Abstract
The relationship between self-efficacy and the cessation of alcohol- and drug-dependent behavior was examined in this study. Evidence suggests that the Relapse Prevention Approach may incorrectly specify a relationship between self-efficacy and recovery. Instead of high situational coping self-efficacy, it may be that the acknowledgment of a loss of control over alcohol and drug use, or low controlled use self-efficacy, promotes recovery because the addict embraces the need for lifelong abstinence. Findings from a prospective study of 356 drug treatment outpatientsindicatethat low controlled use self-efficacy predicted higher levels of abstinence acceptance independent from the possible influences of alcohol and drug use histories and treatment history. A decrease in controlled use self-efficacy overtimewas associated with an increase in abstinence acceptance, and high and increasing levels of abstinence acceptance predicted alcohol and drug abstinence. Contrary to the Relapse Prevention Approach, controlled use self-efficacy does not predict severity or level of use for those who relapse or continue to use alcohol and other drugs. These findings suggest a new social-cognitive theory of recovery--the Addicted-Self Model. This model asserts that the cessation of alcohol- and drug-dependent behavior is more likely to occur when the addict attributes the loss of control over drug and alcohol use to a stable, permanent property of the self and embraces theneedfor life-long abstinence. (Am J Addict 2003;12:346-364)