





































5

Graduate Student Journal of Psychology
2023 Vol. 21

Copyright 2023 by the Department of Counseling and Clinical Psychology
Teachers College, Columbia University

Neuroplasticity Knowledge and Perceived Self-Efficacy 
in Western Adults: A Qualitative Examination 

Self-efficacy is described as people's beliefs regarding their capabilities to produce designated levels of performance that 
affect their lives and is considered important for self-regulation of mental health disorders. Biofeedback has demon-
strated that knowledge of one’s physiology can help regulate mental health disorders, such as anxiety (McKe, 2008). 
Neuroplasticity is defined as the capacity for the brain to rewire its structure and create new neural pathways to make 
up for lost functions due to brain injury. There is limited research in how neuroplasticity can be used as an agent 
for behavioral change. This qualitative study examined if knowledge of the brain’s malleability may affect adults’ 
perception of self-efficacy in recovery from evolutionary-based mental health disorders, with an aim to lay a foun-
dation of general themes for further quantitative studies. Following 12 interviews, themes were recorded regarding 
perceived self-efficacy at time points during mental health recovery from an adult group who was knowledgeable 
about neuroplasticity versus a group which wasn’t knowledgeable. In addition to other differences, the Superordinate 
theme of will was mentioned 64 times across the Knowledgeable group, versus only 11 times in the Non-knowl-
edgeable group. As variations between the groups were perceived, future quantitative research may determine if ed-
ucational programs can assist adults who are turning to self-regulation as a means for recovery from said afflictions.

 Keywords: neuroplasticity, neural plasticity, self-efficacy, biofeedback, CBT

 In the modern day, evolutionary traits can ei-
ther positively or negatively intersect with cognition, 
which may lead to ailments such as addiction, anxiety, 
or depression. These evolutionary attributes (which 
once served us when human survival meant encoun-
tering a greater number of potential physical dangers), 
can contribute to displacement of thoughts, or atten-
tion, generating obstructive ideas or sensations when 
no physical threat exists (Rossman, 2010). In con-
temporary times, without the same level of external 
threats for these responses to usefully react to, humans 
are faced with the task of regulating their thoughts.
 While addiction, anxiety, and depression may arise 
due to several factors (Ducci, 2012), this study focuses 
on the perception of one’s ability to self-regulate ad-
diction, anxiety, or depression (while operating under 
the assumption these afflictions have arisen as result of 
mismanagement of evolutionary traits). The study ex-
plores how awareness of the brain’s biological plasticity 
may assist in the perception of one’s ability to manage 
their cognition to improve their day-to-day experience. 
The supposition asks if adults with knowledge of neu-
roplasticity may generate a higher perception of self-ef-
ficacy through understanding that the brain is a mal-
leable organ, and how their perception of self-efficacy 
may vary from those without knowledge on this topic.
Background
 For the past century, scientific evidence has 
supported the ability for individuals to change pat-
terns in their cognition, and their behavior despite 
the traits we may have inherited through evolution. 

Some successful models of management include:
• Metacognition: A term used for “hyper 

awareness” over one's thoughts which can be 
used as a learning tool when it comes to com-
pleting a task (Flavell, 1979).

• Cognitive behavioral therapy (CBT): 
Originally developed by Aaron Beck to uti-
lize thoughts, feelings, and behaviors in con-
junction with one another for self-regulation 
(Beck et al., 1979). 

• Biofeedback: A method that has been de-
signed to monitor mental health issues, such 
as anxiety through observation of physiolog-
ical metrics (McKee, 2008).

 Neuroplasticity refers to the brain’s ability to re-
wire its neural pathways when injury occurs, or its abil-
ity to generate a novel syntax following the completion 
of an action. Studies in neuroplasticity have demon-
strated that structural changes  in the brain is biologi-
cally possible, even in adulthood. Brain malleability has 
been utilized in recovery from loss of functions due to 
brain injury or damage (Doidge, 2007). However, neu-
roplasticity has yet to be explored as a tool to assist in 
behavioral change as related to mental health concerns. 
Bandura, who coined the term “self-efficacy” (a term 
used in psychology today), described the term as “peo-
ple's beliefs about their capabilities to produce desig-
nated levels of performance that exercise influence over 
events that affect their lives.” (Bandura, 1994, p. 71).
 Due to the perceived success of recovery and/
or management of addiction, anxiety, or depression 

Catherine Agonis
School of Psychology, BPP University 



6

AGONIS

through CBT, biofeedback, and metacognition, this 
study examines if adults with knowledge of their bi-
ological makeup may have a stronger perception in 
their ability to self-regulate their recovery from the 
above-mentioned (possibly evolutionarily induced) 
mental health afflictions. This study will review how 
the above mentioned methods (CBT, biofeedback, 
metacognition) have aided behavioral re-program-
ming to support this supposition. This study also 
asks if it may be worthwhile to further research if 
those who are aware of the brain’s biological abili-
ty to change in adulthood, may utilize this knowl-
edge to cognitively enhance their sense of self-effi-
cacy when it comes to recovery from said afflictions.
The Mind & Evolution
 In a lecture at University of California, psychol-
ogist Martin Rossman (2010, 3:55) was quoted say-
ing that humans have been born with faculties in our 
brains, that as far as we know, don’t belong to any 
other creature on earth, allowing us to evolve from 
a vulnerable prey animal to the dominant creature 
on earth. As human evolution, spanning millions of 
years, has carried changes to our environment, it has 
brought subsequent biological progression with it. 
Dr. Beth Kurland (2018) explores how evolution of 
our species has included certain advantages that were 
once incredibly useful, but do not serve much pur-
pose in a modern setting. These attributes still affect 
the way our thoughts, and even behavior functions 
today (Kurland, 2018). In a contemporary setting, 
each of these evolutionary traits can contribute to 
the afflictions of addiction, anxiety, or depression. 
 Studies have demonstrated that certain substances 
can cause people to over-evaluate their rewards by dis-
rupting our working memory while creating temporal 
myopia (Schultz, 2011). This tendency stems from 
what Kurland (2018) calls “the finger trap dilemma,” 
referring to a desire for humans to avoid unpleasantries 
(such as a snake). This desire which used to assist us 
while living in the wild, may enable us to proactively 
search for escape from discomfort through indulgence 
in things such as addictive substances (Kurland, 2018). 
Rolls and Cowey (1970) captured data from both cap-
tive and semi-free-ranging rhesus monkeys, and they 
found that monkeys displaying impulsive and aggres-
sive behavior (traits which are seen to have been bene-
ficial for our evolution), were also pre-disposed to ad-
diction. It has also been argued that because substance 

