Sponsored by the HealthcareTrainingInstitute.org providing Quality Education since 1979
Add to Shopping Cart

Tobacco Dependency: Treatment Behavioral Solutions for Quitting
Tobacco Dependency continuing education social worker CEUs

Section 16
Self-Efficacy Theory in Tobacco Dependency Counseling

CEU Question 16 | CEU Answer Booklet | Table of Contents | Addictions
Social Worker CEUs, Psychologist CEs, Counselor CEUs, MFT CEUs

Although several innovative substance abuse counseling strategies have emerged recently, none have exhibited greater promise than those based on self-efficacy theory. Numerous studies provide evidence of Abstinence Tobacco Dependency social work continuing edthe clinical effectiveness of a self-efficacy approach to addictive behaviors (Baer, Holt, & Lichtenstein, 1986; Lichtenstein & Glasgow, 1997; Rollnick & Heather, 1982; Rychtarik, Prue, Rapp, & King, 1992). However, the benefits such an approach offers counselors whose practice is closely regulated by third party payers has not been reviewed thoroughly. Therefore, our purpose, here, is to present the advantages a self-efficacy approach has for substance abuse counselors working in a rapidly changing health care environment. Specifically, a rationale for self-efficacy addiction counseling, a review of the tenets of self-efficacy theory, a model to operationalize self-efficacy theory for addiction counseling, and the implications a self-efficacy approach has for substance abuse counselors who work in managed care settings (including different levels of care, brief interventions, and outcome evaluation) are discussed.

Theory
Bandura (1995) defined self-efficacy as an individual's belief in personal capability to mobilize the motivation, cognitive resources, and courses of action needed to exercise control over a variety of tasks. People may perform poorly, adequately, or extremely well depending on individual variations in perceived self-efficacy. Several sources of self-efficacy have been identified: (a) mastery experiences, which provide palpable evidence of personal ability; (b) vicarious experiences, which establish personal beliefs derived from comparing oneself to others; (c) verbal persuasion, which shapes personal beliefs in self-efficacy from the comments made by others; and (d) affective and physiological states, which ground personal perception of personal competence (or lack of it) (Bandura, 1997). These self-efficacy domains provide clinicians with multiple therapeutic leverage points for modifying client self-perceptions related to a variety of behavioral problems.

When confined to a discussion of substance abuse, self-efficacy pertains to an individual's perceptions of his or her ability to mobilize necessary motivation, knowledge, and behavior to control or abstain from use of alcohol or other drugs (DiClemente, 1986). For example, an individual who possesses a strong belief in his or her ability to resist a craving for a cigarette is more likely to avoid nicotine use than are individuals who exhibit less self-regulatory confidence. Several studies have identified specific sources of efficacy related to addictive behaviors. However, of particular interest here is the model proposed by Marlatt, Baer, and Quigley (1995) that identified five categories of self-efficacy related to substance abuse: (a) resistance self-efficacy, (b) harm-reduction self-efficacy, (c) action self-efficacy, (d) coping self-efficacy, and (e) recovery self-efficacy.

Resistance Self-Efficacy : Resistance self-efficacy refers to an individual's perceived ability to withstand attempts to persuade them to use a "recreational" substance for the first time (Marlatt et al., 1995). Resistance self-efficacy is closely related to what counselors have traditionally referred to as a prevention approach. For example, research indicates that children and adolescents who successfully complete refusal skilltraining, and thus increase their resistance self-efficacy, are more confident in their ability to resist peer pressure and are significantly better able to avoid first time use of tobacco, alcohol, or other drugs (Belcher & Shinitzky, 1998; Herrmann & McWhirter, 1997).

Harm Reduction Self-Efficacy: After initial use, many people begin to experiment further with psychoactive substances. The vast majority of these individuals are not addicted, but many do experience serious physical, psychological, and social problems related to excessive alcohol and drug use and are in need of a method to minimize problematic drug use. Research indicates that a harm reduction approach is an effective method to help these individuals minimize these maladaptive behaviors by improving their perceived capacity to restrict personal use of alcohol and drugs (Tatarsky, 1998). For example, young adults who have problems related to drinking, but are not considered alcohol dependent, are often counseled effectively to moderate their frequency and quantity of alcohol consumption.

Action Self-Efficacy: Action self-efficacy is defined as a person's belief in their ability to actualize the behaviors necessary to stop or reduce the use of a psychoactive drug (Marlatt et al., 1995). Many people who become addicted to alcohol or other drugs are unable to stop using simply because they do not perceive themselves as capable of reducing or quitting. However, personal ability related to cessation of an addiction can be raised or lowered depending on how the actions of the individual and others are interpreted (Bandura, 1997). For example, a person who has witnessed a friend's successful attempt to quit smoking may conclude that he or she also could overcome nicotine cravings and stop smoking cigarettes. Alternatively, a person who has previously tried to quit smoking and succumbed to cravings might falsely conclude that past experiences accurately predict future accomplishments and, therefore, refuse to try again.

