Self-efficacy is a psychology term used to describe one's own confidence. It's understood that someone who has high self-efficacy is someone who is determined to achieve their goals and is confident in their actions. When a challenge or obstacle gets in their way, they accept the challenge and make it their mission to conquer it.

Having such a mentality proves useful in terms of seeking mental health treatment, suggests a new study from BMC Psychiatry. Led by Janine Clark, a research officer at the Black Dog Institute, the study examined how patients develop while using self-help intervention programs on mobile devices for their depression, anxiety, and stress. Contrary to having a healthcare professional guide you through treatment, patients create and run treatment plans using their own resources. Clark found that having a confident attitude and actively managing your own treatment plan led to lower symptoms of depression, anxiety, and stress.

Measuring Mental Health Self-Efficacy and Defining its Importance

Clark's experiment consisted of two smaller studies: the first developed a measure for mental health self-efficacy, and the second examined the effects of mental health self-efficacy on symptoms and outcomes of online intervention resources.

To develop a mental health self-efficacy assessment, Clark recruited 49 people who had self-diagnosed themselves with mild-to-moderate symptoms of depression, anxiety, and stress. Clark wanted to measure how confident these subjects were in their self-help strategies and self-initiated treatment plans. Participants completed the following measures before and after the treatment period:

  • Mental Health Self-Efficacy Scale (MHSES): Determines one's capability to perform constructive behaviors related to mental health self-care. Clark, along with the other authors of this study, created all the content in the MHSES. Higher on the MHSES indicated greater self-efficacy.
  • Depression, Anxiety, and Stress Scales (DASS): A self-report measuring depression, anxiety, and stress.
  • Work and Social Adjustment Scale (WSAS): Assesses how severely mental health problems interfere with daily life.
  • Ten-Item Personality Inventory (TIPI): Assesses personality by measuring openness to experience, conscientiousness, extroversion, agreeableness, and neuroticism.

For the course of six weeks, these participants used the myCompass CBT application, an online intervention tool for common mental health problems. Clark then measured any changes in behavior and condition.

The second study involved 721 people. These participants were then divided into a three groups to evaluate the efficacy of myCompass: one group used myCompass for seven weeks, one group used an online attention control program for seven weeks, and one group served as a control and did not perform any treatment. The online attention control program is similar to myCompass in its accessibility—as long as the user can access a connected device, the user can seek relief from the program. Attention control programs are designed to relieve stress by distracting users from the triggering situation at hand. All participants were assessed before and after the seven-week period using the same tools in the first study.

Confidence and Encouragement Goes a Long Way

The MHSES was compared to the DASS, WSAS, and TIPI to determine if the assessment tool Clark had created showed any significant relationships to these established and trusted tools. Clark found that the high MHSES scores indicated low scores of depression and daily life interference. The MHSES shared a positive relationship with the TIPI—higher MHSES scores signified stronger emotional stability. Clark concludes that the MHSES is a “psychometrically sound and easily administered measure" of mental health self-efficacy.

Now that Clark had established an effective measure for mental health self-efficacy, Clark proceeded to examine the role self-efficacy plays in treatment. At the end of the seven weeks, the participants who used myCompass showed greater improvement in mental health self-efficacy than the attention control and control group. And by using the MHSES as a measure, Clark found that “improvements in anxiety and stress symptoms at post-intervention were accounted for by increased mental health self-efficacy."

Having greater self-efficacy is an academic way of saying that you have more confidence in the actions you take. By having a “can-do" attitude and being an active agent in your treatment plans, you can significantly reduce your anxiety and stress. Clarks notes that mental health self-efficacy is an “important factor in overcoming mild-to-moderate mental health problems, as well as a worthy measurable target of program development and research investigating." With that in mind, developers making online self-help tools for anxiety now know to make tools educational, effective, and most importantly, encouraging.


Date of original publication: .

Updated on March 16, 2017 .


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Janine Clarke, Judith Proudfoot, Mary-Rose Birch, Alexis E Whitton, Gordon Parker, Vijaya Manicavasagar, Virginia Harrison, Helen Christensen, Dusan Hadzi-Pavlovic. Effects of mental health self-efficacy on outcomes of a mobile phone and web intervention for mild-to-moderate depression, anxiety and stress: secondary analysis of a randomised controlled trial. BMC Psychiatry, 26 September 2014; DOI: 10.1186/s12888-014-0272-1