Modeling and Role‑Modeling theory (MRM; Erickson, Tomlin & Swain, 1983) provides a paradigm and theory for nursing. MRM is best depicted as a grand theory encompassing numerous mid-range theories. MRM has been applied in a variety of clinical practice settings, educational programs, and research.
Theory and Paradigm
The theory is based on philosophical beliefs and assumptions about people, environments, health and nursing. MRM was both inductively and deductively derived from practice experiences, empirical studies, and several foundational theories. Foundational theories upon which MRM is based include those of Maslow, Erikson, Piaget, Bowlby, Winnicott, Engel, Lindemann, Seyle, Lazarus, and Seligman. The difference between those basic theories and the derived theory (MRM) is the synthesis of the foundational theories in MRM.
In MRM, "Modeling" is to gain an understanding of the client's world from the client's perspective. That is to build a "model" of the client's world view. "Role‑Modeling" is based on the assumption that all humans want to interact with others, they want to carry out selected roles in society. Role-Modeling is using the client's model of the world to plan interventions that meet his or her perceived needs, grow, develop and heal. Role-Modeling requires that we aim to build trust, promote a positive orientation and a sense of control, affirm strengths and set specific mutual goals. Our nursing goal is to help people achieve quality, holistic health.
Major concepts in MRM are related to the underlying assumptions and philosophical beliefs regarding how people are alike, how they differ from each other, and what nurses do. Concepts related to how people are alike include holism, mind-body connections, basic needs including the need for affiliated-individuation, and needs for lifelong growth and development. Concepts that reflect how people are different from each other include genetic endowment, the unique model of the world, adaptation, and self-care. Concepts related to the nurse and nursing role are facilitation, nurturance and unconditional acceptance.
Several of the above concepts are original or uniquely defined in MRM theory. For example, the need for "affiliated-individuation" is original to MRM. "Self-care" is viewed as a tripartite concept consisting of self-care knowledge, self-care resources, and self-care actions. "Adaptation" is an ongoing, interactive process of coping that involves stressors, stress and the ability to mobilize resources. The "adaptive potential assessment model (APAM)" is a model for identifying an individual's potential for mobilizing resources. The states of equilibrium, arousal and impoverishment describe the individual's resource mobilization and coping potential in the APAM. A more complete list of key concepts, organized as Human Nature, Nursing Focus and Nursing Role(s) can be found HERE [PDF]; and selected concept definitions are here.
Basic Theoretical Linkages Used in Practice
- Developmental task resolution (residual) and need satisfaction are related.
- Basic need status, object attachment and loss, growth and development are all interrelated.
- Adaptive potential and need status are related.
Aims of Interventions
The MRM theory delineates five aims for planning interventions with clients:
- Build trust;
- Promote a positive orientation through nurturing self-esteem and hope;
- Promote client control;
- Affirm and promote client strengths;
- Set mutual-directed goals.
Selected midrange theories are:
- Developmental task resolution (residual) and basic need satisfaction are related.
- Object attachment and need status are related.
- Object loss and need status are related.
- Adaptive potential state is related to need status.
- Loss resolution affects developmental residual.
More specific relationships have been empirically tested [PDF] through ongoing programs of research.
Theoretical Propositions for Research:
- Individual's ability to content with new stressors is directly related to the ability to mobilize resources needed.
- Individual's ability to mobilize resources is directly related to their need deficits and assets.
- Distressors are unmet basic needs; stressors are related to unmet growth.
- Objects that repeatedly facilitate the individual in need satisfaction take on significance for the individual. When this occurs, attachment to the object results.
- Secure attachment produces feelings of worthiness.
- Feelings of worthiness result in a sense of futurity.
- Real, threatened or perceived loss of the attachment object results in morbid grief.
- Basic need deficits coexist with the grief process.
- An adequate alternative object must be perceived available in order for the individual to resolve the grief process.
- Prolonged grief due to an unavailable or inadequate object results in morbid grief.
- Unmet basic and growth needs interfere with growth processes.
- Repeated satisfaction of basic needs is prerequisite to working through developmental tasks and resolution of related developmental crises.
- Morbid grief is always related to need deficits.
Erickson, H., Tomlin, E. & Swain, M. (2005) (8th Printing). Modeling and role-modeling: A theory and paradigm for nursing. Cedar Park TX: EST Company. (Original printing by Prentice Hall, 1983).
Erickson, H. (Ed). (2006) Modeling and role-modeling: a view from the client's world. Cedar Park, TX: Unicorns Unlimited.
Erickson, H. (1990). Theory based nursing. In H. Erickson & C. Kinney (Ed). Modeling and role-modeling: theory, practice and research. Vol 1(1), pp. 1-27. Cedar Park, TX: The Society for the Advancement of Modeling and Role-Modeling.