What is Social Cognitive Theory (SCT) in Health and Social Care?

Social Cognitive Theory (SCT) is a psychological model developed by Albert Bandura. It explains how people learn behaviours, develop skills, and maintain certain actions through a combination of social influence, personal motivation, and past experiences. It is used widely within health and social care to understand the reasons behind people’s health choices and behaviours, and to create interventions that support healthier lifestyles.

Rather than viewing learning as a simple cause-and-effect process, SCT looks at how behaviour, personal factors, and the environment work together. This relationship is known as reciprocal determinism. It means that these three elements influence each other continually over time. Individuals do not passively receive information; they actively interpret, model, and adapt their actions based on what they experience and observe.

In health and social care contexts, SCT can explain how individuals develop habits related to diet, exercise, medication use, and social interaction. It can also guide practitioners on how to help clients change harmful behaviours by influencing their thoughts, attitudes, and surroundings.

Principles of Social Cognitive Theory

SCT is built around several core ideas that work together to explain human behaviour:

• Observational learning: People can learn new behaviours by watching others, even without direct experience. In health settings, this can mean learning by seeing peers manage their conditions well.
• Self-efficacy: The belief in one’s ability to successfully carry out a particular behaviour. Someone with high self-efficacy regarding exercise is more likely to commit to a fitness regime.
• Outcome expectations: Beliefs about the possible results of a behaviour, often influencing whether a person chooses to act. If a patient believes quitting smoking will improve breathing and energy, they may be more committed to doing so.
• Reciprocal determinism: The continual interaction between personal factors, behaviour, and environment. Changes in one can influence changes in another.
• Behavioural capability: A person needs both the knowledge and skills to perform a behaviour. Knowing what to do and how to do it are both necessary steps.

These elements help explain why people sometimes maintain healthy behaviours and at other times struggle, even when they have access to the same information or resources.

Observational Learning in Practice

Observational learning is a key reason SCT is valuable in health and social care. It means that people do not need to experience every situation directly to learn from it. Watching others perform a skill or adopt a habit can influence motivation and confidence.

For example, a person recovering from a stroke might watch others in a rehabilitation setting perform certain exercises. By seeing positive results and understanding the process, they may feel more motivated to attempt those exercises themselves. Staff might use video demonstrations, peer support groups, or patient mentors to make observational learning easier.

In community health programmes, showing examples of healthy cooking techniques can encourage better eating habits. The behaviour is not imposed, but modelled in an appealing, relatable way.

Self-Efficacy and Behaviour Change

Self-efficacy determines how persistent an individual will be in trying to change their behaviour. It refers to their level of confidence in their own ability to carry out the tasks needed. The stronger the belief that success is possible, the more likely someone is to try and keep trying, even when they face challenges.

In health and social care, building self-efficacy can involve:

• Setting small, achievable goals so that progress feels possible.
• Providing encouragement, support, and feedback.
• Sharing success stories from people with similar experiences.
• Giving practical training and resources to make tasks easier.

For example, if a person has diabetes, they may feel uneasy about cooking meals that control carbohydrate intake. Offering cooking sessions and explaining recipes step-by-step can build their belief in their ability to manage their diet.

Without self-efficacy, even the most well-designed intervention may fail, as the person may not believe that they can carry it out successfully.

Outcome Expectations

Outcome expectations influence whether someone attempts a behaviour. These expectations can be positive or negative. Positive expectations make it more likely a person will take action; negative expectations often discourage action.

Health workers can support clients by making positive outcomes clear, realistic, and personally relevant. This might involve:

• Explaining health benefits in ways that connect with the person’s values and lifestyle.
• Showing real-life examples of benefits, such as improved energy levels after exercise.
• Being honest about challenges but focusing on manageable solutions.

If a patient believes that attending physiotherapy will help restore movement and independence, they are more likely to attend regularly. If they think it will not make much difference, they may avoid sessions and miss opportunities for improvement.

Reciprocal Determinism in Everyday Care

Reciprocal determinism means changes in one area of the behaviour–personal–environment triangle can produce changes in the other areas. This can be a powerful tool in health and social care.

For instance:

• Environment influencing behaviour: A supportive community exercise group may make people more likely to commit to regular activity.
• Behaviour influencing environment: A person who begins cooking healthy meals may encourage family members to eat better.
• Personal factors influencing behaviour and environment: Higher confidence in cooking skills may lead someone to share recipes, further shaping the environment by spreading knowledge.

Staff can work within this model by improving environments so that healthy choices become easier, while also developing skills and confidence through training or counselling.

Behavioural Capability

Behavioural capability means possessing the right knowledge and skills. People may want to act but lack the information or know-how. This gap often explains why motivation alone does not result in behaviour change.

In health and social care, practitioners can work to improve capability through:

• Education programmes about disease management.
• Training sessions on mobility exercises.
• Clear instructions for using medical equipment.
• Practical demonstrations of healthy habits.

For example, patients using inhalers for asthma may need step-by-step training to ensure the medicine reaches their lungs effectively. Knowledge here is as important as motivation.

Applying SCT to Health Interventions

SCT provides a clear anchor for designing behaviour change programmes. By including observational models, building self-efficacy, and focusing on environmental influences, interventions can be more engaging and effective.

A smoking cessation programme might include:

• Peer support groups where people share experiences.
• Video instructions on techniques to manage cravings.
• Positive stories from former smokers.
• Information about immediate health improvements.

In weight management, SCT can help design meal plans, activity programmes, and community support networks that make healthy behaviour easier to learn and sustain.

Measuring Progress

To measure the success of SCT-based interventions, practitioners can assess:

• Changes in self-efficacy over time.
• Observed behaviour changes.
• Reported outcome expectations.
• Skill acquisition and practical abilities.
• Environmental changes that support the behaviour.

By tracking these factors, practitioners can adjust support strategies to fit the client’s needs better.

Advantages of Using SCT in Health and Social Care

The theory has several strengths that make it useful for designing and delivering care:

• It accounts for the role of social influence and personal beliefs.
• It blends psychological and environmental models.
• It values active participation rather than passive learning.
• It offers practical tools for building skills and confidence.

SCT moves beyond simply telling people what they should do, instead offering strategies for helping them believe they can do it and showing them how to succeed.

Final Thoughts

Social Cognitive Theory explains behaviour change through a continuous interaction between personal factors, environmental influences, and behaviour itself. In health and social care, this can translate into workable interventions that do not rely solely on information but involve skill-building, encouragement, and visible role models.

When applied effectively, SCT helps create settings where healthier choices feel achievable and relevant, and supports individuals to keep making those choices over time.