abuse is linked to human’s evolutionary traits (such as 
the reward system), it should be treated as a human 
tendency which requires management, as opposed to 
a disease which needs medical treatment (Saah, 2005).
 When it comes to anxiety, Brosschot et al. (2016) 
detailed how an inherited stress response in humans 
that is always running in the background,  is ignited 
when a threat occurs. This stress response allowed us 
to stay alert when we had fewer protections and great-
er threats (Rossman, 2010). To assist individuals with 
management of anxiety by providing metrics on what 
healthy levels of anxiety may look like, a signal detection 
framework was published in by Bateson et al. (2011).
 A correlation (though not a causation), between 
symptoms of loneliness and symptoms of low mood 
has also been perceived, while detailing the evolu-
tionary theory of loneliness (Cacioppo et al., 2006). 
Research across several studies has been gathered to 
demonstrate how depression can help with problem 
solving as an adaptive feature (Andrews & Thom-
son, 2009) as depressed moods help us to target and 
avoid exclusion from social groups, which is a dan-
ger when it comes to survival, particularly in the wild 
(Badcock et al., 2017). Given the remnants of these 
traits, it may be natural for adults to experience the 
sensations of addiction, anxiety, or depression in our 
ever-changing environment, requiring on-going man-
agement through models which are accessible to them. 
Evolutionarily-Based Mental Health Disorders 
and Access to Healthcare Today
 In recent decades, addiction, anxiety, and depres-
sion have been on the rise in the West (North Amer-
ica and Europe). According to a study conducted by 
Hidaka (2012), a quantitative measure of moderniza-
tion and lifetime risk of a mood disorder trended to-
ward significance (p = .060) which may be attributed 
to a country’s GDP per capita, the growing number 
of long-term illnesses as a result of changing envi-
ronments, and increased levels of loneliness. It has 
been reported that up to 33.7% of the population 
in the modern day is affected by an anxiety disorder 
during their lifetime (Bandelow & Michaelis, 2015). 
It has also been recorded that there has been a surge 
in overdose deaths in the West related to addiction 
to opioids (Garg et al., 2019). Other studies have 
discussed the increase in difficulty to afford access to 
mental health care in the West due to inflation, a rise 
in demand for therapy leading to burnout from ther-



7

NEUROPLASTICITY KNOWLEDGE AND PERCEIVED SELF-EFFICACY .

apists, and a lack of therapists in rural areas (Chan, 
2022). With these trends, it’s important for science 
to examine additional ways that adults can self-regu-
late experienced mental health symptoms, as access 
to clinical assistance isn’t consistently available for all.
 Digitizing mental health care in the modern day 
became more prevalent and accepted following the 
COVID-19 epidemic, which caused people world-
wide to stay at home. A study examining digitalized 
mental health care cited Talkspace, an online therapy 
application which reported a 65% increase in clients 
following the epidemic (Gratzer et al., 2020). Fur-
thermore, researchers have examined the increase in 
the use of social media as a tool to self-regulate men-
tal health (Ozimek & Förster, 2021). An example is 
the Instagram channel @headspace, with over one 
million followers worldwide, which creates posts re-
garding the benefits of meditation, self-care, and more 
to help people at home with navigating their mental 
health experiences (Headspace, 2023). Continuing 
to digitize education surrounding psychology as a 
self-regulation tool may assist those who are suffer-
ing from the above-mentioned afflictions, with insuf-
ficient access to assistance in a clinical environment.
Neuroplasticity and the Brain’s Ability to 
Change
 In The Brain That Changes Itself, Dr. Doidge 
(2007) details how our neural pathways can be al-
tered. If a neural pathway becomes damaged or 
blocked from an injury, the brain automatically 
searches for new connections for certain tasks or uti-
lizes other paths to send signals. He also provides an 
example of people who become blind and are then 
able to enhance other sensations to complete a task. 
This is known as re-organization (Doidge, 2007).
 Doidge’s (2007) book details how the brain is 
the only organ that is capable of giving the owner 
a qualitative, subjective sensation and inner aware-
ness. The sensation one has while eating gelato from 
Grom in the Latin Quarter of Paris will likely be dif-
ferent from the sensation one feels while living iso-
lated with the flu in a London flat. Each conscious 
state has “a certain feel to it.” The awareness of 
our sensations will be important later in this study.
 Dr. Paul Bach-Y-Rita has done extensive work in 
the use of tongue sensors to treat balance disorders due 
to deteriorated vestibular functions. His findings show 
that re-calibrating the central nervous system through 

these sensors can improve patients’ balance (Bach-y-
Rita et al., 2005; Tyler et al., 2003). Dr. Pascual-Le-
one once said, “The system is not plastic, but elastic,” 
meaning the brain could be molded and formed, but 
was unable to completely “snap back,” to a previous it-
eration (Doidge, 2007, p. 209). Pascual-Leone’s quote 
was demonstrated in a study where teachers of blind 
students were submerged in complete darkness for a 
week. At the end of the week, the teachers could de-
cipher what kind of motorcycle was near to them by 
listening to the engines. When their blindfolds were 
lifted, they were completely disoriented. Pascual-Le-
one mapped their brains using transcranial magnetic 
stimulation. He then used the brain scans to perceive 
that the visual cortex had been used to process audito-
ry signals (Pascual-Leone & Hamilton, 2001).  
 Based on Roll’s experiment, Dr. Jeffrey M. Schw-
artz designed a study for his own patients with obses-
sive compulsive disorder (OCD). He introduced mind-
fulness into an OCD clinic and developed a four-step 
method, instructing patients to create real-time men-
tal notes to obstruct the experience they were having 
with mindful commentary when they get caught up in 
compulsive thoughts. His findings were the following:

Our PET scans had shown that the orbital 
frontal cortex, the caudate nucleus, and the 
thalamus operate in lockstep in undoubtedly 
the source of a persistent error-detection sig-
nal that makes the patient feel that something 
is dreadfully wrong. By actively changing be-
haviors, refusing changes which brain circuits 
become activated, and thus also changes the 
gating through the striatum. The striatum 
has two output pathways, as noted earlier, 
direct and indirect. The direct pathway tends 
to activate the inhibited cortical activity. Re-
focusing, I hoped, would change the balance 
of gating through the striatum so that the 
indirect, inhibitory pathway would become 
more traveled, and the direct, excitatory 
pathway would lose traffic. The result would 
be to damp the down activity of this OCD 
circuit (Schwartz & Begley, 2003, p. 85).

