American Nursing Diagnosis Association) diag-
noses, which demonstrated considerable overlap.
Poster, Dee, and Randell (1997) found the JBSM
was an effective framework to use to evaluate pa-
tient outcomes.
EDUCATION
Johnson’s model was used as the basis for under-
graduate education at the UCLA School of
Nursing. The curriculum was developed by the fac-
ulty; however, no published material is available
that describes this process. Texts by Wu (1973) and
Auger (1976) extended Johnson’s model and pro-
vided some idea of the content of that curriculum.
Later, in the 1980s, Harris (1986) described the use
of Johnson’s theory as a framework for UCLA’s cur-
riculum. The Universities of Hawaii, Alaska, and
Colorado also used the JBSM as a basis for their un-
dergraduate curricula.
Loveland-Cherry and Wilkerson (1983) ana-
lyzed Johnson’s model and concluded that theCHAPTER 8 Dorothy Johnson’s Behavioral System Model and Its Applications 89Box 8–1 Author’s Research Highlighted
My program of research has examined normal and atypical patterns of behavior of children with a chronic ill-
ness and the behavior of their parents and has examined the interrelationship between the children and the
environment. My goal was to determine the causes of instability within and between subsystems (e.g., break-
down in internal regulatory or control mechanisms) and to identify the source of problems in behavioral sys-
tem balance.
My first study (Holaday, 1974) compared the achievement behavior of chronically ill and healthy children.The
study showed that chronically ill children differed in attributional tendencies when compared with healthy chil-
dren and showed that the response patterns differed within the chronically ill group when compared to certain
dimensions (e.g., gender, age at diagnosis). Males and children diagnosed at birth attributed both success and fail-
ure to the presence or absence of ability and little to effort.This is a pattern found in children with low achieve-
ment needs. The results indicated behavioral system imbalance and focused my attention on interventions
directed toward set, choice, and action.
The next series of studies used the concept of “behavioral set” and examined how mothers and their chron-
ically ill infants interacted (Holaday, 1981, 1982, 1987). Patterns of maternal response provided information re-
lated to the setting of the “set goal” or behavioral set; that is, the degree of proximity and speed of maternal
response. Mothers with chronically ill infants rarely did not respond to a cry indicating a narrow behavioral set.
Further analysis of the data led to the identification of a new structural component of the model-conceptual
set. A person’s conceptual set was defined as an organized cluster of cognitive units that were used to inter-
pret the content information from the preparatory and perseveratory sets. A conceptual set may differ both in
the number of cognitive units involved and in the degree of organization exhibited. The various cognitive units
that make up a conceptual set may vary in complexity depending on the situation. Three levels of conceptual
set have been identified, ranging from a very simple to a complex “set” with a high degree of connectedness be-
tween multiple perspectives (Holaday, 1982).Thus, the conceptual set functions as an information collection and
processing unit. Examining a person’s set, choice, and conceptual set offered a way to examine issues of indi-
vidual cognitive patterns and its impact on behavioral system balance.
The most recent study (Holaday,Turner-Henson, & Swan, 1997) drew from the knowledge gained from pre-
vious studies.This study viewed the JBSM as holistic, in that it assumed that all part processes—biological, phys-
ical, psychological, and sociocultural—are interrelated; developmental, in that it assumed that development
proceeds from a relative lack of differentiation toward a goal of differentiation and hierarchic integration of or-
ganismic functioning; and system-oriented, in that a unit of analysis was the person in the environment where
the person’s physical and/or biological (e.g., health), psychological, interpersonal, and sociocultural levels of or-
ganization are operative and interrelated with the physical, interpersonal, and sociocultural levels of organiza-
tion in the environment. Our results indicate that it was possible to determine the impact of a lack of functional
requirements on a child’s actions and to identify behavioral system imbalance and the need for specific types of
nursing intervention.
The goal of my research program has been to describe the relations both among and within the subsystems
that make up the integrated whole and to identify the type of nursing interventions that restore behavioral sys-
tem balance.