Who holds the key to recovery? The relevance of health locus of control in physiotherapy.

Health locus of control (HLC) is a key psychological construct that influences how individuals perceive control over their health and engage in rehabilitation. This masterclass provides an overview of HLC and its relevance to physiotherapy practice. Drawing from social learning theory (SLT), HLC reflects the extent to which individuals attribute health-related outcomes to internal or external factors. Evidence suggests that HLC is associated with health behaviors, treatment adherence, patient-provider communication, and rehabilitation outcomes. Individuals with a more internal HLC believe that their health outcomes are largely shaped by their personal actions and behaviors. In contrast, individuals with a more external HLC, characterized by the belief that health outcomes are primarily determined by factors outside one's control, such as healthcare providers, luck, fate, genetics, or environmental circumstances, may rely more heavily on external guidance or contextual factors. However, these relationships are complex and influenced by cognitive, emotional, social, cultural, and environmental processes. Following an educational and clinically oriented masterclass article format, we outline how validated instruments may be used qualitatively to inform clinicians' perspectives on patients' HLC, and emphasize the importance of adopting a holistic and dynamic perspective. Rather than viewing HLC as a fixed trait, it is conceptualized as a context-dependent and potentially modifiable process that evolves through experience, interaction, and therapeutic dialogue. Finally, HLC is situated within the broader shift toward psychologically informed physiotherapy. Implications for education and professional development include preparing clinicians to recognize and respond to patients' control beliefs, strengthening the therapeutic alliance, and supporting individualized, patient-centered care.