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Sunday, October 2, 2011

Research: Self-efficacy and Addiction

"Young adults undergoing addiction treatment arrive ready and willing
to make the personal changes that bring about recovery, but it's the help
and guidance received during treatment that build and sustain those changes, 
according to a longitudinal study published electronically and in press
within the journal Drug and Alcohol Dependence."

The study was conducted collaboratively by the Center for Addiction Medicine at Massachusetts General Hospital and Harvard Medical School and the Butler Center for Research at Hazelden. ("Young Adults Want to Recover from Addiction but Need Help to Make It Happen, Study Suggests," ScienceDaily, September 30, 2011)

Retrieved October 2, 2011, from­ /releases/2011/09/110930123048.htm. Read the article here: 

"This study suggests that strong motivation to change may exist from the get-go among young adults with severe addiction problems entering residential treatment, but the know-how and confidence to change come through the treatment experience," explains John F. Kelly, Ph.D., of the Center for Addiction Medicine who authored the study with Center colleagues Karen Urbanoski, Ph.D., and Bettina Hoeppner, Ph.D., and Valerie Slaymaker, Ph.D., of the Butler Center for Research at Hazelden.

When entering treatment, study participants reported high levels of motivation to remain abstinent but lower levels of coping skills, self-efficacy and commitment to mutual support groups. During-treatment increases in these measures predicted abstinence from alcohol or other drug use at three months post-treatment.  

Self-efficacy or increased confidence in ability to sustain recovery was the strongest predictor of abstinence.

The study found that young people who make meaningful changes in residential treatment position themselves for improved outcomes.

These things help provide the boost that young people need to succeed:

1. Reducing their psychological distress,
2. Developing their recovery-focused coping skills,
3. Increasing their commitment to AA and other groups,
4. Enhancing their overall confidence to stay clean and sober.


Psychologist Albert Bandura (1986, 1993, 1997) and other researchers have demonstrated, self-efficacy can have an impact on everything from psychological states to behavior to motivation. This is known as the social cognitive theory. Self-efficacy may be understood as a person’s belief in his or her ability to succeed in a particular situation.

Specifically, self-efficacy is defined as people's beliefs about their capabilities to produce designated levels of performance that exercise influence over events that affect their lives. Beliefs in personal efficacy affect life choices, level of motivation, quality of functioning, resilience to adversity and vulnerability to stress and depression.

People with a strong sense of self-efficacy actually view challenging problems as tasks to be mastered. They seem to develop a deeper interest in activities in which they participate and form a stronger sense of commitment to these activities and their interests. They also recover quickly from setbacks and disappointments.

Conversely, those with a weak sense of self-efficacy often avoid challenging tasks while believing these situations are beyond their capabilities. They are much more apt to focus on personal failings and negative outcomes, so, naturally, they quickly lose confidence in their personal abilities.

Young adults must cope with many new demands. They are faced with beginning a productive vocational career in a modern workplace of rapid technological changes. Many find themselves dealing with the expanded role of both parent and spouse, and increasing numbers of mothers are joining the work force either by economic necessity or personal preference.Combining family and career has now become the normative pattern. It can be a trying period for those who lack a sense of efficacy to manage the expanded demands. They are highly vulnerable to stress and depression.

People improve their self-efficacy by

1. Mastering Experiences

A resilient sense of efficacy requires experience in overcoming obstacles through perseverance, even in the face of pressing situational demands, failures and setbacks that have significant repercussions

2. Social Modeling (Vicarious Experience)

“If they can do it, I can do it as well.” Seeing people similar to oneself manage the demands of tasks successfully increases self-efficacy. This process is more effectual when a person sees him- or herself as similar to his or her own model. If a peer who is perceived as having similar ability succeeds, this will usually increase an observer's self-efficacy.

3. Social Persuasion

Social persuasions relate to encouragements/discouragements. Getting verbal encouragement from others helps people overcome self-doubt and instead focus on giving their best effort to the task at hand.

4. Psychological Responses

Our own responses and emotional reactions to situations also play an important role in self-efficacy. Moods, emotional states, physical reactions, and stress levels can all impact how a person feels about their personal abilities in a particular situation.

A person who becomes extremely nervous before speaking in public may develop a weak sense of self-efficacy in these situations. However, Bandura also notes "it is not the sheer intensity of emotional and physical reactions that is important but rather how they are perceived and interpreted" (1994). By learning how to minimize stress and elevate mood when facing difficult or challenging tasks, people can improve their sense of self-efficacy.


Young adults desperately want to recover from debilitating dependency, but many who resolve to change their relationship with an addictive incentive do not have realistic expectations about the nature of their challenge. Consequently, they relapse, become demoralized, and lose faith in their ability to overcome their problem. They lack sufficient self-efficacy.

Effective treatment should include concentrated instruction of coping skills, exercises in developing confidence (especially in the face of possible setbacks), and development of commitment to mutual support groups.
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