The Use of the Johnson Behavioral System Model to Measure Changes During Adolescent Hospitalization

Abstract

This study utilized a patient categorization instrument based upon the Johnson Behavioral System Model (JBSM) to assess 38 patients hospitalized on an adolescent psychiatry inpatient unit. The results indicated that the model was effective in targeting specific behavioral subsystems requiring nursing intervention and evaluating behavioral changes during the hospitalization. Eight behavioral subsystems and an overall behavioral category were ranked according to four levels of behavioral efficiency reflecting severity of symptoms and patient care requirements. Assessment of the levels of behavioral efficiency among the 8 behavioral subsystems revealed that the aggressive-protective subsystem of 60% of the patients became more efficient within the first week of hospitalization. While overall improvement was found in adolescents with diagnoses of conduct disorder, borderline personality disorder and eating disorder, there was considerable variability in improvement in specific behavioral subsystems related to all 3 phases of hospitalization. Specific subsystem efficiency scores provided not only an indicator of effectiveness of the interventions, but also pointed to the need to target specific areas for intervention post-discharge. The use of the JBSM, a behavioral system model which focuses on measurable behavior change, provides clinicians with valuable information on which to target specific interventions, monitor behavioral change, and evaluate the impact of interventions. © 1992, Taylor & Francis Group, LLC. All rights reserved.