Self-Efficacy in Chronic Illness
Belief in one's capability during chronic illness.
Posted May 15, 2026 | Reviewed by Monica Vilhauer Ph.D.
Psychologist Albert Bandura developed his self-efficacy theory in the late 1970s. Bandura defined self-efficacy as “a person’s beliefs about how capable he or she is in performing the behaviors needed to bring about a desired outcome (Bonsaksen, Lerdal, & Fagermoen, 2012)." In the context of chronic illness , self-efficacy matters.
First, the stress of illness is likely to negatively affect a person’s self-efficacy (Bonsaksen, Lerdal, & Fagermoen, 2012). Illness can dramatically change a person’s capabilities, such that she loses capacities she had as a healthy person. Further, the uncertainties of chronic illness — particularly the ebb and flow of symptoms and energy levels — can impede a person’s belief in her own competence. This drop in self-efficacy can lead to hopelessness and helplessness (Heslin & Klehe, 2006). We know that improving self-efficacy in chronically ill people leads to better clinical outcomes and improved quality of life (Achury-Saldana, De-Villalobos, & Fuentes-Ramirez, 2025).
Self-Efficacy Inventory
Self-efficacy varies across tasks or domains. That is, an individual can feel a strong sense of self-efficacy with respect to some tasks and little to no self-efficacy with respect to others. For example, I have a strong sense of self-efficacy when it comes to driving an automobile and a weak sense of self-efficacy regarding driving a spaceship. Take a few minutes to make your own self-efficacy list. What are the tasks that you are confident you can perform well? There are likely a myriad of situations in which you have high self-efficacy.
Think about how you developed high self-efficacy in these areas of competence. It’s likely that (1) somebody taught you how to do the task (provided information ); (2) you had a lot of opportunities to practice the task and improve performance; and (3) you had experiences with helpers and role models to reinforce and enhance skills.
Self-Efficacy in Chronic Illness
What does self-efficacy mean in terms of living with chronic illness? Researchers have typically examined this question by looking at disease management (Aujoulat et al, 2008). That is, they look at how people living with illness rate their competence at following medical advice. The self-efficacy question in this context is: “Do I believe in my ability to take medications as directed, to make lifestyle choices ( diet , sleep, exercise, stress reduction) that enhance my health, and to monitor symptoms and seek care when needed?” If you are saying, “Yes! I am confident in my ability to manage these tasks" — Congratulations! If you’re saying, “This feels like an insurmountable burden to me and I don’t know where to start,” read on.
Building Self-Efficacy
Let’s pick one aspect of disease management and go through the self-efficacy checklist: taking medications as directed. Do you have the information you need? That is, have you been taught what your medications do, why it’s important to take them, and how dosing works? Have you had opportunities to practice ? Learning to give a self-injection, for example, requires repetition to develop competence. Finally, are you using helpers or role models to reinforce competence? A helper can be an inanimate object like a phone alarm set to remind you to take medication . It can also be a friend or family member you enlist to give you support and encouragement.
If you have all of these pieces in place and are still struggling to do the tasks that protect your health, it’s important to look at another piece of self-efficacy: the belief that you can manage challenging emotions like grief and anger . When we are baffled by our seeming inability to follow through with behaviors that support our well-being, we have to ask, “Is there something deeper going on?”
Self-efficacy in chronic illness is about more than mastering the tasks of disease management. It’s also about “coming to terms with one’s threatened security and identity (Aujoulat et al., 2008).” Sometimes we have all of the pieces in place regarding managing our health and still do not feel confident in our ability to complete the necessary tasks. This is a sign that we are struggling emotionally with chronic illness. Perhaps we feel hopeless about our condition, and/or angry at everything illness has taken from us. Perhaps we feel lost about who we have become and helpless in this new identity. Our task then is to lean in to this struggle. The self-efficacy question becomes: “How confident do I feel in my ability to acknowledge and cope with painful feelings about my illness?”
As you’re thinking through this self-efficacy question, run through the checklist. Do you have information about your emotions? Can you name them, understand them, and identify when and how they tend to arise? Have you had opportunities to practice managing these feelings? Many of us have never been taught how to do this. Therapy is an excellent opportunity to learn and practice working with emotions. Finally, are you using helpers and role models to enhance your competence? Talking to friends and family members, journaling, and other self-care practices can boost your ability to handle the painful emotions that may be sabotaging your belief in yourself.
Chronic illness stressors can diminish our self-efficacy. Luckily, self-efficacy is a mindset that can be strengthened. Therapists are trained to help with this. Don’t hesitate to reach out for assistance.
Achury‐Saldaña, D., Duran De‐Villalobos, M. M., & Fuentes‐Ramirez, A. (2025). Self‐Efficacy in people with chronic disease: an evolutionary concept analysis. Nursing Open , 12 (7), e70276.
Aujoulat, Isabelle, et al. "Reconsidering patient empowerment in chronic illness: a critique of models of self-efficacy and bodily control." Social science & medicine 66.5 (2008): 1228-1239.
Bonsaksen, T., Lerdal, A., & Fagermoen, M. S. (2012). Factors associated with self‐efficacy in persons with chronic illness. scandinavian Journal of psychology , 53 (4), 333-339.
Heslin, P. A., & Klehe, U. C. (2006). Self-efficacy. Encyclopedia Of Industrial/Organizational Psychology, SG Rogelberg, ed , 2 , 705-708.
Share this post Facebook Bluesky Linkedin Email
There was a problem adding your email address. Please try again.
By submitting your information you agree to the Psychology Today Terms & Conditions and Privacy Policy
Katie Willard Virant, MSW, JD, LCSW , is a psychotherapist practicing in St. Louis.
Get the help you need from a therapist near you–a FREE service from Psychology Today.
This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.