bottom of the pyramid are basic
physical requirements including the need for food,
water, sleep, and warmth. Once these lower-level
needs have been met, people can move on to the
next level of needs, which are for safety and security.
~ As people progress up the pyramid, needs become
increasingly psychological and social. Soon, the need
for love (Links to an external site.), friendship, and
intimacy becomes important. Further up the pyramid,
the need for personal esteem and feelings of
accomplishment take priority.
~ Like Carl Rogers (Links to an external site.),
Maslow emphasized the importance of
self-actualization, which is a process of growing and
developing as a person in order to achieve individual
potential.

○ Maslow (1943) initially stated that individuals

must satisfy lower level deficit needs before
progressing on to meet higher level growth
needs. However, he later clarified that
satisfaction of a need is not an “all-or-none”
phenomenon, admitting that his earlier
statements may have given “the false
impression that a need must be satisfied 100
percent before the next need emerges”
(1987, p. 69).
○ When a deficit need has been 'more or less'
satisfied it will go away, and our activities
become habitually directed towards meeting
the next set of needs that we have yet to
satisfy. These then become our salient
needs. However, growth needs continue to
be felt and may even become stronger once
they have been engaged
THEORY OF HUMAN MOTIVATION AND
SUMMARY OF MASLOW’S THEORY OF
HUMAN MOTIVATION AND HIERARCHY
OF BASIC HUMAN NEEDS
PHENOMENON
o Need motivates behavior.
Example:
- If you don’t have anything to eat or drink and
you don;t have shelter. So what type of need
is compromised? Probably your
physiological and your safety needs as
well. Your behavior will be greatly affected.
So at this point, you will do everything in your
power to get food and water

HIERARCHY OF BASIC HUMAN NEEDS IDEA

o According to Abraham Maslow, we have different o Needs that motivate behavior are hierarchical in
needs. order.
o Of course you will first need to fulfill the basic needs
more than fulfilling your self-esteem needs, your
self-actualization needs, etc.
KEY CONCEPTS / INTERNAL VARIABLES
HIERARCHY OF HUMAN NEEDS
o Those things that humans need to survive and
thrive.
PHYSIOLOGIC (PHYSIOLOGICAL NEEDS)
o Air, food, water, shelter.
o These are biological requirements for human
survival, e.g. air, food, drink, shelter, clothing,
warmth, sex, sleep.
o If these needs are not satisfied the human
body cannot function optimally. Maslow
considered physiological needs the most
important as all the other needs become
secondary until these needs are met.
SAFETY (SAFETY NEEDS)
o Shelter from harm.
o Once an individual’s physiological needs are
satisfied, the needs for security and safety become
salient. People want to experience order,
predictability and control in their lives. These needs
can be fulfilled by the family and society (e.g. police,
schools, business and medical care).
o For example, emotional security, financial security
(e.g. employment, social welfare), law and order,
freedom from fear, social stability, property, health
and wellbeing (e.g. safety against accidents and
injury).
o A person should not be threatened.
o If safety is not fulfilled or if the patient feels
threatened, his or her actions might differ.
LOVE (LOVE AND BELONGINGNESS NEEDS)
o Affection and acceptance.
o Intimate relationships, friends
o After physiological and safety needs have been
fulfilled, the third level of human needs is social and
involves feelings of belongingness. The need for
interpersonal relationships motivates behavior.
o Examples include friendship, intimacy, trust, and
acceptance, receiving and giving affection and love.
Affiliating, being part of a group (family, friends, work).
SELF-ESTEEM (ESTEEM NEEDS)
o Self- worth, positive self-image.
o Prestige feeling of accomplishment.
o The fourth level in Maslow’s hierarchy - which
Maslow classified into two categories: (i) esteem for
oneself (dignity, achievement, mastery,
independence) and (ii) the desire for reputation or
respect from others (e.g., status, prestige).
o Maslow indicated that the need for respect or
reputation is most important for children and
adolescents and precedes real self-esteem or dignity.
SELF-ACTUALIZATION
(SELF-ACTUALIZATION NEEDS)
o Development of potential.
o achieving one’s full potential, including creative
activities
o The highest level in Maslow's hierarchy, and refer to
the realization of a person's potential, self-fulfillment,
seeking personal growth and peak experiences.
Maslow (1943) describes this level as the desire to
accomplish everything that one can, to become the
most that one can be.
o Not all people can satisfy the self-actualization
needs because not everyone can achieve their full
potential in life.
PROPOSITIONS
● Human Need motivates behavior
● Human needs are ordered according to a
survival hierarchy
● The majority of needs in one level must be
met before moving to the next
ASSUMPTIONS
● Motivation is hierarchical
● Males and females have the same motivation
● To be well adjusted, physiological needs must
be met first (because if the physiological
needs are not properly met, it will be hard for
an individual to achieve other needs)
FACTS/PRINCIPLES/LAWS
Fact: Physiological needs must be met for survival
Principle: Need are based in a hierarchical
Law: Need motivates Behavior
 ERIC ERICKSON
~ Eric Erickson, a German-born psychoanalyst,
identified concepts associated with personality
formation that eventually turned into a theory of
personality development. Erickson included social
and cultural experiences as significant to personality
development and emphasized that there is continual
personality development across the lifespan.