Coping Self-Efficacy: Individuals who successfully negotiate the action stage and achieve abstinence are often faced with high-risk situations that threaten their newly established self-efficacy. Unfortunately, the relapse rate is high among those who do not perceive themselves as capable of coping with stress provoking events (e.g., family discord, peer pressure, financial problems, or temptation) without the use of a drug. However, research indicates that those who receive relapse prevention counseling are more confident in their ability to cope effectively when confronted with crisis situations (Annis & Davis, 1989; DiClemente, Fairhurst, & Piotrowski, 1995; Monti, Rohsenow, Michalec, Martin, & Abrams, 1997). For example, recovering clients who have received instruction in and rehearsed strategies for refusing a drink offered by an associate or friend are significantly more confident that they can avoid relapse (Monti, Gulliver, & Myers, 1994).

Recovery Self-Efficacy: Unfortunately, many who achieve sobriety often experience setbacks or relapses in the quest to maintain long-term recovery. However, it is not the relapse but rather the interpretation of the event that guides an individual's future drag-related behaviors (Bandura, 1997). Those with higher levels of recovery self-efficacy view the relapse as a learning experience and intensify their efforts to return to and maintain sober behaviors. Those who lack personal confidence in their ability to recover from a setback often view themselves as powerless and unable to manage cravings, pressures, and temptations and fail to take further action to return to abstinent behaviors.
- Whittinghill, David; Whittinghill, Laura Rudenga; Loesch, Larry C.; The Benefits of a Self-Efficacy Approach to Substance Abuse Counseling in the Era of Managed Care; Journal of Addictions & Offender Counseling;  Apr2000; Vol. 20 Issue 2
The article above contains foundational information. Articles below contain optional updates.

Personal Reflection Exercise #9
The preceding section contained information about self-efficacy theory in tobacco dependency counseling.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 16
What are the five categories of self-efficacy proposed by Marlatt? Record the letter of the correct answer the CEU Answer Booklet

 

CEU Answer Booklet for this course | Addictions
Forward to Section 17
Back to Section 15
Table of Contents
Top

The article above contains foundational information. Articles below contain optional updates.
Why Choose Gender Specific Treatment? - April 30, 2016
Gender plays an important role in addiction and addiction treatment. Although many like to believe that men and women are equal in all things, this is not true of drug addiction. It might not seem like it, but there are some very good reasons to choose gender specific treatment. Different Genders Have Different Needs According ...
The post Why Choose Gender Specific Treatment? appeared first on Addictions.
5 Ways You Can Help a Friend in Inpatient Care - April 24, 2016
When someone begins inpatient care, it means they will require intensive treatment away from those they love for a specific period of time. Though this treatment option is incredibly necessary for certain individuals, it can be a difficult period as well. Below are 5 ways you can help a friend in inpatient care. For assistance ...
The post 5 Ways You Can Help a Friend in Inpatient Care appeared first on Addictions.
5 Things to Say to an Addict to Help Them Realize They Need Treatment - April 23, 2016
There are no magic words to help someone suddenly realize they have lost control over their drug abuse and need treatment. However, there are things you can say to an addict to better help them see your point… and to more strongly make it. Call today to find treatment centers that can help your loved ...
The post 5 Things to Say to an Addict to Help Them Realize They Need Treatment appeared first on Addictions.
Achieving Sobriety with Support, Strength, Self-Forgiveness - April 22, 2016
No tools are more important for sobriety than support, strength, and self-forgiveness. Without these three together, the addict would not be able to achieve their goals of becoming clean and no one will work on its own. There are a few ways to achieve sobriety with support, strength, and self-forgiveness. Support for Sobriety Recovery support ...
The post Achieving Sobriety with Support, Strength, Self-Forgiveness appeared first on Addictions.
8 Ways to Tell if You are Living with a Drug Addict - April 21, 2016
If you haven’t been exposed to addiction, you might not notice when one is living with you. Fortunately, there are clear signs that someone you are with or are close to is using or abusing drugs. According to the Department of Health and Human Services, there are several signs that you can watch out for. ...
The post 8 Ways to Tell if You are Living with a Drug Addict appeared first on Addictions.

CEU Continuing Education for
Social Work CEUs, Psychology CEUs, Counselor CEUs, MFT CEUs

 


OnlineCEUcredit.com Login


Forget your Password Reset it!