Abstract

In an attempt to address the consistently high relapse rate confronting substance abusers and meet the changing demands of the health care system, attention has focused on aftercare and its role in preventing relapse. There has also been increased interest in the cognitive processes underlying changes in addictive behavior, and specifically, the role of self-efficacy in substance abuse behavior change. The present study prospectively examined the role of abstinence self-efficacy in recovery among two groups who, in addition to receiving intensive and aftercare treatment at a substance abuse treatment facility, also received either a relapse prevention (RP) or a 12-step (AA) aftercare. A Reference group only received the usual care. The groups were compared on self-efficacy across three time periods (pre-aftercare, post-aftercare, and 6-month follow-up). The predictive relationship between self-efficacy and outcome was also explored. Results demonstrated that self-efficacy increased over time in situations involving negative emotional states. No group effect was obtained, although participation in the AA group appeared to contribute the most to this effect. Analyses also showed that pre-aftercare self-efficacy scores predicted improved family and social relations, less psychological distress, and an increased number of abstinent days at follow-up. Both pre- and post-aftercare self-efficacy were significant predictors of latency-to-lapse and latency-to-relapse. The results provide support for the multidimensionality of the self-efficacy construct, and the association between greater abstinence self-efficacy and improved functioning following substance abuse treatment.