|عنوان فارسی مقاله:||نقش خوداثربخشی در درمان اختلالات استفاده از مواد|
|عنوان انگلیسی مقاله:||The role of self-efficacy in the treatment of substance use disorders|
|رشته های مرتبط:||روانشناسی و پزشکی، روانپزشکی، روانشناسی بالینی، روانشناسی عمومی|
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|نشریه||الزویر – Elsevier|
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In recent decades, there have been a growing number of studies demonstrating the importance of self-efficacy as a predictor and/or mediator of treatment effects in various domains, such as education, sports, chronic medical conditions, psychopathology, and addictive disorders. Nevertheless, despite considerable empirical evidence, the concept of self-efficacy has yet to become a significant factor in the development of psychosocial treatments. The present paper provides a review of the self-efficacy concept as it has been studied with respect to substance use disorders, and considers why it has thus far had only limited impact.
2. The concept
Bandura (1977) conceptualized efficacy expectancy as the belief that one can successfully execute behaviors needed to produce a desired outcome. He distinguished this from outcome expectancy, which is the belief that performing a given behavior will lead to certain outcomes. The latter belief, that a particular behavior will lead to a desired outcome, does not necessarily entail believing that one can successfully perform the activities required to achieve that outcome. Bandura and Locke (2003) provided a review of 9 meta-analyses that examined self-efficacy beliefs across diverse spheres of behavioral functioning (e.g., work-related performance, academic performance, athletic performance, psychosocial functioning, health functioning). Self-efficacy was found to be a strong predictor of the occurrence of coping behavior, level of performance, and perseverance in the face of difficult problems. It was also found that the relation between earlier performance and subsequent performance was heavily mediated through efficacy beliefs. Bandura and Locke concluded that belief in one’s performance efficacy, i.e., the belief that desired results can be achieved by one’s own efforts, is necessary to mobilize and sustain coping behaviors. Bandura (1986) noted that self-efficacy can affect actions independently of past behavior, and cited numerous studies in which perceived self-efficacy predicted future behavior better than past performance.
with respect to substance use disorders With regard to substance use disorders, numerous studies have shown a strong relationship between self-efficacy beliefs (often referred to as abstinence self-efficacy) and drinking/drug-use outcomes, following a variety of treatments. As noted by Bandura (1986), people who have both the necessary skills and strong coping efficacy are likely to mobilize the effort needed to successfully resist situations of high-risk for drinking or drug use. In the event of a slip, highly self-efficacious persons are inclined to regard the slip as a temporary setback and to reinstate control, whereas those who have low self-efficacy are more likely to proceed to a full-blown relapse. In what follows, a number of relatively recent studies assessing the role of self-efficacy among abusers of various substances are cited, but the list is not meant to be exhaustive. The review is organized according to Fig. 1. We first consider studies in which self-efficacy has been shown to be related to outcome, which are by far the most frequent type of studies. We then consider studies in which various interventions have been shown to enhance self-efficacy, followed by studies in which self-efficacy has been shown to be a mediator between treatment and outcome.