THEORY OF PERSONALITY
DEVELOPMENT
o Describes the human life cycle as a series of 8 ego
development stage from birth to death
o Each stage present a psychosocial crisis, the goal
of which is to integrate psychological,
maturation and social demands
o The result of 1 stage may not be permanent but can
be changed by experience later in life.
o Occurs a life long series of crises affected by social
and cultural,social factors
o Each psychosocial crisis must be resolved for the
child or adult to progress emotionally, unsuccessful
resolution can leave the person emotionally disabled.

o In his theory, Erickson identified 8 developmental

stages that human beings move through. The 8
stages are growth categories of infant, toddler, ➔ How important is psychosocial
preschool, school, adolescent, young adult, middle development? According to Eric Erickson, if
adult and older adult. Each of these categories has a one task is not achieved, it will be revisited or
corresponding developmental stage it will affect the person’s life all throughout.

o The goal is to complete the necessary

developmental tasks before moving to the next stage,
Erickson felt that if tasks of a particular stage were
not accomplished, they would be revisited by the
individual during a later stage.

ERICKSON’S STAGES OF PSYCHOLOGICAL

DEVELOPMENT
 Stage 1: Trust vs. Mistrust
● The first stage of Erikson's theory of
psychosocial development occurs between
birth and 1 year of age and is the most
fundamental stage in life. Because an infant
is utterly dependent, developing trust is
based on the dependability and quality of the
child's caregivers.
● At this point in development, the child is
utterly dependent upon adult caregivers for
everything they need to survive including
food, love, warmth, safety, and nurturing. If a
caregiver fails to provide adequate care and
love, the child will come to feel that they
cannot trust or depend upon the adults in
their life.
Outcomes
● If a child successfully develops trust, the child
will feel safe and secure in the world.2
● Caregivers who are inconsistent, emotionally
unavailable, or rejecting contribute to feelings
of mistrust in the children under their care.
Failure to develop trust will result in fear and
a belief that the world is inconsistent and
unpredictable.
● During the first stage of psychosocial
development, children develop a sense of
trust when caregivers provide reliability, care,
and affection. A lack of this will lead to
mistrust.
● No child is going to develop a sense of 100%
trust or 100% doubt. Erikson believed that
successful development was all about striking
a balance between the two opposing sides.
● When this happens, children acquire hope,
which Erikson described as an openness to
experience tempered by some wariness that
danger may be present.
● Subsequent work by researchers including
John Bowlby and Mary Ainsworth
demonstrated the importance of trust in
forming healthy attachments during childhood
and adulthood.
Stage 2: Autonomy vs. Shame and Doubt
● The second stage of Erikson's theory of
psychosocial development takes place during
early childhood and is focused on children
developing a greater sense of personal
control.
● The Role of Independence
● At this point in development, children are just
starting to gain a little independence. They
are starting to perform basic actions on their
own and making simple decisions about what
they prefer. By allowing kids to make choices
and gain control, parents and caregivers can
help children develop a sense of autonomy.2
● Potty Training
● The essential theme of this stage is that
children need to develop a sense of personal
control over physical skills and a sense of
independence. Potty training plays an
important role in helping children develop this
sense of autonomy.
● Like Freud, Erikson believed that toilet
training was a vital part of this process.
However, Erikson's reasoning was quite
different from that of Freud's. Erikson
believed that learning to control one's bodily
functions leads to a feeling of control and a
sense of independence. Other important
events include gaining more control over food
choices, toy preferences, and clothing
selection.
Outcomes
● Children who struggle and who are shamed
for their accidents may be left without a
sense of personal control. Success during
this stage of psychosocial development leads
to feelings of autonomy; failure results in
feelings of shame and doubt.
● Finding Balance
● Children who successfully complete this
stage feel secure and confident, while those
who do not are left with a sense of
inadequacy and self-doubt. Erikson believed
that achieving a balance between autonomy
and shame and doubt would lead to will,
which is the belief that children can act with
intention, within reason and limits.
Stage 3: Initiative vs. Guilt
● The third stage of psychosocial development
takes place during the preschool years. At
this point in psychosocial development,
children begin to assert their power and
control over the world through directing play
and other social interactions.
● Children who are successful at this stage feel
capable and able to lead others. Those who
fail to acquire these skills are left with a
sense of guilt, self-doubt, and lack of
initiative.
Outcomes
● The major theme of the third stage of
psychosocial development is that children
need to begin asserting control and power
over the environment. Success in this stage
 leads to a sense of purpose. Children who try
to exert too much power experience
disapproval, resulting in a sense of guilt.
● When an ideal balance of individual initiative
and a willingness to work with others is
achieved, the ego quality known as purpose
emerges.
Stage 4: Industry vs. Inferiority
● The fourth psychosocial stage takes place
during the early school years from
approximately ages 5 to 11. Through social
interactions, children begin to develop a
sense of pride in their accomplishments and
abilities.
● Children need to cope with new social and
academic demands. Success leads to a
sense of competence, while failure results in
feelings of inferiority.
Outcomes
● Children who are encouraged and
commended by parents and teachers
develop a feeling of competence and belief in
their skills. Those who receive little or no
encouragement from parents, teachers, or
peers will doubt their abilities to be
successful.
● Successfully finding a balance at this stage of
psychosocial development leads to the
strength known as competence, in which
children develop a belief in their abilities to
handle the tasks set before them.
Stage 5: Identity vs. Confusion
● The fifth psychosocial stage takes place
