A brief exploration of the self – efficacy concept and its implication in the recovery process

The development of the self occurs in a social context that varies from culture to culture. The degree to which the individual self succeeds in its various roles and tasks, or in its overall purpose, and which Maslow referred to as self-actualization (1972) is determined by a variety of social influences upon the individual which serve to establish distinct areas of effectiveness and focus. Mead describes the self as a process, not a thing (Mead, 1934).

The process of “becoming” is described by Mead as dependent, to a significant extent, upon motivating factors affected by personal beliefs in one’s ability to learn and perform the skills required for a variety of necessary functions. So too, is the ability to prevent negative outcomes from occurring to the individual. The beliefs in one’s ability to perform tasks and to control outcomes important to daily functioning serve to provide a sense of predictability while decreasing anxiety.

Beliefs influence actions, feelings, and thoughts and they permeate choice-making processes. Overview Albert Bandura is a psychologist of tremendous influence whose work in social learning theory places him in the company of Sigmund Freud, Jean Piaget, B. F. Skinner, and Carl Rogers (Bandura’s Biography, 1997). As an extension of his research into the cognitive processes involved with learning, Bandura addressed the perception that an individual experiences regarding his/her self-efficacy to handle situations in specific domains.

He defined four main influences upon the development of efficacy (control beliefs): mastery experiences (personal successes, the most authentic and powerful means), vicarious experiences (provided by observing social models), social persuasion (positive verbal appraisals offered by others), and self-feedback based on physiological and emotional states (Bandura, 1986). These beliefs affect human functioning through four general areas of mental processing including cognitive processes, which determine visualization of goal-directed behavior and are generated and organized by appraisal of ones ability.

Planning occurs as thought, and a resilient sense of efficacy maintains the thought processes by which perseverance in difficult tasks occurs. Motivational processes are also thoughtful in nature, and Bandura defines three types of cognitive motivators: causal attributions, outcome expectancies, and cognized goals (Bandura, 1986). Efficacy beliefs influence goal choices, efforts expended, and resiliency to setbacks. Affective processes are also strongly affected by efficacy beliefs.

Anxiety/confidence, depression/resilience, unfulfilled aspiration/self-actualization are examples of contrasting effects of low and high senses of efficacy. Selection processes, by which the individual determines the types of environments to be involved in and activities to pursue, can affect ones life course based on his/her perceptions of what is safe, attainable, challenging, or rewarding. Thus does self-efficacy influence behavioral choices, goal setting, performance of effort toward goals, and persistence of effort in the face of difficulty.

While efficacy is important in all these areas critical to achievement and self-actualization, it is also experienced at levels specific to individual experiential domains. Bandura views the concept of ability as one that is not a fixed attribute or trait in one’s repertoire, but rather, as a generative capability in which cognitive, motivational, emotional and behavioral skills must be organized and effectively orchestrated to serve diverse purposes.

A person with a strong sense of his or her own efficacy for a type of behavior will tend to set higher goals and stick with them through greater difficulties and will more readily accept challenges to perform without feeling threatened. The individual will also more readily recover from failures, which tend to be perceived as indicating a need for greater effort on their part; and will be less vulnerable to stress and depression, which Bandura attributes to low estimations of self-efficacy (Bandura, 1977).

Developmental Aspects of Self-Efficacy Self-efficacy exists as one of a type of beliefs known as control beliefs. Flammer (1995) defines them as self-consciously knowing that one is able to act in such a way that certain effects are produced. He describes the evolution of these general beliefs in five developmental levels. Level one, event schema, consists of the first perceived life events to be impacted by activities of the self, such as sucking or moving of the head.

Level two, causal schema, begins normally around six months, and involves a noticeable development of interest in secondary effects caused by the activities of the self. Level three, attribution of internal causes, begins about age two and defines the distinction between self and others actions. Typical behaviors involve refusing help and saying no to direction by others. Level four, personal achievement, features recognition of successful self-effort, defined as a personal achievement that matches a personal standard, and may be seen between ages 2. and 3. 5.

At this age, children will seek to complete tasks on their own, without the assistance of one who might share the credit for attainment. Pride in accomplishment is seen as motivating their independence, and appears to emerge prior to shame. Level five, the control belief, involves the development of concepts of global ability, effort intensity, task difficulty, and compensation of effort and ability. These are completed by the age of ten years and herald the attainment of the first fully functional system of control beliefs.