 Following the completion of these studies, we bet-
ter understand how the malleability of the brain may 
lead to recovery or improvement from certain neuro-
logical ailments and specific mental health afflictions, 
such as obsessive-compulsive disorder (OCD). It is 



8

AGONIS

worth exploring if it may potentially do the same for evo-
lutionarily induced mental health disorders which are 
currently regulated with use of biofeedback, metacog-
nition, or CBT. We will explore the current understand-
ing of these methods more in the following sections.
Biofeedback & Self-Regulation
 Biofeedback is a process which measures physi-
ological information that is displayed to patients so 
they can better attempt to control their symptoms. 
In the case of psychology, biofeedback is utilized 
for management of stress and anxiety, and requires 
patients who have a strong psychological aware-
ness of their own symptoms. Patients have record-
ed physiological changes they’ve experienced during 
times of stress (such as sweating), demonstrating 
it is possible for notions of mind-body interac-
tions to resonate with an individual (McKee, 2008).
 Accurate feedback of performance facilitates the 
learning of any skill, not just when it comes to con-
trolling physiological behaviors. It assists with ev-
erything from hitting a golf ball into the hole on the 
green to solving an algebra problem (we will observe 
this more in the section on metacognition). A person 
bowling with a blindfold on isn’t as likely to make a 
strike – not only because they cannot see what they're 
doing – but because the visual feedback of their per-
formance following an action informs their next at-
tempt. For instance, if they visually recorded that the 
way they tossed the bowling ball forced it to go too 
much to the left, and therefore into the gutter, they 
know to straighten up their grip in the next round. 
For biofeedback to work successfully with patients, 
the patient must have the capacity to respond, be mo-
tivated, receive positive reinforcement from learning, 
and be provided with accurate information regard-
ing the results of their learning. From biofeedback, 
we see the potential of observation when it comes 
to recovery from mental health issues, namely anx-
iety (McKee, 2008). In a study related to obesity re-
duction, Teufel et al. (2013) recorded an increase in 
self-efficacy following treatments of biofeedback in 
31 women, however, additional studies would need 
to be conducted to statistically support this theory. 
 As science has recorded the benefits of observ-
ing our biology as self-regulation tool for mental 
health disorders, the author asked whether a simi-
lar methodology could be applied when it comes to 
neuroplasticity, training adults on the malleability 

of the brain, and testing their perception of self-ef-
ficacy before and after. Before designing a research 
proposal on this hypothesis, it was supposed that 
conducting a preliminary study on any key differ-
ences in themes between adults who are knowledge-
able about neuroplasticity and those who aren’t 
would be prudent. Through this initial, qualitative 
study, science can first assess if variation in perceived 
self-efficacy exists between those with knowledge 
of brain malleability and those without knowledge.
Metacognition & CBT
 Metacognition is a term used for “hyper aware-
ness” over one's thoughts. This concept has been de-
veloped in various ways since Aristotle, however, it is 
often associated with John Flavell who suggested that 
an awareness of control regarding cognitive process-
ing of thoughts regarding learning was drawn from 
both metacognitive knowledge, followed by regula-
tion (Flavell, 1979). To properly evaluate and mon-
itor one’s own learning, metacognition not only in-
volves a patient thinking about what they’ve learned, 
but how they learned, in addition to examining their 
own learning process (Flavell, 1979). Flavell’s 1979 
work detailed metacognition into the various forms:
• Content knowledge (declarative knowledge): 

An understanding of capabilities, such as 
a singer knowing the strength of their vocal 
cords, or a salesperson knowing their memo-
rization skills.  

• Task knowledge (procedural knowledge): A 
perception of a tasks’ difficulty based on the 
type of assignment, the length and what it 
entails.

• Strategic knowledge (conditional knowl-
edge): The ability to strategize based on the 
available tools to learn. 

 Metacognition has recorded that using our cog-
nitive thoughts in learning can improve performance 
in an array of ways. It has been found that self-ques-
tioning as a strategy to monitor and regulate perceived 
performance was effective (Child et al., 1998). Studies 
have also recorded a significant positive relationship 
between the use of Metacognitive Reading Strate-
gies and mastery-approach goal orientation (Baker 
& Brown, 1984). The practices behind metacogni-
tion has led into CBT which is described by the Na-
tional Health Service (NHS, 2023) as the following:
• CBT is based on the concept that your 



9

NEUROPLASTICITY KNOWLEDGE AND PERCEIVED SELF-EFFICACY 

thoughts, feelings, physical sensations and 
actions are interconnected, and that negative 
thoughts and feelings can trap you in a nega-
tive cycle.

• CBT aims to help you deal with overwhel-
ming problems in a more positive way by 
breaking them down into smaller parts.

 You're shown how to change these negative pat-
terns to improve the way you feel. Unlike some oth-
er talking treatments, CBT deals with your current 
problems, rather than focusing on issues from your 
past. Evidence-based practice of CBT details that 
there are numerous empirical studies published re-
garding the success of this treatment for ailments 
such as addiction, anxiety, and depression, with lit-
erature on this topic from less than 2,000 studies, ar-
ticles or books published in 1995-1999, to 14,000 in 
between 2010-2014. The three principles are defined 
by Dobson and Dobson (2017) as the following:
1. Access hypothesis: This means that thoughts 

are accessible to us and aren’t unconscious. 
2. The mediation hypothesis: This means 

that our thoughts are responsible for how we 
experience or feel about situations which sur-
round us.

3. The change hypothesis: This means that 
by changing our thoughts we can change our 
behavioral or emotional response to certain 
stimuli or events. 

 Given the current research and understanding 
of CBT as a tool to regulate thoughts which then ef-
fect behaviors or emotions, this study questions if 
knowledge of the makeup of the brain itself may be 
used as a self-regulation tool within these methods.
Visualization, a Psychological Perspective
 “Worry gets a lot of bad press because we 
don’t use it very well.” (Rossman, 2010, 3:44)
 In his lecture, How Your Brain Can Turn Anx-
iety into Calmness, Dr. Rossman (2010) makes the 
case that imagination is the key mental faculty that 
separates humans from animals. Imagination allows 
humans to remember things from the past and project 
inventions or creative ideas into the future. It allows 
us to picture how reality may vary if we try things in 
different ways. Rossman argues that few of us have 
been taught the correct way to use our imagination. 
Empirical analysis designed by philosophers such as 
Aristotle have also contributed to the progression of 

