Health locus of control changes during a workshop in behavioral medicine.

Abstract

While measures of health locus of control have been employed to predict the responses of patients to various medical interventions, the beliefs of mental health professionals have been neglected. If t h s construct is a stable personality characteristic as Lau (1) suggests, it may be a selection variable for interest in behavioral medicine. If health locus of control is more statedependent, it may be a variable that changes with training in behavioral medicine. The Health Locus of Control Scale (2) was administered to 40 participants, before and after a >-day behavioral medicine workshop. Subjects were 16 men and 24 women (age = 38.9 yr.) who were practicing therapists (26 MSW, 11 Marriage, Family and Child Counselors, 2 Ph.D. and 1 M.D.). Prior to the workshop, subjects scored 33.66 versus 30.29 afterward ( t19 = 7.98, p<.001), indicating a significant shift toward an internal orientation. A factor analysis (Systat commercial package, varimax rotation) indicated the health locus of control scores were best explained by a single factor, accounting for 56.6% of the variance. After the workshop, an identical factor analysis indicated the scores were best explained by a 3-factor model which explained 65.5% of the variance. Factor 1 (26.0%), loaded by Questions 2, 8, 10, involved past personal responsibility for health. Factor 2 (21.5%), loaded by Questions 1, 4, 6, 11, involved present ~ersonal responsibility for health. Factor 3 (18.0%), loaded negatively by Questions 3, 5, 9, indicated health was a question of luck, fortune, and accidental happenings. The preworkshop score of 33.66 was not more internal than the original normative data from nonill persons, indicating participants interested in behavioral medicine were not a selfselected sample of internal scorers. The final score was significantly more internal than those of any of the original samples, suggesting that the training increases an internal orientation consistent with the attitudes of behavioral medicine. Previous factor analytic studies of responses to the Health Locus of Control Scale have also produced three factors, but not as a function of intervention, i.e., after training. Education in behavioral medicine stresses treatment techniques, but also changes health attitudes and the clustering of these atticudes as well. At least within mental health professionals, health atticudes may not be as intractable as has been previously believed. A measure of their behavioral expression as well should be sought.