While he describes the process of developing control beliefs as complete by age ten, Flammer offers the opinion that the extension of developing self-conceptions throughout the life cycle of self-esteem, self-control, maintaining values, and dealing with issues of changing and declining abilities, control, and health continue the process of defining control beliefs. He points out people who face the onset of severe disability, loss of social supports, or severe environmental degradations or war and experience ongoing reformulation of beliefs.

He also posits that it is essential to mental health and well-being to be able to reassess and redevelop personal control throughout the lifespan, since it is typical that personal control tends to increase over several decades, but will decrease eventually due to the effects of aging, or suddenly as mentioned above. I would add that an individual caught in the grip of problematic behaviors as related to addictions is in a state of crisis not dissimilar to these degradations and experiences Flammer notes. Self-Efficacy, Stress, and Health

The role of self-efficacy in the area of health and stress management is receiving increasing attention. A conversion from a biomedical to a biopsychosocial model seems to be taking place in Western culture in recent years (Bandura, 1995). Health is being viewed increasingly as interplay between biological and psychosocial factors, and also increasingly as amenable to enhancement as well as correction. In other words, there is a sharing of focus between wellness and sickness. What is more, there is an expanded emphasis placed on individual responsibility for making lifestyle choices which impact health (Miller & Rollnick, 1991).

Notable influences on this paradigm shift have been the epidemic spread of venereal diseases, especially AIDS; the recognition of the negative effects of smoking on health; the skyrocketing costs of healthcare, generally; increased awareness of nutritional choices on cardiovascular diseases, as well as needs for regular exercise; the negative effects of drug and alcohol abuse, increasing in much of the world presently; and the effects of violence upon individuals and the environment.

It is estimated that half of all deaths that occur in Canada are attributable to negative health habits, which shorten life. Bandura asserts that it is not stressful conditions per se but the perceived inability to manage them that produces the detrimental biological effects. Stress and other health concerns are forms of environmental conditions over which people need to perceive their own abilities to cope, otherwise they experience distress and inhibited functioning (Skinner, lecture May, 2001).

This may take the form of lowered immune system response and/or elevated levels of biochemical reactions, which indicate agitation, and release of stress-related hormones. Studies show that the perception of diminished control of the experienced environment increases susceptibility to disease and acceleration of its progression (Bandura, 1995). As addiction and specifically alcoholism are often viewed as a disease it is in keeping with these studies that increased efficacy will aid in mastery of control and perception of abilities.

This does not implicate all stress as negative, however, since stress is adaptive in many ways. The central factor in making it a negative factor to health is the perception of the lack of ability to cope with it with efficacy. The ability to learn mastery over stressful situations is a circumstance, which strengthens the individual and increases perceived efficacy for that condition. Since so many health issues relate to lifestyle choices, there exist a wide range of opportunities for people to positively impact their own well-being. Their beliefs in their own self-efficacy to do so is crucial to the attempt.

Bandura (1986) outlines a system of self-regulation, which may serve to build the necessary skills, including self-monitoring, goal setting, and attaining incentives and needed supports. Such mastery experiences build efficacy and provide a system of feedback, which is self-perpetuating. He also stresses the need for children to learn good health habits, which will endure throughout their life cycles. Here, our educational systems have existing capabilities to successfully impact children’s perceived efficacy to control their own destinies and their abilities to resist beginning detrimental habits.

The society at large, however, must make the needed commitments to ensure that children at risk are given opportunities to live in a culture which values their health and well-being and demonstrates it through appropriate supports for its schools and by clear messages about the dangers of substance abuse. Self-Efficacy and Addictive Processes The development of addictions and the processes of recovery from them are both influenced by self-efficacy beliefs.

Likewise is the ability to resist addictive substances or to use them in a controlled manner determined in a fairly complicated way by an individuals beliefs in their own abilities to do so, often in the face of peer influence or other forms of social pressure (Miller & Rollnick 1991). Research on these issues has largely been concerned with use of alcohol, marijuana, and tobacco, all of which tend to be considered as gateway drugs. If one eventually becomes involved with hard drugs, it is often by first experiencing a process which is developed by use of these first.