society. For us to test a hypothesis and survey the re-
sults, we first must make observations, invent a scenar-
io, then bring that scenario to fruition. In other words, 
without science, ideas are just ideas. But still, the scien-
tific discoveries, prior to being tested, were ideas first
 To examine how the imagination may manifest 
itself into action, Dr. Pascual-Leone (1995) conduct-
ed an experiment with piano players which demon-
strated that visualizing playing the piano lit up the 
visual cortex in the same format as if one were actual-
ly playing it. In other words, when people close their 
eyes and imagine a simple object, such as the letter A, 
the primary visual cortex lights up, just as it would if 
the subjects were looking at the letter A. Imagining 
scenarios or outcomes also overlaps with the neural 
circuits required to complete the execution of an ac-
tion (Agnati et al., 2013). With this knowledge, it is 
implied that visualization as a function of the imagi-
nation can improve performance–with a drawback 
being humans oftentimes visualize or imagine negative 
events or scenarios, partially due to our evolutionary 
faculties. While this study is preliminary research re-
garding cognitive awareness as it pertains to neuro-
plasticity, it is worth asking if holding knowledge of 
the brain’s malleability may assist in the ability for 
one to imagine their brain changing physically, which 
will be further explored in the discussion section.
Criticisms and Gaps in Knowledge Regarding 
Neuroplasticity, Biofeedback, and Metacognition 
as Tools for Change
 While neuroplasticity has been examined through 
several studies, its usage has mainly been applied re-
garding recovery from loss of brain function, or to as-
sist with OCD. Research has supported that plasticity 
of the brain may be a key function into improving sen-
sations of depression (Wilkinson et al., 2019), mean-
while, other studies perceived how various gray matter 
in the brain is responsible for the ability to learn as 
we age (Fischer et al., 2022). However, when it comes 
to the ability to form new pathways or connections, 
there are also no current experiments or papers which 
examine how knowledge of this capability may affect 
the perceived self-efficacy of recovery from the men-
tal health issues of addiction, anxiety, and depression. 
 While biofeedback has been a successful tool when 
it comes to the monitoring of anxiety, it is costly and 
requires the patient to be in a certain place at a certain 
time, with specific facilities available. Biofeedback’s in-



10

AGONIS

ability to scale is a hindrance to its overall success as 
a tool for recovery from mental health disorders, par-
ticularly given the earlier research cited regarding the 
growing trend to self-regulate mental health disorders 
in the West due to a lack of access to such facilities. 
Metacognition is a helpful practice when it comes 
to learning, but there aren’t current searchable stud-
ies which function on its ability to change behavior.
 Finally, certain research has perceived brain 
activity during visualization in its participants as 
well as some physiological effects, though it did 
not allow us to explore how associating cogni-
tive thought with the power of imagination may 
relate to perceived self-efficacy in recovery from 
mental health afflictions (Chen et al., 2017).
Purpose of the Study
 As a recap, science is aware of the following:
• Certain mental health afflictions are induced 

by evolutionary traits, and are rising in prev-
alence today, with an increasingly difficult 
access to healthcare in the West, leading to a 
growing tendency for adults to self-regulate 
mental health disorders. 

• Cognitive awareness is an effective tool in the 
regulation from these evolutionarily based 
disorders through methods such as CBT.

• Observation of biology is also an effective tool 
in the regulation of evolutionarily based dis-
orders, mainly anxiety through the method of 
biofeedback.

• It is biologically possible for the brain to form 
new neural pathways.

 Science has yet to record if knowledge regarding 
the biological malleability of the brain may equip 
people with a higher sense of perceived self-efficacy 
when it comes to recovery, and/or management from 
these evolutionarily based-mental health disorders. 
The purpose of this study is to lay a foundation for 
the uses of neuroplasticity in conjunction with cogni-
tion and biological awareness and examine how these 
faculties may work with each other. This is an initial 
investigation into any potential associations between 
adults’ knowledge in neuroplasticity and their belief 
in the potential for recovery from mental health afflic-
tions. The three afflictions of addiction, anxiety, and 
depression were chosen as a focus as these disorders 
may be evolutionarily induced and therefore treatable 
through self-regulation. If these disorders are present 

in the modern day as a response to humans attempting 
to navigate a rapidly changing environment which our 
evolutionary fear responses cannot adequately adapt 
to, it is possible that utilizing cognitive awareness 
around the topic of neuroplasticity may be an agent 
of assistance. By examining the potential difference 
in themes between those who are knowledgeable re-
garding brain malleability and those who aren’t when 
it comes to perceived self-efficacy for recovery from 
addiction, anxiety, and depression, the psychologi-
cal community can determine if promoting knowl-
edge regarding neuroplasticity to the general popu-
lation can help with management of said disorders.
 Should the findings of the interviews demonstrate 
themes that knowledge of neuroplasticity may cor-
relate to one's perceived self-efficacy when it comes to 
recovery from these mental health disorders, there may 
be opportunity to explore how training people on the 
functions of the brain may help with their own self-reg-
ulation as a form of therapy. Scaling such training and 
education could potentially be more accessible and 
affordable than individual patients utilizing clinical 
assistance, such as CBT, or biofeedback sessions. The 
potential for knowledge sharing as a means of assist-
ing with recovery from these disorders should be fur-
ther explored after quantitative investigations, which 
would be dependent on the findings of this study.

Method
 A foundational, qualitative study based on com-
bining knowledge of neuroplasticity and cognitive 
awareness was created, aiming to perceive how these 
two components may correlate in adults with the men-
tal health disorders of addiction, anxiety, and depres-
sion. In this preliminary investigation, the researcher 
examined potential associations between knowledge of 
neuroplasticity and a positive outlook on recovery from 
mental health issues with an objective to document ini-
tial research. The study utilized ground theory (Strauss 
& Corbin, 1994), reasoning that allowing themes to 
arise from the data may detail potential findings that 
justified resources for more extensive quantitative 
studies. This was decided following a non-conclusive 
search for published studies regarding this supposition.
Research Design
 The research was carried out in 12 interviews 
total, across an adult population ages 25-71. Six par-
ticipants who held general knowledge of the subject 



11

NEUROPLASTICITY KNOWLEDGE AND PERCEIVED SELF-EFFICACY 

of neuroplasticity were placed in the Knowledgeable 
group, while six who attested they had no gener-
al knowledge of the subject of neuroplasticity were 
placed in the Non-knowledgeable group. The aim of 
dividing the results into two groups was to examine 
the variation of themes (whether Superordinate or 
Subordinate) which arose between those with knowl-
edge versus those without knowledge and to record 
any differences. Prior to the interviews, each of the par-
ticipants filled in a survey which asked two questions 
detailed below to place them in the correct group. 
The exact questions sent in the survey are detailed 
below with the full survey detailed in Appendix B.
Survey Questions:
1. Have you heard of the term neuroplasticity? 

(Yes/No)
2. Please rate your knowledge of neuroplasticity 

from 1-5, with 1 being little-to-no knowledge 
and 5 being an expert in the subject. (1,2,3,4,5)

 Participants who answered question one 
with “Yes,” and question two with any rating of 
“two” or above, were placed in the Knowledge-
able group. Once six participants for each group 
had been gathered, the interviews commenced.
Research Questions
 Participants in both groups were asked the ques-
tions detailed below in a one-to-one interview with 
the researcher which was recorded and then tran-
scribed. The questions chosen were the same across 
both groups as the aim was to see any general differ-
ences in the perception of one’s ability to change 
and possibly recover from addiction, depression, or 
anxiety and then assess the different themes. The re-
searcher did not ask about knowledge of brain mal-
leability during the interview, as the goal was not to 
provoke an association between knowledge and the 
themes of recovery that the participants may not have 
had. By asking both groups the same set of questions 
and analyzing the themes afterwards, differences in 
the groups which existed regarding the overall senti-
ment towards recovery and the possibility for change 
in adults were able to be recorded. The full interview 
schedule with instructions can be seen in Appendix C.
• Do you think that human beings can change 

habits once they become an adult?
• How much do you believe in the phrase, “You 

can’t teach an old dog new tricks?”
• Do you believe people with mental health dis-

orders such as addiction, depression or anxiety 
have a high potential to recover if they’re pro-
vided with the right resources?

