Objective: To understand better the relationship between substance-use disorder treatment and abstinence self-efficacy, more information is needed about what factors predict greater abstinence self-efficacy.

Method: Participants (n = 2,350) from 88 community residential facilities were assessed at treatment entry and 1-year follow-up. Treatment providers reported on patients' engagement in specific components of treatment. After examining univariate associations with self-efficacy, a multiple regression analysis was used to test a model of patient- and treatment-related predictors of self-efficacy 1 year after treatment.

Results: More years of education, lower baseline substance- related problems, and higher baseline confidence in abstinence were associated with higher posttreatment self-efficacy. After controlling for these patient factors, patients who were more engaged in skills-training activities and who inspired providers' confidence in their ability to remain abstinent had higher 1-year self-efficacy.

Conclusions: The development of higher levels of posttreatment abstinence self-efficacy is driven not only by what a patient brings to treatment but by the activities a patient engages in during treatment. Because of the close relationship between self-efficacy and treatment outcomes, providers may want to target patients with low self- efficacy for interventions that focus on skills-training techniques.