during the often turbulent teenage years. This
stage plays an essential role in developing a
sense of personal identity which will continue
to influence behavior and development for
the rest of a person's life. Teens need to
develop a sense of self and personal identity.
Success leads to an ability to stay true to
yourself, while failure leads to role confusion
and a weak sense of self.
● During adolescence, children explore their
independence and develop a sense of self.2
Those who receive proper encouragement
and reinforcement through personal
exploration will emerge from this stage with a
strong sense of self and feelings of
independence and control. Those who
remain unsure of their beliefs and desires will
feel insecure and confused about themselves
and the future.
● What Is Identity?
● When psychologists talk about identity, they
are referring to all of the beliefs, ideals, and
values that help shape and guide a person's
behavior. Completing this stage successfully
leads to fidelity, which Erikson described as
an ability to live by society's standards and
expectations.
● While Erikson believed that each stage of
psychosocial development was important, he
placed a particular emphasis on the
development of ego identity. Ego identity is
the conscious sense of self that we develop
through social interaction and becomes a
central focus during the identity versus
confusion stage of psychosocial
development.
● According to Erikson, our ego identity
constantly changes due to new experiences
and information we acquire in our daily
interactions with others. As we have new
experiences, we also take on challenges that
can help or hinder the development of
identity.
● Why Identity Is Important?
● Our personal identity gives each of us an
integrated and cohesive sense of self that
endures through our lives. Our sense of
personal identity is shaped by our
experiences and interactions with others, and
it is this identity that helps guide our actions,
beliefs, and behaviors as we age.
Stage 6: Intimacy vs. Isolation
● Young adults need to form intimate, loving
relationships with other people. Success
leads to strong relationships, while failure
results in loneliness and isolation. This stage
covers the period of early adulthood when
people are exploring personal relationships.2
● Erikson believed it was vital that people
develop close, committed relationships with
other people. Those who are successful at
this step will form relationships that are
enduring and secure.
● Building On Earlier Stages
● Remember that each step builds on skills
learned in previous steps. Erikson believed
that a strong sense of personal identity was
important for developing intimate
relationships. Studies have demonstrated
that those with a poor sense of self tend to
have less committed relationships and are
more likely to struggle with emotional
isolation, loneliness, and depression.
● Successful resolution of this stage results in
the virtue known as love. It is marked by the
 ability to form lasting, meaningful person will be left with feelings of bitterness
relationships with other people. and despair.
● Those who feel proud of their
Stage 7: Generativity vs. Stagnation accomplishments will feel a sense of integrity.
Successfully completing this phase means
● Adults need to create or nurture things that looking back with few regrets and a general
will outlast them, often by having children or feeling of satisfaction. These individuals will
creating a positive change that benefits other attain wisdom, even when confronting death.
people. Success leads to feelings of
usefulness and accomplishment, while failure
results in shallow involvement in the world. PROPOSITIONS
● During adulthood, we continue to build our 1. Humans develop psychologically by
lives, focusing on our career and family. progressing through specific developmental
Those who are successful during this phase stages
will feel that they are contributing to the world 2. Developmental stages correspond with
by being active in their home and chronological age
community.2 Those who fail to attain this skill 3. The goal of each stage is that the
will feel unproductive and uninvolved in the developmental tasks are accomplished prior
world. to moving to the next stage
● Care is the virtue achieved when this stage is
handled successfully. Being proud of your
ASSUMPTIONS
accomplishments, watching your children
grow into adults, and developing a sense of 1. Developmental stages correlate with specific
unity with your life partner are important chronological ages
accomplishments of this stage. 2. Accomplishing developmental tasks in order
is necessary for healthy development
Stage 8: Integrity vs. Despair 3. If tasks are not accomplished, they will be
revisited at future stages
● The final psychosocial stage occurs during
old age and is focused on reflecting back on
life.2 At this point in development, people FACTS/PRINCIPLES/LAWS
look back on the events of their lives and Fact: Human beings progress through specific
determine if they are happy with the life that developmental stages
they lived or if they regret the things they did
or didn't do. Principles: Progression through developmental
● Erikson's theory differed from many others stages is dependent upon accomplishing
because it addressed development developmental tasks
throughout the entire lifespan, including old
age. Older adults need to look back on life Law: Developmental stage influences the personality
and feel a sense of fulfillment. Success at this of an individual
stage leads to feelings of wisdom, while
failure results in regret, bitterness, and
despair.
● At this stage, people reflect back on the
events of their lives and take stock. Those
who look back on a life they feel was
well-lived will feel satisfied and ready to face
the end of their lives with a sense of peace.
Those who look back and only feel regret will
instead feel fearful that their lives will end
without accomplishing the things they feel
they should have.
● Outcomes
● Those who are unsuccessful during this
stage will feel that their life has been wasted
and may experience many regrets. The
 KURT LEWIN
~ Kurt Lewin, a psychologist in the tradition of
Erickson and others, studied the motivation and intent
behind human behavior. However, he differed from
the others in that he not only offered analysis of the
motivation and behavior, but he also studied how to
improve that behavior, especially with regard to
bringing about change within systems
~ Considered the father of social psychology, he is
known for Group dynamics, action research, T-
groups, is often considered he the father of modern