• On a scale of 1-5 with 1 being the lowest ability 
and 5 being the highest ability, how do you rate 
your own ability to change habits or behaviors 
you find are no longer serving you?

• What techniques do you use to change what you 
view as unhelpful behaviors? 

• Is there anything else you’d like to add?
Research Setting
 All participants were interviewed remote-
ly using Microsoft Teams via an invitation 
sent out using the researcher’s BPP University 
sponsored email account c.agonis@my.bpp.com. 
Participants
 The inclusion criteria for participants required 
that they were over the age of 18 (therefore in the adult 
category) and weren’t part of a known vulnerable group 
within that category (such as those with a learning dis-
ability). The questions asked were focused around the 
participant’s views on the ability to recover from ad-
diction, anxiety, and depression, and didn’t examine 
active recovery from these afflictions. Therefore, there 
was no mental health criteria utilized in recruitment. 
Those who expressed verbally or in writing that they 
may be part of a vulnerable category were excluded, as 
this study was a preliminary investigation on the gen-
eral adult population to lay a foundation for further 
studies and wasn’t set to examine those of a particular 
vulnerable group. Participants were chosen from coun-
tries within North America and Europe, as the research 
conducted for the study pertained to Western trends 
and practices. Of the 12 participants sampled, the de-
mographics included two male-identifying adults and 
10 female-identifying adults, ages 31-71 residing in 
the UK, USA, and Switzerland. The full table of par-
ticipant characteristics can be viewed in Appendix A.
Procedure & Data Collection
 Each participant was recruited using the re-
searcher’s personal Instagram account (@chixonthe-
hud) and Facebook page (dallas_athent). The full 
advertisement text was pre-approved by BPP’s ethics 
community prior to posting, and is detailed below:
 Slide 1: As many of you know, I’m currently 
obtaining my MSc in Psychology at BPP University. 
For my dissertation, I’m running a study on self-effi-
cacy for recovery from mental health issues in adults.



12

 Slide 2: I will be interviewing participants re-
garding their perception on the potential to recover 
from mental health issues, and examine if that has 
any correlation with knowledge of neuroplasticity.
 Slide 3: If you’d like to help me by partaking in the 
study, please submit your email here and I will email you 
additional information. You do not need to have knowl-
edge about neuroplasticity. We need participants for 
both the study group and control group. Thank you all.
 Participants were accepted for the study regardless 
of if they knew the researcher personally. The only uti-
lized criteria is that listed above in the participants sec-
tion. Once interest was expressed via the Instagram and 
Facebook posts, participants were emailed a consent 
form via the researcher’s BPP University email address 
(c.agonis@my.bpp.com) which asked them if they 
consented to participate in the study and informed 
them they could withdraw any time without conse-
quence. The consent form provided the basic outline 
of the study and a breakdown of the kinds of ques-
tions that were to be asked. It detailed that the study 
was run as part of the researcher’s MSc in Psycholo-
gy and that the researcher was a student at BPP Uni-
versity. The full consent form and information sheet 
sent to the participants can be viewed in Appendix D.
  Upon receiving the participants’ signed consent 
forms, participants were then sent the survey detailed 
above in this document’s research design section us-
ing the Microsoft Forms account connected to the 
researcher’s BPP University email address. The survey 
notification informed the participants it was captur-
ing their email addresses for the purposes of adding 
them to the Non-knowledgeable group or Knowl-
edgeable group. Once the groups were formed, the 
participants were emailed virtual appointment op-
tions held on Microsoft Teams which were recorded 
and saved (audio only) in the researcher’s password 
protected BPP University SharePoint account, with 
no personal information included. Participants were 
advised prior to recording to turn off their camer-
as for additional privacy. No identifiable informa-
tion was shared in any interview recording including 
names. The recorded interviews were then transcribed 
using Sonix, and permanently deleted once tran-
scription had concluded. The participants were 
notified via email upon deletion of the recordings.
Interview Process
 To ensure consistency across the interviews, each 

participant was interviewed by the author of this pa-
per. Each participant was asked a set of pre-defined 
questions during the interviews, which can be seen 
in Appendix C. These questions were not altered 
across all 12 interviews, nor were they re-ordered. 
If the participant only gave a short answer, (such as  
only a few words), the interviewer would ask them 
what they thought of when they heard the word “re-
sources” following question three, in order to gener-
ate additional insight. All participants were able to 
speak at their own desired length to each question.
Ethical Considerations
 Ethical considerations for this study were low, 
as all participants were adults over the age of 18 and 
weren’t part of a known vulnerable group. In the in-
formation sheet provided prior to the interviews, 
candidates with any mental health issues they felt 
could be affected by partaking from the study were 
encouraged to withdraw, which was also shared with 
the participants verbally prior to the interviews being 
recorded. During the recording process of the inter-
views, the researcher ensured not to use any of the 
participants’ names so that they would not appear in 
any transcripts. The study conducted was not exper-
imental, meaning there was no intervention through-
out the interviews. During the study and in line with 
the BPP University Ethics Committee, participants 
were notified that they could opt out at any time 
throughout the study, including during the interview.
Data Analysis 
 Following the transcription of all interviews, the 
transcripts were analyzed using Thematic Analysis 
(TA) using the steps outlined by Braun and Clarke 
(2006). TA was the chosen process for reviewing the 
results of this study, as the process of the researcher 
familiarizing themselves with the material via sever-
al read-throughs ensured thorough examination of 
potential underlying themes. Additionally, using TA 
would also allow for replication of this study, or fur-
ther analysis of the interviews already conducted by 
additional parties, who can continue to iterate on the 
transcribed interviews if necessary. In a qualitative 
analysis, TA involves a process of pre-determining 
themes and searching for codes in the research which 
may support or negate those themes, or reading each 
transcript several times, and marking each expression 
of a thought, feeling, idea or association made by a 
participant as a “code” (Byrne, 2021). This study took 

