Self-Efficacy as a Potential Mechanism of Behavior Change in Mindfulness-Based Relapse Prevention

Self-efficacy, the belief in one’s ability to moderate or abstain from heavy drinking and drug use, predicts outcomes following substance use disorder (SUD) treatment. The current study examined whether self-efficacy was associated with treatment outcomes in a trial of mindfulness-based relapse prevention (MBRP), cognitive-behavioral relapse prevention (RP), and treatment as usual (TAU). We hypothesized self-efficacy would mediate the effects of treatment on substance use outcomes.

Greater self-efficacy at post-treatment and increases in self-efficacy over time predicted a significantly higher probability of no drug use and no heavy drinking at 12-month follow-up. Greater self-efficacy at post-treatment was also associated with significantly fewer days of heavy drinking among those who drank, and mediated the association between treatment condition and probability of no drug use and fewer heavy drinking days at 12-month follow-up. Those who received MBRP had the highest self-efficacy at post-treatment, which was associated with greater probability of no drug use and fewer heavy drinking days.

Self-efficacy is an important treatment target for individuals with SUD. These results highlight the potential utility of MBRP in improving self-efficacy and suggest self-efficacy may be one mechanism by which MBRP is effective.

https://ClinicalTrials.gov; registration number: NCT01159535.