change management theory, developed a change
model involving three steps: unfreezing, changing
and refreezing
~ The uniqueness of his theory is that he would help
people change and improve their acceptance to
change.
CHANGE THEORY OR FORCE FIELD
ANALYSIS
o His work culminated in the development of a
landmark theory of change within the systems. His
work culminated in the development of a landmark
theory of change which is sometimes referred to as a
psychological field theory or the force field analysis
model (FFAM)
o FFAM provides structure for identifying and
understanding motivation behind individual’s
responses to change and for improving behavior
during change.
CHANGE THEORY
○ Considered the father of social psychology,
he is known for Group dynamics, action
research, T- groups, is often considered he
the father of modern change management
theory, developed a change model involving
three steps: unfreezing, changing and
refreezing.
○ For Lewin, the process of change entails
creating the perception that a change is
needed, then moving toward the new, desired
level of behavior and finally, solidifying that
the new behavior as the norm.
○ Kurt Lewin theorized a three stage model of
change that is known as the unfreezing
-change-refreeze model that requires prior
learning to be rejected and replaced. Lewin’s
theory states behaviors dynamic balance of
forces working in opposing directions.
○ The Kurt Lewin change theory model is
based around a 3 step process
(unfreeze-change-freeze) that provides a
high level approach to change. It gives a
manager or other change agent a framework
to implement a change effort, which is always
very sensitive and must be made as
seamless as possible.
○ One of the cornerstone models
understanding organizational change was
developed by Kurt Lewin back in the 1940’s,
and still holds true today. His model is known
as unfreeze- change- refreeze, which refers
to the three stage process of change that
describes.
○ Theory of Change is a specific type of
methodology for planning, participation and
evaluation that is used in companies,
philanthropy, not for profit and government
sectors to promote social change. Theory of
change defines long term goals and then
maps backward to identify necessary
preconditions.
DRIVING FORCE
o Move behavior toward a positive state of mind that
encourages change.
o Driving force should be increased.
RESTRAINING FORCE
o Also known as static forces, move behavior toward
a negative state of mind that supports maintaining the
status quo, thus opposing the change.
o Restraining force should be eliminated, or if
not totally eliminated, should be significantly
decreased.
➔ The driving force and the restraining force are
the two forces that influence how a person
sees change in his/her life.
Example:
- A person is diagnosed with a heart block. If
you're diagnosed with a heart block there
would be a lot of changes that will occur. First
would be, you would need to maintain a good
and healthy diet especially low in fat,
cholesterol, and sodium to help with your
condition. There will be a driving force and
restraining force.
Restraining force: if that person is very used to
eating high-cholesterol, fat, sodium foods, there will
be a lot of restraining forces that may impede his/her
acceptance to a specific change or modification
Driving force: would be to live a healthier life, to live
a longer and healthier life to be with his/her family, to
see his/her children grow, etc,
 ● Driving force may be the result of external
influence on the system or they may be the
result of external influence on the system.
● According to Lewin, the environment is also
known as fields, this includes not only the
external factors but also the beliefs, behavior,
philosophy and attitude of the person.
STAGES OF CHANGE
UNFREEZING
o The stage of change where the motivation or need
for change becomes apparent. Driving and restraining
forces that influence change are identified, and
activities are initiated to decrease the restraining
forces and increase the driving force.
➔ Meaning, this is the time in which the person
will realize that there is something that needs
to be changed. Will it be a diet or exercise
modification, a change in his/her environment
or any change, it’s already obvious it is there
and it should happen.
➔ If there is a change that should happen that is
already obvious and apparent, driving and
restraining forces will arise and it should be
identified.
➔ Meaning the person is now realizing that
these are the restraining forces or the
reasons why he/she is reluctant to do the
change or to accept the change
What are the driving forces that will help this
person accept the change?
- Activities are initiated to decrease the
restraining force and increase the driving
force.
- So the unfreezing is the most challenging of
all the stages because this is the time when
the need for a change is apparent, this is the
time when you will identify the driving and the
restraining forces, and it is also the time
when the person will try to decrease the
restraining forces and decrease the driving
forces
MOVING / CHANGE
o The stage where the details of the change are
planned and initiated. This stage involves people who
may not have been involved in the decision to make
the change and as a result may have to be
persuaded as to its necessity.
➔ This is the time after the driving and the
restraining forces are already identified, then
change or the moving should happen.
➔ This is when the details of the change are
planned and initiated.
➔ This is when the acceptance for change
happens.
REFREEZING
o The final stage where changes that have been
initiated become integrated, established and
stabilized.
➔ After the moving and the change stage, it will
now go to the refreeze wherein the change
will now be part of the person's life.
➔ The ‘change’ will not be considered as
change but already a new part of his/her life.
➔ The change will now become permanent in
his/her life.
❖ With every person, we have different phase
or movements or time for these stages.
❖ Some people will have a longer time with the
unfreezing stage probably because he/she
will have a difficult time identifying the
restraining and driving forces and it's hard for
them to decrease the restraining forces and
increase the driving forces. Some will have a
longer time doing the change or accepting
the change.\
❖ Each individual has a different time frame
with the stages of change but these are the
stages that can help the person accept
changes.
PHENOMENON
o People respond to change differently.
IDEA
o Motivation influences an individual’s response to
change.
KEY CONCEPTS / INTERNAL VARIABLES

