Previous evidence from studies with college students on three continents and with teachers in an Israeli border community under constant terrorist threat indicates that individuals who are higher in "controllability awareness" (CA, the extent to which an individual's responses to life situations reflect attention to distinctions between controllable and uncontrollable aspects of potential outcomes) perceive their lives as less stressful, report fewer physical symptoms, and think in ways that enable them to cope more effectively with environmental demands. The current study extends these findings to include clients seeking treatment in an outpatient institute for the treatment of psychological stress. Correlational findings from measures of CA, perceived stress and personality variables indicate that CA is associated with higher stress tolerance irrespective of clinical diagnosis and appears to mitigate a wide range of psychological difficulties. Clinical and research implications are discussed.