Helping our patients with both internal and external loci of control through counseling

In counseling, we work on two main strategies to help our patients solve problems.

1 We can focus on the person’s external locus of control. These include structured problem solving, conflict resolution, social/relationship skill training, parenting skill training, and “life skills” in general. We try to influence the environment and external variables to impact change.

2 We can also focus on our internal locus of control which is more about understanding our values and beliefs, and influencing those internal variables to change our perception and our actions/behaviours.

Both strategies are important of course because external factors affect the internal experience, and the internal factors affect the external experience.

How do we choose which strategies to

I think it really depends on the patients and the context. At the end of the day, do what works.

Some folks are biased towards working on the “external”. Some prefer to work on the “internal”. If one has exhausted one’s “external strategies”, we may focus on the internal. If one has exhausted one’s “internal strategies”, we may focus on the external. Often, we will need to integrate both all at the same time.

Word of caution. When working on the internal locus control, it’s important that we have fully validate our patient’s experiences. This can be misread as victim blaming if one is not careful.