Self-efficacy and relapse among inpatient drug and alcohol abusers: a predictor of outcome.

Monthly intreatment ratings of self-efficacy to avoid drug and alcohol abuse were examined among 419 substance abuse inpatients of a residential treatment community. Posttreatment interviews were conducted with 81 patients approximately 6 months following discharge to assess the relationship between self-efficacy and relapse. As expected, self-efficacy increased during treatment and was higher among abstainers than relapsers at follow-up. Contrary to expectations, low self-efficacy at intake was related to longer inpatient residence and more positive conditions of discharge. Furthermore, abstainers had slightly lower self-efficacy scores than relapsers at intake and increased their self-efficacy two-fold over relapsers during the course of treatment. Contrary to previous research with tobacco smoking, self-efficacy ratings at the end of treatment were not related to substance abuse at follow-up. It is proposed that the present findings are consistent with previous research in demonstrating a relationship between self-efficacy and outcome, and provide new information suggesting that low self-efficacy may be related to positive outcome under certain circumstances. Hypotheses are advanced regarding (1) the potential utility of intreatment change measures, (2) the role of underestimation in self-efficacy ratings and (3) the role of denial in substance abuse populations.