Table 2.

Overview of Existing Key Theories and How they Inform the Development of the Preference-Based Model of Care

	A Theory of Human Motivation	Self-determination Theory	Competence-Press Model	Living Systems Framework	Theory of Positive Emotion
Key assertions	All humans have a basic set of hierarchical needs that drive goal-directed behavior. These needs include: physiological, safety, belongingness and love, esteem, and self-actualization. Humans are consciously and unconsciously motivated to meet these goals in order to gain self-fulfillment. Needs do not occur in isolation.	People are intrinsically motivated toward personal growth when their environment is supportive and their psychological needs are met; specifically, their need for autonomy, competence, and relatedness.	There is a transaction between a person’s level of competence and the level of environmental press (e.g., environmental demand).	Expressions of needs are conceptualized in terms of goal-directed “behavior episodes”; when people attempt to achieve a need/goal, they decide what to accomplish (directive), how to do it (control), act based on plan (transactional), observe and evaluate the success or failure of plan (monitoring) and readjust plan as needed (regulatory).	A person has a daily ratio of positive to negative emotions (e.g., affect balance); optimal level of affect balance is to have more positive emotions each day.
Role in Preference-Based Model of Care	Psychosocial preferences are indicators of an individual’s physiological and psychological needs.	Psychosocial preferences are expressions of how a person fulfills their needs for autonomy, competence, and relatedness.	Outlines how a person’s well-being is impacted by environment; provides social, cultural, and political context to the interactions between the person, their environment, and related outcomes.	Goal-directed behavior episodes are the actions a person takes to fulfill preferences; people are active in fulfilling their needs (e.g., preferences); preference fulfillment results in positive outcomes (e.g., affect).	Affect balance and well-being are outcomes essential to understanding how and if a person’s preferences have been fulfilled.
Relationship to outcomes	A positive outcome is reflected by satisfied people who demonstrate positive affect; negative outcomes result in unsatisfied people resulting in neurotic behaviors or negative affect.	Positive outcomes (e.g., well-being) result when a person’s needs are fulfilled and supported by their environment; negative outcomes (e.g., ill-being) result when a person’s needs are not fulfilled or supported by their environment.	Positive outcomes (e.g., well-being) result when there is a person–environment fit (i.e., balance between competence and press); negative outcomes (e.g., ill-being) result when there is a lack of fit.	Positive outcomes (e.g., positive affect) result post-behavior episode when goal achieved and needs are met; negative outcomes (e.g., negative affect) result post behavior episode when goals not achieved or needs are not met.	Positive outcomes (e.g., well-being) result when a person’s affect balance has a higher positivity ratio; negative outcomes (e.g., ill-being) result when a higher negativity ratio.