Paper long abstract:

Concepts and models originating within social cognitive theory play a significant role in psychology and beyond. Especially Bandura's concept of perceived self-efficacy has been influential and is widely used as theoretical underpinning in different kinds of behaviour management programs and activities not the least within health promotion and disease prevention. I start out investigating the appeal of perceived self-efficacy for patient empowerment programs. I show how the interactive aspects of behaviour, cognition and environment in Bandura's social cognitive theory fade to the background with the concept of perceived self-efficacy. I also note that self-efficacy works by 'desocializing' individuals from their social contexts, by 'deinstitutionalizing' through lack of attention to interactions between agents and institutions, and by 'dehistoricizing' the question of social agency and control. I then turn to ethnographic explorations of situations of disease self-management and how Bandura's notion of perceived self-efficacy is applied in patient empowerment programs. I show how this directs attention towards particular manageable aspects of life with a chronic condition and seeks to instantiate standardised trajectories of change; and not the least how this involves frictions between these aspirations and practiced situations of disease self-management. I end by discussing how these STS inspired insights may be thought of and generate reflection within psychology and social cognitive theory particularly.