This study used Rasch methodology to pursue three goals. First, we sought to demonstrate the psychometric limitations of the Falls Efficacy Scale (Tinetti, Richman, & Powell, 1990). Second, we addressed these limitations using a simultaneous calibration of the Falls Efficacy Scale and Mobility Efficacy Scale items. Third, we review previous explorations of the self-efficacy construct in relationship to health behaviors and discuss a possible treatment program based on the simultaneous calibrated items and Social Cognitive Theory. Results indicate that responses from the Falls Efficacy Scale fail to assess the higher ends of the self-efficacy continuum. Simultaneous calibration of items improved this lack of scale definition. This initial work in assessing self-efficacy perceptions provides a theoretical framework for planning treatment programs that may be more cost effective than collecting performance measures.