Drug zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA and Alcohol Dependence. 27 (1990) 87 - 94 Elsevier Scientific Publishers Ireland Ltd. a7 Role of self-efficacy in predicting outcomes from a programme for controlled drinking T. Sitharthan” and D.J. Kavanaghb ‘Dmg and Alcohol Department, Royal Prince Alfred Hospital Camperdown, and hDepartment of Psychology, University of Sydney, Sydney /AustraliaJ (Received August 22nd. 1990) This study predicts the outcomes of 40 men and 20 women who attended a controlled drinking programme within a general hospital. Drinking levels over a 6-month follow-up were significantly predicted by consumption during the programme, by the severity of alcohol problems in the past and by a new measure of self-efficacy level that was administered at post-treatment. The self-efficacy prediction was still significant even after all of the other variables were forced to enter a prediction equation. Results are discussed in terms of a social-cognitive theory of sustained response to treatment. Key words: alcoholism; treatment: prediction; self-efficacy; controlled drinking zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPON Introduction While the last 20 years have seen major advances in interventions for addictive behav- iours, there continues to be a high rate of relapse after treatment is concluded. A major task for clinicians and researchers is to under- stand the process where some people revert to drug abuse and to use this information to design strategies that might reduce the risk of relapse. Social-cognitive theory [l] has made a significant contribution to understanding and predicting relapse. In particular, the concept of self-efficacy [2] has demonstrated utility as a predictor of sustained response to interven- tions for a range of problems [3,4] including cig- arette smoking [5]. Self-efficacy reflects confidence in being able to muster coping behaviours to deal with situational challenges, and Bandura [2] argued that it is a determinant of outcomes through its influence on effort and Correspondence to: Mr. T. Sitharthan, Drug and Alcohol Department, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia. persistence. Evidence on phobias, depression and cigarette smoking gives some support for the causal hypothesis, whereby self-efficacy judgments give a more powerful prediction of outcomes than do performance attainments [4,6], especially when the prediction is over a shorter term and the person has sufficient information to make an informed judgment. At the moment there is little evidence on self-efficacy about control of alcohol abuse or dependence. Rist and Watzl [7] examined the utility of a similar concept in predicting out- comes after an abstinence-oriented pro- gramme. Subjects rated how difficult it would be for them to avoid drinking in a variety of situations where there was social pressure to drink. These ratings significantly predicted outcomes over a 3-month follow-up, but an 18- month prediction fell short of significance and 80% of the relapses did not occur in social pres- sure situations. A significant 3-month predic- tion was however obtained from the global self- efficacy question, “Do you believe that you will ever be able to stop drinking completely?“. 0376.8716/91/$03.50 0 1991 Elsevier Scientific Publishers Ireland Ltd Printed and Published in Ireland