CHANGE
● To make a difference.

MOTIVATING FORCES
● Factors that influence behaviors

DRIVING FORCES
● Support Change.

RESTRAINING FORCES
● Resist change.

FIELD
● The environment in which driving and
restraining forces are interacting.

CHANGE PROCESS
● The process of making a difference.

UNFREEZING
● The need for change becomes apparent.

MOVING
● Change Initiated.

REFREEZING
● Change established.

PROPOSITIONS
1. Change is influenced by driving and
restraining forces
2. Driving and restraining forces interact within a
field
3. Change is dependent upon refreezing,
moving and refreezing behaviors

ASSUMPTIONS
1. Change always has oppositions
2. Driving and restraining forces are the only
forces influencing change
3. Moving occurs before refreezing
 HARRY SULLIVAN Preadolescence (9-12 Developing
yrs) relationships within
~ Harry Stack Sullivan psychiatry or Interpersonal
same gender
Psychoanalysis
~ He proposed an interpersonal theory of personality. Early Adolescence (12- Identity
~ He explained the role of interpersonal relationships 14 yrs)
and social experiences in shaping personality.
~ He also explained about the importance of current Late Adolescence (14- Forming lasting,
21 yrs) intimate relationships
life events to psychopathology.
~ The theory further states that the purpose of all
behavior is to get needs met through interpersonal o Sullivan explained about three types of self:
interactions and decrease or avoid anxiety ● The ‘good me’ versus the ‘bad me’ based
on social appraisal and the anxiety that
➔ Harry Sullivan’s stages of development is results from negative feedback
somewhat similar to Eric Erickson but the ● The ‘not me’ refers to the
goal of Harry Sullivan is to understand how a unknown,repressed component of the self.
person develops his/her personality and that o Sullivan's theory explains about anxiety, self-system
is the interpersonal theory of personality. and self-esteem:
● Security operations –those measures that the
individual employs to reduce anxiety and
INTERPERSONAL THEORY OF enhance security.
● Self-system – all of the security operations an
PERSONALITY individual uses to defend against anxiety and
ensure self esteem

STAGES OF DEVELOPMENT
KEY CONCEPTS
● Tensions
● Needs (tenderness)
● Anxiety
● Energy Transformation
● Dynamism
● Malevolence
● Intimacy
● Lust

LEVELS OF COGNITIONS (WAYS OF

PERCEIVING, IMAGING, AND
CONCEIVING)
A. Prototaxic (undifferentiated experiences that
are completely personal)
o Sullivan explained six developmental stages - The person is not fully aware of his/her
called "epochs" or heuristic Stages in personality.
Development. B. Parataxic (prelogical experiences that are
communicated to others only in a distorted
Stages (Epochs) Characteristics fashion
- The fantasy world of a person in which
Infancy (Birth-18 Gratification of needs sometimes, they use this fantasy world or
months) fantasy personality to combat stress and
difficult emotions.
Childhood (18 mo-6 yrs) Delayed gratification C. Syntaxic (consensually validated
experiences that can be accurately
Juvenile era (6-9 yrs) Formation of peer group
communicated to others)
- The awareness of self.
 APPLICATIONS
➢ Sullivan's interpersonal theory provides the
theoretical basis for interpersonal
psychotherapy (IPT) for depression and
schizophrenia.
➢ Interpersonal theory proposes that
depression develops most often in the
context of adverse events, particularly
interpersonal loss. (Tasman 2008)
➢ He also wrote on techniques and approaches
on psychiatric interviews.

~ The theory of personality developed by Harry Stack

Sullivan, which is based on the belief that people’s
interactions with other people, especially significant
others, determine their sense of security, sense of
self, and the dynamisms that motivate their behavior.

~ For Sullivan, personality is the product of a long

series of stages in which the individual gradually
develops “good feeling” toward others and a sense of
a good me toward himself or herself.

~ The individual also learns how to ward off anxiety

and correct distorted perceptions of other people,
learns to verify his or her ideas through consensual
validation, and above all seeks to achieve effective
interpersonal relationships on a mature level.
 ALBERT BANDURA
~ Albert Bandura is an influential social cognitive
psychologist who is perhaps best known for his social
learning theory, the concept of self-efficacy, and his
famous Bobo doll experiments. He is a Professor
Emeritus at Stanford University and is widely
regarded as one of the greatest living psychologists.