AGONIS



13

the second approach. Once the codes were marked, 
common themes emerged from the data. Themes were 
not proactively searched for in the process and were 
only determined following the coding process. In an 
example from Participant’s 8 interview, two codes were 
marked in the sentence “I think there is capacity (code 
12) to change both depending on just where you are 
on the spectrum of your brain's ability (code 13) and 
what's left of it,” as they both expressed a thought, 
feeling, idea or association. The first expression that 
was coded was that there is capacity to change, and 
the second was that there was a neurological component 
related to this capacity. A full example of the coding 
process and following TA can be seen in Appendix F. 
 A quantitative measure was added to the thematic 
analysis, with the frequency of each mentioned code 
being recorded to heighten each code's prevalence 
within their respective themes. To promote consis-
tency, all codes listed in the results were transcribed in 
their original form and were not used as placeholders 
for other terms. Ambiguous sentences were interpret-
ed within context following several read-throughs by 
the author of this paper and researcher, Catherine 
Agonis, who remained the sole reader of the results 
throughout the study. How the researcher’s own ex-
perience may have affected these interpretations are 
detailed in the reflexivity statement below. As the re-
searcher is aware that having one reader may result in 
a potential bias in the analysis of the results, they have 
included a sample analysis in the appendix, which is 
color coded, for review. The researcher can also be 
contacted to release the transcripts of all 12 interviews 
should peers wish to examine their contents for further 
analysis. Once the interview transcripts were printed, 
read, and the codes were marked, they were organized 
in a Google Sheet utilizing various tabs for each theme.
 To begin the thematic analysis, the interviews were 
first broken into two groups, the Non-knowledgeable 
and Knowledgeable groups. The researcher then fa-
miliarized themself by reading each transcribed inter-
view three times. Codes that were mentioned more 
than once have been marked with the count number 
in their respective tables denoting the number of times 
mentioned. The amount of mentions also affected the 
importance of the code for the overall theme, as it was 
supposed that if a code was mentioned more than once 
in an interview, or across multiple interviews, it was 
held in higher regard to the speaker. The top themes 

with the most code “counts” were then selected as the 
Superordinate themes, and the rate of frequency from 
which the theme was mentioned was denoted. Any 
codes or themes not related to the key themes were 
considered outliers and removed from the analysis. 
To ensure consistency in the analysis of the codes, the 
researcher conducted all the reviews using Braun & 
Clarke’s (2006) TA structure. The researcher reviewed 
the four most frequently mentioned Superordinate 
themes per each group, in addition to the key overall 
themes mentioned, as recommended by Eval Acad-
emy in this kind of thematic analysis (Jones, 2022).
Reflexivity Statement
 As an individual who grew up in the USA in the 
1990s, I understand I am personally used to “finding a 
solution” to my own issues and tend to be “solutions 
oriented” when an uncomfortable experience arises. 
During my upbringing, the USA maintained a “pull 
yourself up by your bootstraps” culture, in conjunc-
tion with the notion of the “American Dream.” Both 
sentiments induced not only a belief, but a pressure 
on citizens to “make it” at all costs and persevere no 
matter the background or experience. This is demon-
strated in pop culture of the era, including Hollywood 
films such as Forest Gump and superhero comics such 
as Spiderman which tell stories regarding individu-
als who found triumph despite all unlikely adversar-
ies, largely due to the accepted, innate goodness and 
strength of their persona. These narratives (some re-
alistic and others clearly fantasy), shared a different 
message than that of media from other periods, such 
as the Victorian age. An example of a popularized nar-
rative whose aesthetics varied from that of contempo-
rary times would be Edith Wharton’s Summer, (1917) 
which ends tragically for the heroine despite all her 
efforts to live “truthfully” as a single woman during 
a time where marriage was considered of utmost im-
portance. With the influx of positive messaging in the 
USA during the 1980s-early 2000s, it felt accepted by 
society that if you “really pushed and tried,” and “had 
a magical touch,” you could make anything happen.
 In addition to the cultural surroundings, the 
household of my upbringing lacked a comparatively 
large presence of an authoritative figure compared to 
that of my peers. Learning to self-govern potentially gave 
me a personally higher sense of perceived self-efficacy as 
I never believed designated authorities were to credit for 
my success (nor my failures). With this said, there’s the 

NEUROPLASTICITY KNOWLEDGE AND PERCEIVED SELF-EFFICACY 



14

possibility that my position in this study, which exam-
ines perceived self-efficacy, was influenced by my gen-
eral position that I personally hold will and influence 
over my own behavior and the subsequent outcomes.
 Additionally, as it pertains to the review of the 
codes, it should be noted that I was raised speak-
ing American-English, which may hold a dif-
ferent analysis than an individual of a different 
English-speaking country, as Americans have the ten-
dency to be more expressive, thereby potentially re-
ducing the perception of the implied intensity when 
it came to the interpretation of particular thoughts. 

Results
Identified Codes & Themes 
 To begin the thematic analysis, the participants 
were put into one of two groups, those being the 
Knowledgeable group and the Non-knowledgeable 
group. The findings for both groups are listed below, 
with breakouts for Superordinate themes and Sub-
ordinate themes particular to each group. Several of 
the codes were related to themes which did not have 
enough total mentions to substantiate inclusion in the 
results. For instance, within the Non-knowledgeable 
group, the theme of the perception of biology playing 
a major role in one’s ability to change was mentioned 
only 10 times across all six of the interviews. Codes re-
lated to this theme, and this theme itself were removed. 
Common Themes Across Both Groups
 In order to assess the themes respective to the 
Non-knowledgeable group versus the Knowledgeable 
group, the themes were coded separately and then 
combined into common Superordinate themes where 
there were major alignments. The three Superordinate 
themes which overlapped are discussed in this section, 
and are listed and detailed as the following in Table 1:
• The day-to-day environment is a key factor in 

one’s ability to change.
• The possible techniques one can utilize range 

from medical to holistic.
• Overall, one’s ability to change their behav-

iors or recover from addiction, anxiety or de-
pression is not only possible, but promising.

 On average, the length of the interviews for 
the Knowledgeable group were 18% longer than 
the Non-knowledgeable group with an average of 
1278 words spoken in the former group versus an 
average of 1052 in the latter. The Knowledgeable 

group’s extended length of average interview times 
meant that certain themes were mentioned with 
greater frequency, as the topics were discussed at 
longer intervals. What these metrics may indicate 
will be examined more in the discussion section.
The Day-To-Day Environment Is a Key Factor in 
One’s Ability to Change 
 Both groups of participants recorded one’s envi-
ronmental surroundings as a key contributing factor 
to their ability to change. Environmental factors men-
tioned were access to basic needs, access to varied experi-
ences, and access to mental health resources. This theme 
had a total of 83 code mentions across all 12 interviews.
 Sub-Theme: Community, Family, Friends 
and Having a Person Is a Key Component 
to Recovery. “Having a person,” whether that 
person was a partner, family, chosen family or 
friends, was reported as a needed element to an in-
dividual’s direct surroundings to support change 
from both groups of participants, as seen below. 

