There is a strong link between our capacity to cope with negative emotional states and their associated negative thoughts and substance use relapse. When individuals use substances as a coping mechanism this strategy may be effective in the short term and but proves maladaptive in the long run. The use of drugs provides both negative reinforcement (namely, the reduction of painful feelings via self-medication), and positive reinforcement (that is, the pleasant experience of being high via positive outcome expectancies). The self-medication hypothesis applies when the individual is using a substance to cope with negative emotions, conflict, or stress (negative reinforcement). From a positive outcome expectancy perspective, the person is focusing on the positive aspects and euphoria of using a substance (positive reinforcement), while ignoring the negative consequences. Therefore, an essential component of recovery is learning healthy ways to self-soothe and cope with stress and painful emotions, and the negative thoughts and rumination associated with them. Without healthy coping skills, a key component of recovery capital, individuals in recovery will continue to seek dysfunctional ways to self-regulate. In this chapter the reader is introduced to one of the causes behind negative rumination and over-compensatory behaviour that accompanies it, which perpetuates the cycle of addiction.

This chapter outlines the utility of the health action process approach (HAPA), a hybrid social cognition model that aims to describe, explain, and modify health behaviors. The HAPA combines features of stage and continuum social cognition models. The model makes the distinction between motivational and volitional phases involved in the change process. In the motivational phase, outcome expectancies, action self-efficacy, and risk perceptions are constructs that make formation of intentions more likely. In the volitional phase, coping self-efficacy and action and coping planning are important determinants of behavior, with behavioral maintenance determined by recovery self-efficacy and action control. Behavioral intention bridges the motivational and volitional phases, while planning serves to link intentions with behavior. HAPA-based interventions target change in the appropriate components from each phase most likely to move the individual further toward goal attainment. For individuals who are not motivated to change, interventions targeting change in outcome expectancies, action self-efficacy, and, for some behaviors and in some contexts, risk perceptions promote intention formation. For individuals who already hold intentions to change, interventions focusing on changing coping self-efficacy, planning, and action control are most appropriate. Empirical evidence supports the usefulness of the phase-specific approach to changing behavior proposed in the HAPA.

Social cognitive theory focuses on the reciprocal interaction of the person, environment, and behavior and provides a description of the ways in which individuals initiate and maintain behaviors, taking into consideration their social environment. The main operative constructs in the theory are outcome expectancies and self-efficacy. Outcome expectancies pertain to the anticipated consequences of one’s actions. Self-efficacy reflects a subjective estimate of the amount of personal control an individual expects to have in any given situation. The theory has been applied as a basis for changing behavior in a wide variety of disciplines and settings, including sport, education, career and occupational development, and mental and physical health settings. Interventions have targeted change in self-efficacy, outcome expectancies, or both, assuming that an improvement in these beliefs translates to changes in behavioral outcomes. A considerable body of evidence supporting theory predictions has accumulated. Research has underscored the beneficial effects of such interventions on target behaviors and outcomes such as academic achievement, career promotion, job search, smoking cessation, participation in physical exercise, and eating a healthy diet across a broad array of populations and settings. The theory has been influential in the development of other theories that have adopted parts of it, in particular, the self-efficacy construct.