Bobo Doll Experiment

- Shows that a child will mimic or follow what
adults are doing.
- In this experiment a child was watching an
adult assault a doll. While the child watches
the adult physically assault the doll, the child,
according to Albert Bandura, is trying to
understand what is happening and according
to Albert Bandura, what an adult does will
have a great effect on the character of the
child. The child will try to mimic what an adult
is doing because for a child, whatever an
adult is doing is correct. So when the child
was asked to do something to the doll,
instead of playing with it (which is what a
normal child should do), what the child did is
the same thing that the adult did earlier.the
child also assaulted the doll.
SOCIAL LEARNING THEORY
o Children observe the people around them behaving
in various ways. Individuals that are observed are
called models. In society, children are surrounded by
many influential models, such as parents within the
family, characters on children’s TV, friends within their
peer group and teachers at school. These models
provide examples of behavior to observe and imitate,
e.g., masculine and feminine, pro and anti-social, etc.
➔ The environment they are residing in will
greatly influence their personality that is why
guidance is very important. And it is the
responsibility of the adult surrounding these
children to be more responsible with what
they are doing.

o Social learning theory, proposed by Albert Bandura,

o Children pay attention to some of these people
emphasizes the importance of observing, modelling,
(models) and their behavior. At a later time they may
and imitating the behaviors, attitudes, and emotional
imitate (i.e., copy) the behavior they have
reactions of others. Social learning theory considers
observed.They may do this regardless of whether the
how both environmental and cognitive factors interact
behavior is ‘gender appropriate’ or not, but there are
to influence human learning and behavior.
a number of processes that make it more likely that a
child will reproduce the behavior that its society
o In social learning theory, Albert Bandura (1977)
deems appropriate for its gender.
agrees with the behaviorist learning theories of
➔ Sometimes the gender appropriate action of
classical conditioning and operant conditioning.
what a boy should and what a girl should do,
However, he adds two important ideas:
also influence the social learning theory.
➔ Gender stereotyping was also mentioned in
1. Mediating processes occur between stimuli &
the social learning theory.
responses.
➔ What are the stimuli? The stimuli are your
o First, the child is more likely to attend to and imitate
vision, your sense of smell, sense of hearing,
those people it perceives as similar to itself.
sense of touch, sense of taste, etc.
Consequently, it is more likely to imitate behavior
modeled by people of the same gender.Second, the
2. Behavior is learned from the environment
people around the child will respond to the behavior it
through the process of observational
imitates with either reinforcement or punishment. If a
learning.
child imitates a model’s behavior and the
consequences are rewarding, the child is likely to
continue performing the behavior.
➔ For example, the child imitates a good
behavior5 acted by the significant other or the
parent and the child is rewarded for it. The
 child will think that it was a good thing since
he/she is being rewarded. Hence, the child
will continue with the behavior. However,
there are also disadvantages of this. For
example, since a child doesn’t know what is
right or wrong yet at an early age, abuse
might happen

o If a parent sees a little girl consoling her teddy bear

and says “what a kind girl you are,” this is rewarding
for the child and makes it more likely that she will
repeat the behavior. Her behavior has been
reinforced (i.e., strengthened).Reinforcement can be
external or internal and can be positive or negative. If
a child wants approval from parents or peers, this
approval is an external reinforcement, but feeling
happy about being approved of is an internal
reinforcement. A child will behave in a way which it
believes will earn approval because it desires
approval.

o Positive (or negative) reinforcement will have little

impact if the reinforcement offered externally does not
match with an individual's needs. Reinforcement can
be positive or negative, but the important factor is that
it will usually lead to a change in a person's behavior.

o Third, the child will also take into account what

happens to other people when deciding whether or
not to copy someone’s actions. A person learns by
observing the consequences of another person’s (i.e.,
models) behavior, e.g. A younger sister observing an
older sister being rewarded for a particular behavior is
more likely to repeat that behavior herself. This is
known as vicarious reinforcement.

o This relates to an attachment to specific models

that possess qualities seen as rewarding. Children
will have a number of models with whom they identify.
These may be people in their immediate world, such
as parents or older siblings, or could be fantasy
characters or people in the media. The motivation to
identify with a particular model is that they have a
quality which the individual would like to possess
 LAWRENCE KOHLBERG
~ Lawrence Kohlberg was an American psychologist
and is very famous for his work on the Theory on
Moral Development. He was an educator at the
University of Chicago and Harvard University
(Graduate School). Studying moral development is
not popular during his time, but still he decided to
focus on this subject, he was inspired by the work of
Jean Piaget about children’s cognitive development
~ Lawrence Kohlberg talks about morality, when did
it start, and how development of morality affects our
decision making and ethics.
~ Because Lawrence Kohlberg believes that morality
starts or was developed during childhood or an early
age.
JEAN PIAGET’S THEORY OF COGNITIVE
DEVELOPMENT
● Back in the day, children were believed to be
less smarter than an adult or an older man
but according to Jean Piaget, that is not
correct. Children are not less smarter than
older people, it's just that children or younger
individuals have different cognition or
awareness of the surrounding.
SENSORIMOTOR STAGE
- Birth to 2 years old
- Children of this stage are aware that what
they are holding is a glass but they are not
aware of what is inside the glass
- Hence why children from this stage are prone
to food poisoning
- They only have sensory ability but lacks
cognition
PREOPERATIONAL STAGE
- 2 to 7 years old
- Child is already aware that there is a fluid
inside the glass and the child is already
aware that the content of the glass is water
- However, at this stage, children can not
distinguish abstract or concrete reasoning
- If you will introduce two glasses of water in
front of a 4 year old child, one glass is shorter
and the other, taller, and you will pour the
same amount of water in those two glasses
and you will ask the child which one has
more fluid, the child will tell you that the taller
glass has more water. Because it looks like
the taller glass has more but in reality both
glasses have the same amount of water.
CONCRETE OPERATIONAL STAGE
- 7 to 11 years old
- Children on this level will now have concrete
and abstract reasoning
- They will know which one has more water or
if both glasses have the same amount of
water because they already have analytical
skills and critical thinking skills
FORMAL OPERATIONAL STAGE
- 12 years old and up
- On this stage, it’s more on formal and
abstract reasoning
- They have their own reasoning and
justification
 MORAL DEVELOPMENT THEORY
o Involve acceptance of values & rules of society in a
way that shapes behavior classified in a series of
levels & behaviors sequential but people do not
automatically go from 1 stage or level to the next as
they mature.