Interviewer: When you think of the re-
sources, what does it look like to you?
Participant 1: Okay. So, in the very begin-
ning, the support of your immediate cir-
cle, whether that's family or chosen family. 
(Participant 1, Non-knowledgeable group)

 When discussing available resources that assist 
with recovery accessible within one’s environment, 
Participant 1 named support from family first. Part-
ner-related comments were made 26 times within 
the Knowledgeable group, versus 13 times in the 
Non-knowledgeable group. In some cases, such as 
in Participant 10’s statement below, the perceived 
potential of assistance from loved one’s was also de-
pendent on the ability of a person to keep a relation-
ship, indicating there is an element of responsibility 
on the individual to ensure that resource is available.

But, you know, family resources and friend 
resources and the ability to develop relation-
ships and friendships is an important resource, 
which is very much based on the individu-
al. (Participant 10, Knowledgeable group).

 It was unclear from the interviews what cor-
relation knowledge of neuroplasticity (if any) 
may have to a stronger belief in perceived self-ef-
ficacy if human connections are also formed.

AGONIS



15

Possible Techniques One Can Utilize Range from 
Medical to Holistic 
 Perceived techniques mentioned to help people 
change habits or behaviors ranged from medical (name-
ly attending therapy and use of prescribed medications), 
to holistic (such as taking part in meditation). This 
theme’s codes had 70 mentions across all 12 interviews. 
Two sub-themes regarding techniques were mentioned 
frequently across both groups as discussed below.
 Sub-Theme: Therapy. It was reported across both 
groups that therapy was a helpful component to re-
cover from mental health afflictions with some par-
ticipants also mentioning medication in conjunction 
with seeking professional help. This indicated that in-
stitutionally supported assistance was relevant to recov-
ery, regardless of perceived personal capabilities. Ther-
apy was mentioned 17 times in the Knowledgeable 
group, and six times in the Non-knowledgeable group.

Quote 1:
Interviewer: And what do you think the kinds 
of resources that should be provided are?
Participant 2: Firstly, as many forms of thera-
py as possible, like cognitive behavioral ther-
apy, for example. (Participant 2, Non-knowl-
edgeable group)
Quote 2:
My first thought is therapy when I hear re-
sources. (Participant 9, Knowledgeable 
group)

 Similarly to Participant 10 who viewed access to 
support from family and friends as a key resource with-
in one’s surroundings, Participants 2 and 9 associated 
therapy as a technique one can turn to which could be 
used to aid recovery. The prevalence of therapy in dis-
cussions across both groups demonstrated an overall 
belief that professional assistance was a key factor for 
change, regardless of knowledge of brain malleability.
 Sub-Theme: Writing / Journaling. In both 
groups, several participants described using writ-
ing and journaling to assist with improving behav-
iors and advancing past bad habits. Participant 1 ex-
pressed that the process of writing helped assist them 
in knocking off small intentions throughout the day.

I actually have to write it down. If I put it on 
my phone, I'm less likely to have completed it. 
I don't know why I have to write it. (Partici-
pant 1, Non-knowledgeable group). 

 As Participant 1 shared, a greater level of sat-

isfaction occurred when writing-by-hand was in-
volved. Participant 9 expressed the satisfaction 
they received by crossing things off a to-do list or 
seeing their intentions written on the page, shar-
ing a similar sentiment to Participant 1 of writing 
and/or journaling as a useful technique inconse-
quential to levels of neuroplasticity knowledge. 

My biggest thing that I do is bullet journaling, 
and so I've done habit trackers in there where 
like for example, one thing that I really want-
ed to start doing a few years ago was to make 
sure to always read something before I looked 
at my phone in the morning and something 
that I tracked where I wrote out the days of 
the week and I put a little dot for every day 
that I did it, and it just felt very satisfying to 
look when there were a lot of dots. (Partici-
pant 9, Knowledgeable group) 

 While this sub-theme had arisen between both of the 
groups, its presence wasn’t related to the thesis question at large.  
One’s Ability to Change Their Behaviors or Re-
cover From Addiction, Anxiety or Depression Is 
Not Only Possible, but Promising
 All 12 participants expressed they believed change 
was possible when it came to the mental health afflic-
tions of addiction, anxiety, and depression, in addition 
to a disbelief that one is unable to change habits once 
reaching adult age. In referring to the colloquial phrase 
“You can’t teach an old dog new tricks” as “nonsense,” 
Participant 3 expressed a disbelief that adulthood 
hindered one’s ability to update their programming.
 Similarly, negative reactions to this phrase were 
present across all participants. Additionally, when 
asked at the beginning of the interview “Do you think 
that human beings can change their habits once they’ve 
become an adult?”, all participants responded affirma-
tively regardless of which group they were in, alas, no 
difference in this sentiment was recorded between the 
groups. However, sentiments of positivity were ex-
pressed with greater prevalence in the Knowledgeable 
group. In total, this theme received 64 mentions across 
10 interviews, with 41 mentions in the Knowledgeable 
group versus 23 in the Non-knowledgeable group.
Non-knowledgeable Group: Particular Themes
 Following the initial analysis, the Non-knowl-
edgeable group generated 90 codes which were col-
lated into eight Superordinate themes. Each of the 
Superordinate themes were ranked according to the 

NEUROPLASTICITY KNOWLEDGE AND PERCEIVED SELF-EFFICACY 



16

number of total codes mentioned with repeated codes 
counted towards the total. After additional re-reads of 
all interviews, the list of codes was reduced to 66 out 
of the original set of 90. Codes which did not relate to 
an overall theme, and were therefore outliers, were re-
moved. A recount of the codes within each theme was 
completed, allowing deduction to four major themes 
with linked Subordinate themes. The breakdown 
of final codes can be seen in Table 2. While three of 
these Superordinate themes were included in the over-
all theme group and discussed above, this paper will 
highlight the Superordinate themes and Subordinate 
themes particular to the Non-knowledgeable group in 
this section so their differences from the Knowledge-
able group may be discussed for additional analysis.
Changing One’s Behavior Is Possible Through
Activity 
 Despite having no knowledge in neuroplastici-
ty as demonstrated by the participants’ surveys, the 
participants in the Non-knowledgeable group each 
attested to a belief or understanding that the brain 
is a malleable object whose structure can be altered 
through a repetition of actions or activity. This theme 
had a total of 39 codes mentioned across six interviews. 
 Sub-Theme: Introduce Randomness. Par-
ticipants in the Non-knowledgeable group recorded 
the need for an individual to attempt to introduce 
varied experiences into their own surroundings inde-
pendent of the immediate offerings of their environ-
ment to aid their ability to change behaviors. The call 
to action in Participant 3’s statement below utilized 
an understanding of evolution as an exploration of 
how randomness helps us evolve on a macro-level.

