Self-efficacy, locus of control and planned behavior
- Theory
Self-confidence, a sense of control and what others think all shape whether a person changes their health behaviour.
What it is
Several theories explain why the intention to look after oneself does not always become action. Bandura's self-efficacy is confidence in being able to carry out a specific behaviour. Rotter's locus of control describes whether a person credits what happens to their own actions or to outside forces. Ajzen's theory of planned behavior combines attitudes, social norms and perceived control to predict intention and behaviour.
Key facts
- In health, three control orientations are described: internal, powerful others (the doctor, the family) and chance.
- An internal health locus of control goes with better health outcomes (in chronic pain: less pain and disability, better quality of life) and more adaptive coping.
- Subjective norm: what the person believes the people who matter to them expect, and their wish to comply.
- Intention–behaviour gap: many well-intentioned people do not act; concrete ‘when, where and how’ plans help close it.
The three theories compared
| Theory | Author | Core idea | Clinical use |
|---|---|---|---|
| Self-efficacy (social cognitive theory) | Bandura | Person, behaviour and environment influence each other (reciprocal determinism) | Small goals, guided practice, peer models |
| Locus of control | Rotter | Internal or external attribution of outcomes | Fit the message and strengthen the sense of control |
| Planned behavior | Ajzen | Intention depends on attitude, subjective norm and perceived control | Work on beliefs, social support and real obstacles |
Clinical notes
- In diabetes, someone confident they can check their glucose and adjust their diet is more likely to do it: hands-on training raises self-efficacy.
- An extreme external locus (‘it all depends on God or the doctor’) is not fought; it is used to bring the family, community or team in as allies.
Test yourself
Think of the answer, then tap the question to see it.
What is the most powerful source of self-efficacy according to Bandura?
Mastery experiences: having successfully done the behaviour, or part of it.
Which three factors predict intention in the theory of planned behavior?
Attitude toward the behaviour, subjective norm and perceived behavioural control.
How do self-efficacy and locus of control differ?
Self-efficacy is believing you are able to do something; locus of control is believing whether outcomes depend on your own actions or on outside forces.
What is reciprocal determinism?
Bandura's idea that behaviour, personal factors (beliefs, expectations) and the environment all influence one another.
Connections
Educational content on behavior and the clinical relationship; not a diagnostic or treatment guide and no substitute for assessment by a health professional. If you or someone near you is at risk, seek help now from an emergency service or a mental-health helpline.
Sources: Theory at a Glance: A Guide For Health Promotion Practice (Second Edition) (National Cancer Institute, National Institutes of Health (US), 2005); Locus of control patterns in headaches and chronic pain (Pain Research & Management (PubMed Central), 2013).
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Representative model, for educational purposes only.