Kohlberg’s Stages of Moral

Development
o Kohlberg identified three levels of moral reasoning:
pre-conventional, conventional, and
post-conventional. Each level is associated with
increasingly complex stages of moral development.
STAGE 1: OBEDIENCE-AND-PUNISHMENT
o Kohlberg identified three levels of moral reasoning: ORIENTATION
pre-conventional, conventional, and ● Focuses on the child’s desire to obey rules
post-conventional. Each level is associated with and avoid being punished. For example, an
increasingly complex stages of moral development. action is perceived as morally wrong because
the perpetrator is punished; the worse the
LEVEL 1: PRECONVENTIONAL punishment for the act is, the more “bad” the
act is perceived to be.
○ A child’s sense of morality is externally
● For a child, his/her actions are morally wrong
controlled. Children accept and believe
if he/she is punished for it. If he/she is not
the rules of authority figures, such as
punished with that action, that means that
parents and teachers. A child with
his/her actions are morally correct or right.
pre-conventional morality has not yet adopted
● That is why at this stage, it is important for
or internalized society’s conventions
parents or authority figures to explain why the
regarding what is right or wrong, but instead
child is being punished. Explain to a child
focuses largely on external consequences
why he/she is being punished and what are
that certain actions may bring.
the incorrect actions.
○ At this stage, children are not yet familiar with
● Because if you do not explain to a child what
the right and wrong in terms of societal
are his/her incorrect actions, the child will
convention. He/she does not know yet rules,
have a misconception that punishment is the
guidelines, and law. What he/she knows is
right thing to do.
that only his/her parents, teacher, or an
● But if you let a bad behavior slide past
authority figure like a guideline, for a child,
without any punishment, according to
these people are the leaders or the authority
Lawrence Kohlberg that is an incorrect
figure and they will only follow what they say.
practice because morality is being
That is why it is crucial, at this stage, for
developed at this stage.
authority figures to follow rules and
● This stage is very critical for children
regulations because it is important for a child
to see a role model.
STAGE 2: INSTRUMENTAL ORIENTATION
○ Throughout the preconventional level, a
child’s sense of morality is externally ● Stage 2 expresses the “what’s in it for
controlled. Children accept and believe the me?” (WIFM) position, in which right
rules of authority figures, such as parents and behavior is defined by whatever the individual
teachers. A child with pre-conventional believes to be in their best interest. Stage two
morality has not yet adopted or internalized reasoning shows a limited interest in the
society’s conventions regarding what is right needs of others, only to the point where it
or wrong, but instead focuses largely on might further the individual’s own interests.
external consequences that certain actions ● As a result, concern for others is not based
may bring. on loyalty or intrinsic respect, but rather a
“you scratch my back, and I’ll scratch yours”
 mentality. An example would be when a child
is asked by his parents to do a chore. The
child asks “what’s in it for me?” and the
parents offer the child an incentive by giving
him an allowance.
● Why will I follow you?
● Will I benefit from this?
● During this stage, children are very interested
in the scheme of the parents or household for
a cause
Example:
- Wash the dishes = 20 pesos
LEVEL 2: CONVENTIONAL
○ Throughout the conventional level, a child’s
sense of morality is tied to personal and
societal relationships. Children continue to
accept the rules of authority figures, but this
is now due to their belief that this is
necessary to ensure positive relationships
and societal order. Adherence to rules and
conventions is somewhat rigid during these
stages, and a rule’s appropriateness or
fairness is seldom questioned
STAGE 4: LAW-AND-ORDER ORIENTATION
○ During this stage, children on this stage are
either preschool or grade school. Students
during this stage will not question any rules
and authority, they will just follow because at
this stage, they will just blindly follow rules
and guidelines
○ Because at this stage they are aware that
there are societal guidelines that must be
followed. They will still allow or accept
authority figures but the children now believe
that there is a set of protocols that they need
to follow for societal order.
○ They already believe and l;isten to the
guidelines of their own respective institutions
STAGE 3: GOOD BOY, NICE GIRL
ORIENTATION
● Children want the approval of others and act
in ways to avoid disapproval. Emphasis is
placed on good behavior and people being
“nice” to others.
● During this stage, if a child will continue to do
g0ood but will not be acknowledged for their
good deeds, when the child matures, the
child will only seek approval from other
people and acknowledgement from other
people.
● The child blindly accepts rules and
conventions because of their importance
in maintaining a functioning society. Rules
are seen as being the same for everyone,
and obeying rules by doing what one is
“supposed” to do is seen as valuable and
important. Moral reasoning in stage four is
beyond the need for individual approval
exhibited in stage three. If one person
violates a law, perhaps everyone
would—thus there is an obligation and a
duty to uphold laws and rules.
● Most active members of society remain at
stage four, where morality is still
