Locus of Control and how it affects caring for our patients

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    I have learned about locus of control in the past. Some of it was from OT school and the rest of it was from my undergraduate degree, a little from D&D as well (like the article mentioned). I am uniquely aware of how people place the blame on either themselves or the world when problems arise. I can point out each and every family member and if they have an internal or an external locus of control, if you're reading this and nodding your head, you probably can too. I scored a 13 on the Rotter's Locus of Control Scale, which doesn't surprise me. I am never an extremist, I almost always fall in the middle of every scale when it is about personal attributes. This topic is so vital to know about especially how it can manifest its way into our future client's treatment plans. As healthcare providers, we want to treat and especially within the field of OT, we are passionate about helping people. It is wise for all future and current practitioners to proceed with caution on the "helping" side, especially for those who a more external locus of control.

    Building trust and using therapeutic use of self is something OTs take very seriously. At my internship when I had a new kid on my caseload, I spent the whole first session just playing with them (quietly observing of course). The goal was to build trust and I wanted the kid to trust me and feel comfortable or we would get nowhere in therapy. I would create situations where they would win the game or they would ask for things and I would give it to them. This, of course, worked great and they loved Mrs. Sam. However, by the second session, things changed. I would challenge them and encourage them to do things for themselves and really work for things, something they didn't like at first but it was better for them in the long run. 

    It is so important to encourage the client to make decisions for themselves, even if it is as simple as asking to touch them before working on lower body dressing. You can also ask them if they are okay with a certain person in the room, this gives them the autonomy over who has access to their medical information. Limiting certain interventions that are more passive is something I wouldn't have thought about when it comes to locus of control but it makes perfect sense. If a client looks to you as the person who is going to solve all their problems, they will either A. never leave or B. not grow and develop to become more independent and healthy. No matter how much we love a patient, we always want them to leave and discharge because they means they don't need us anymore and that they are able to optimally function and be independent within their envrionment. Alas, the goal of OT! 

Keeping in mind how our clients think when designing treatment plans, goals, and intervention ideas will better equipt us to treat them and instill a sense of independence within them so they can be their biggest advocate!

Until next time,
Sam the Student

References:

Meira, E. (2013). The Science PT. Are your patients out of control? https://thesciencept.com/are-your-patients-out-of-control/