untitled

important point she made about the value system is
that “given that the person has been provided with
an adequate understanding of the potential for and
means to obtain a more optimal level of behavioral
functioning than is evident at the present time,
the final judgment of the desired level of function-
ing is the right of the individual” (Johnson, 1980, p.
215).
The source of difficulty arises from structural
and functional stresses. Structural and functional
problems develop when the system is unable to
meet its own functional requirements. As a result of
the inability to meet functional requirements,
structural impairments may take place. In addition,
functional stress may be found as a result of struc-
tural damage or from the dysfunctional conse-
quences of the behavior. Other problems develop
when the system’s control and regulatory mech-
anisms fail to develop or become defective.
The model differentiates four diagnostic classifi-
cations to delineate these disturbances. A disorder
originating within any one subsystem is classified
as either an insufficiency, which exists when a sub-
system is not functioning or developed to its fullest
capacity due to inadequacy of functional require-
ments, or as a discrepancy, which exists when a be-
havior does not meet the intended conceptual goal.
Disorders found between more than one subsystem
are classified either as an incompatibility, which ex-
ists when the behaviors of two or more subsystems
in the same situation conflict with each other to the
detriment of the individual, or as dominance,
which exists when the behavior of one subsystem is
used more than any other, regardless of the situa-
tion or to the detriment of the other subsystems.
This is also an area where Johnson believed addi-
tional diagnostic classifications would be devel-
oped. Nursing therapeutics deal with these three
areas.
The next critical element is the nature of the in-
terventions the nurse would use to respond to the
behavioral system imbalance. The first step is a
thorough assessment to find the source of the diffi-
culty or the origin of the problem. There are at least
three types of interventions that the nurse can use
to bring about change. The nurse may attempt to
repair damaged structural units by altering the in-
dividual’s set and choice. The second would be for
the nurse to impose regulatory and control meas-
ures. The nurse acts outside the patient environ-
ment to provide the conditions, resources, and

controls necessary to restore behavioral system bal-

ance. The nurse also acts within and upon the ex-

ternal environment and the internal interactions of

the subsystem to create change and restore stability.

The third, and most common, treatment modality

is to supply or to help the client find his or her own

supplies of essential functional requirements. The

nurse may provide nurturance (resources and con-

ditions necessary for survival and growth; the nurse

may train the client to cope with new stimuli and

encourage effective behaviors), stimulation (provi-

sion of stimuli that brings forth new behaviors or

increases behaviors, that provides motivation for a

particular behavior, and that provides opportuni-

ties for appropriate behaviors), and protection

(safeguarding from noxious stimuli, defending

from unnecessary threats, and coping with a threat

on the individual’s behalf ). The nurse and the client

negotiate the treatment plan.

PART TWO

Applications

Fundamental to any professional discipline is the

development of a scientific body of knowledge that

can be used to guide its practice. JBSM has served

as a means for identifying, labeling, and classifying

phenomena important to the nursing discipline.

Nurses have used the JBSM model since the early

1970s, and the model has demonstrated its ability

to provide: a medium for theoretical growth; or-

ganization for nurses’ thinking, observations, and

interpretations of what was observed; a systematic

structure and rationale for activities; direction to

the search for relevant research questions; solutions

for patient care problems; and, finally, criteria to

determine if a problem has been solved.

RESEARCH

Stevenson and Woods state: “Nursing science is the

domain of knowledge concerned with the adapta-

tion of individuals and groups to actual or poten-

tial health problems, the environments that

influence health in humans and the therapeutic in-

terventions that promote health and affect the con-

sequences of illness” (1986, p. 6). This position

CHAPTER 8 Dorothy Johnson’s Behavioral System Model and Its Applications 87