Attributions of change and self-efficacy in a randomized controlled trial of medication and psychotherapy for problem drinking.

The current study examines participants' attributions of change in a double-blind, randomized controlled trial of problem drinkers wanting to moderate their alcohol consumption. Participants were assigned to 12 weeks of naltrexone or placebo, which was paired with either combined motivational interviewing and cognitive behavioral therapy (MBSCT) along with an enhanced medication management intervention or enhanced medication management only. Upon treatment completion, a questionnaire assessed participants' attributions of change along with their self-efficacy in their ability to maintain treatment gains. Participants differed in strength of attributions of change and self-efficacy according to both their therapy condition and their hypothesized medication condition. Specifically, those in the MBSCT condition who hypothesized that they received placebo displayed greater confidence in continuing changes without medication compared with the other groups. How treatment condition and attributions of change relate to self-efficacy for long-term maintenance of treatment gains are discussed.