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This article presents self-efficacy as an integrative theoretical framework to explain psychological changes achieved by different modes of treatment. The theory states that psychological procedures alter the level and strength of self-efficacy, which means an individual's conviction that s/he can successfully accomplish chan- ges in health behaviour. Self-efficacy forms the framework in a training programme for patients undergoing total hip replacement. Expectations of personal efficacy are derived from four sources of self-efficacy: performance attainments, vicarious experience, verbal persuasion and emotional arousal. The four sources are described, subsequent to which their use in the training programme are illustrated.

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