The influences of efficacy beliefs on the resistance to drug use, initiation of use, changing of use habits, and relapse prevention have all been discussed by various researchers (Marlatt, Baer, & Quigley, 1995). The researchers developed five factors in addiction, which are influenced by self-efficacy beliefs. During the phase prior to actual onset of an addiction, the individual must judge their ability to avoid using the substance in resistance self-efficacy. After some usage has occurred, they are faced with the need for reducing risk in harm reduction self-efficacy.

When the substance user attempts to change the addictive behavior, their assessment of their own ability to modify their actions in regard to the substance is described as action self-efficacy. Maintaining their goal of controlled use or abstinence is determined by coping self-efficacy, and coping with relapses is affected by recovery self-efficacy. Prevention of addiction faces two levels of process, one for preventing the person who has not used at all from beginning, and the other for limiting those who have begun from continuing to the point that harm to the individual occurs.

In the first case, according to Marlatt and colleagues (Marlatt, Baer, & Quigley, 1995), programs attempting to prevent initial experimentation have been employed focusing on strengthening resistance self- efficacy. Programs reported successfully reducing rates of first usage for children in the seventh grade, which appeared to generalize across substances. These programs employed booster lessons in later grades to a degree but eventually reported poor results for the students once they reached the upper grades. Early results, however, showed decreased drinking of alcohol, and less smoking of tobacco and pot.

This training also gave good results for limiting, decreasing, or eliminating use for all three substances for those in the harm-reduction phase. The same authors also mention one significant, yet somewhat disturbing point in regard to experimentation in citing a longitudinal study which seems to demonstrate that children who did try drugs were better adjusted than their peers who either did not experiment at all and those who became abusers. Action self-efficacy refers to beginning the process of changing the behavior by abstinence or limiting use.

For tobacco, efficacy measures show clear ties to successful cessation, although the individuals negative beliefs prior to treatment are not influential in light of strengthened beliefs after treatment. Surprisingly, those with moderate ratings at the beginning of cessation were more successful than those with high ratings, apparently highlighting the danger of overconfidence, which is reportedly a factor with all substances. Alcohol users tend to have low efficacy beliefs on entering treatment, experience increases during treatment, and show successes related to current beliefs, rather than former beliefs of low efficacy.

Overconfidence in efficacy scores seem to be tied to denial of severity of condition, lack of motivation, or external pressure to quit use. Relapse does not seem to be predicted by either post-treatment efficacy or change in efficacy assessment. Coping self-efficacy and recovery self-efficacy are built by providing predetermined strategies for use in the case relapse and treating the experience as if it is a normal part of the recovery process rather than due to uncontrollable internal conditions (Skinner, lecture May, 2001).

All five stages of the addictive process have been shown by the researchers to be responsive to positive enhancements in self-efficacy beliefs. Marlatt therefore recommends treatment and prevention modalities that rely on the use of all four types of enhancers of efficacy beliefs in the areas for which they are shown to be most effective, for example mastery experiences for smoking cessation. They also state the need for efficacy assessments to be used to identify those most at risk to experience problems with either experimentation or quitting, as well as for assessing particular times and situations, which could become problematic.

Conclusions The construct of self-efficacy is an idea that has a pervasive influence upon human endeavors. As Bandura puts it, peoples’ beliefs in their efficacy play a paramount role in how well they organize, create, and manage the circumstances that affect their life course (Bandura, 1995). Virtually all experiences of learning, choice making, and conscious motivation are affected by the individuals perception of their own ability to succeed.

The findings cited above demonstrate the need to consider this factor in a wide range of concerns of importance in the Behavioral Sciences, including education, substance abuse and recovery, physical health and wellness, mental health and self- actualization, family dynamics, and human developmental processes. Furthermore, the existence of the human species is continuously challenged (or threatened, depending upon ones level of efficacy) to adapt to circumstances that by many measures seem increasingly dangerous.

Overpopulation, environmentally damaging practices, violence, substance abuse, and other problems which affect humanity need to be addressed by individuals and their social systems, whose success may be predicted by their sense of individual and group self-efficacy. As members of a helping profession commitment to the well being of individuals and communities requires awareness and nurturing of this human attribute.