predominantly dictated by an outside force.
● At this stage, the child will blindly accept rules
and conventions. No matter what it is, the
child will follow. The child will be very
obedient with those laws
● But during this stage, they no longer need the
good boy and nice girl orientation. They will
not seek for any approval or
acknowledgement anymore because they
know that they need to blindly follow rules
and regulations
● Although a child will blindly follow a rule, at
this stage if someone will not follow a rule
among the group. If there’s this one person
 who will not follow the rule, other people will
think that it is okay not to follow because
somebody disobeyed but was tolerated.
● It is critical for authority figures to uphold the
laws and rules because if there is just one
person that you will tolerate, you will need to
tolerate all because most of them will know
start to stop following the rules
● Most active members of society remain at
stage four, where morality is still
predominantly dictated by an outside force.
● Children follow because they need to follow.
When I was in elementary school there was a
rule in our school that we are forbidden to
buy and eat junk food during recess, we
blindly followed, also another rule is that we
can’t go to the highschool dept. without any
rationale we followed.
LEVEL 3: POST CONVENTIONAL
○ Throughout the post conventional level, a
person’s sense of morality is defined in terms
of more abstract principles and values.
People now believe that some laws are
unjust and should be changed or
eliminated. This level is marked by a
growing realization that individuals are
separate entities from society and that
individuals may disobey rules
inconsistent with their own principles.
○ Post-conventional moralists live by their own
ethical principles—principles that typically
include such basic human rights as life,
liberty, and justice—and view rules as useful
but changeable mechanisms, rather than
absolute dictates that must be obeyed
without question. Because post-conventional
individuals elevate their own moral evaluation
of a situation over social conventions, their
behavior, especially at stage six, can
sometimes be confused with that of those at
the preconventional level. Some theorists
have speculated that many people may never
reach this level of abstract moral reasoning.
○ Some theorists have speculated that many
people may never reach this level of abstract
moral reasoning.
○ At this level. People are now aware that there
are some guidelines that are unjust and
unfair to other people. They now believe that
human individuality is different from the
society
○ At this level, people believe that if there is
something unfair then they should do
something about it.
○ They will not just follow a rule they feel is
unfair for them and for everyone. They will
stand what is right and they will find a way for
them to be heard by other people.
STAGE 5: SOCIAL-CONTRACT ORIENTATION
● The world is viewed as holding different
opinions, rights, and values. Such
perspectives should be mutually respected as
unique to each person or community. Laws
are regarded as social contracts rather than
rigid edicts. Those that do not promote
general welfare should be changed when
necessary to meet the greatest good for
the greatest number of people.
● This is achieved through majority decision
and inevitable compromise. Democratic
government is theoretically based on stage
five reasoning.
STAGE 6: UNIVERSAL-ETHICAL-PRINCIPAL
ORIENTATION
● Moral reasoning is based on abstract
reasoning using universal ethical principles.
Generally, the chosen principles are abstract
rather than concrete and focus on ideas such
as equality, dignity, or respect. Laws are valid
only insofar as they are grounded in justice,
and a commitment to justice carries with it an
obligation to disobey unjust laws.
● This is the highest form of moral reasoning in
which people at this stage or people who
 reach this stage will now use ethical
principles in their moral reasoning, not just
the societal laws or guidelines, people now at
this stage will use ethical principle or
reasoning.
● Their principles are equality, dignity, and
respect. They will not follow laws that are
unjust.
● Moral reasoning of people at this stage will
be “it is my obligation to disobey unjust
laws”
● People choose the ethical principles they
want to follow, and if they violate those
principles, they feel guilty. In this way, the
individual acts because it is morally right
to do so (and not because he or she wants
to avoid punishment), it is in their best
interest, it is expected, it is legal, or it is
previously agreed upon.
● Although Kohlberg insisted that stage six
exists, he found it difficult to identify
individuals who consistently operated at that
level.
● As we age and mature, our moral reasoning
also mature and develop. But again not
everyone will reach level 3 moral reasoning.

HEINZ DILEMMA

Heinz’s wife was dying from a particular type of

cancer. Doctors said a new drug might save her.
The drug had been discovered by a local
chemist and Heinz tried desperately to buy
some, but the chemist was charging ten times
the money it cost to make the drug and this was
much more than Heinz could afford. Heinz could
only raise half the money, even after help from
family and friends. He explained to the chemist
that his wife was dying and asked if he could
have the drug cheaper or pay the rest of the
money later. The chemist refused, saying that he
had discovered the drug and was going to make
money from it. The husband was desperate to
save his wife, so later that night he broke into the
chemist’s and stole the drug.