The more randomness you introduce, the 
higher your probability is that you will find an 
experience that teaches you something mean-
ingful or that will lead to change. I think that’s 
how biology evolves, right? It doesn’t know 
what a good gene is, so it just keeps chang-
ing its genes and the good genes survive. And 
yeah, I think that that can be taken for human 
behavior as well… Reading a book is random-
ness…Traveling is randomness. (Participant 3)

 The scientific outlook, despite claiming no 
knowledge of neuroplasticity, took an empir-
ical approach towards personal advancement. 
It has the potential to be linked to the environ-
mental Sub-theme described later in this section.

Sub-Theme: Repetition as a Driver for Change. 
Several participants within the Non-knowledge-
able group mentioned how the repetition of tasks 
as a practice could eventually induce a new pattern 
from a person who is looking to alter their behav-
ior. For example, Participant 5 described a belief 
that dedicating oneself to a conscious repetition led 
to an acceleration towards self-improvement de-
spite claiming no knowledge regarding brain mal-
leability and the ability to reorganize or create new 
pathways through activity via this study’s survey. 

And you continue to proceed forward 
as a different human. It takes constant 
practice and control. (Participant 5)

 Where this supposition stemmed from was unclear 
and will be examined further in the discussion section.
(The Day-to-Day Environment Is a Key Factor 
in One’s Ability to Change) Subordinate Theme: 
Varied Surroundings 
 Participants in the Non-knowledgeable group 
brought up diversity and exposure to varied ex-
periences as a key factor in one's environment 
which will help them to change. These mentions 
were different from the codes related to the Sub-
ordinate theme of “introducing randomness.”

I think observations play a huge role, and if 
you've never had a chance to observe an im-
proved version of a state, then you might just 
not know that that is something that could be 
improved or something that can even change 
if you've never seen a change. If you grow up 
in a broken household where I don't know, 
the parents are always arguing, the relation-
ship is toxic and you're never exposed to a pos-
itive relationship, it is possible that you just 
don't have the observation to know that good 
relationships are possible. (Participant 6)

 Via this quote from Participant 6, it is possible 
that the idea of benefiting from varied surroundings 
is linked to the idea of introducing randomness. Both 
express a need for diversity to advance improvement, 
with the above comment leaning more towards the 
general environmental factors outside of a person’s 
control as a resource, and the introduction of ran-
domness through activities such as reading and trav-
el as a technique within an individual’s authority.
 Sub-Theme: Privilege. Participants in the 
Non-knowledgeable group mentioned privilege when 

AGONIS



17

it came to access to basic human needs including health-
care, housing, and time as affecting one’s ability to change. 
I feel like I'm privileged enough to have the resources to 
make any change that I choose to make. (Participant 3) 
As Participant 3 implied, their own privilege was 
seen as a factor in their ability to alter their habits. 
It was indicated from participants without knowl-
edge regarding the brain’s plasticity that environ-
mental factors, which may be out of a person’s 
control, may affect their perception of self-effica-
cy when it comes to recovery from these disorders.
Knowledgeable Group: Particular Themes
 Following the initial analysis, the Knowledgeable 
group generated 280 codes which were collated into 
seven Superordinate themes. Each of the Superordinate 
themes were ranked according to the number of total 
codes mentioned with repeated codes counted towards 
the total. After additional re-reads of all interviews, the 
list of codes was reduced to 192 out of the original set 
of 280. A recount of the codes within each theme was 
completed, allowing deduction to four major themes 
with linked Subordinate themes. The breakdown of fi-
nal codes can be seen in Table 3. While three of these Su-
perordinate themes were included in the overall theme 
group and discussed above, this paper will call out 
Superordinate themes, and the Subordinate themes 
particular to the Knowledgeable group in this section.
Will Is a Key Factor in Changing Behavior 
 The participants in the Knowledgeable group re-
corded the importance behind individual will when 
it comes to recovery from mental health afflictions 
or unhelpful behaviors. Numerically, this was the 
most expressed theme between any group, with 62 
total mentions across six interviews, and the high-
est frequency of mentions across all interviews with 
one mention per 0:50 minutes on average. While 
this theme was also raised in the Non-knowledgeable 
group, the total mentions were 11, ranking it below 
other more commonly mentioned themes and ex-
cluding it from the overarching themes from that 
group. The difference in mentions highlights the rel-
evance of this theme to the Knowledgeable group. 
 Sub-Theme: Positive Mindset. Participants 
in this group recorded that maintaining hope, pos-
itivity and/or an intrinsic outlook towards “the 
glass being half-full” assisted in their perception 
of self-efficacy when it came to behavioral change. 
An example was expressed by Participant 7, who 

shared a belief that a solution is always available.
I think intrinsically it's the hope, like the ev-
eryday will bring something new. Every day 
there is always a chance to modify whatev-
er is being like in the past. There is always a 
solution. I'm 100% convinced. There is al-
ways a solution for everything. (Participant 7)

 While none of the participants linked a positive 
mindset with knowledge of the brain’s malleability, the 
concept of “keeping positive” as an agent for change 
was demonstrated more frequently within this group.
 Sub-Theme: Although Possible, Change Isn’t 
Easy and Takes Effort. Mentions regarding the 
amount of effort required to induce change were some-
times linked to the desire of the individual. Participants 
in this group called on the reality that change is a pro-
cess, which requires personal dedication and intention. 

I would say that's completely based on your 
openness and receptiveness to changing behav-
iors. I think that that's a really difficult thing to 
change in somebody subconsciously if they're 
not open to it themselves. (Participant 8)

 In addition to discussing the effort required from 
an individual to recover from addiction, depression, or 
anxiety and/or change their behavior, Participant 8 in-
dicated that improvement efforts were characteristic. 
 Sub-Theme: Openness. Several participants in 
the Knowledgeable group shared that an individu-
al’s ability to changed was linked to a personal open-
ness to do so. There wasn’t a recorded trend regard-
ing what the participants believed led to openness.

Interviewer: And how much do you believe in 
the phrase you can't teach an old dog new tricks?
Participant 8: For dogs or for people? [Laughter]
Interviewer: I guess it's a phrase for people. 
Participant 8: I definitely don't believe that 
at all. I think if the dog is open to learn-
ing new tricks, then the dog handler can 
teach it new tricks, yeah. (Participant 8)

 While records such as Participant 8’s demon-
strated a belief that the ability to change in adult-
hood stems from an individual’s openness, it is un-
clear how this may be linked to knowledge of brain 
malleability. (Additionally, it is important to note 
that while responding, the Participant was laughing, 
leading to an interpretation that they were playful-
ly joking about the analogy referring to dogs. Due 
to the non-verbal reactions during the interview, it 

NEUROPLASTICITY KNOWLEDGE AND PERCEIVED SELF-EFFICACY 



18

was supposed that the Participant was continuing 
to speak about the dog as an analogy for humans.)
The Possible Techniques One Can Utilize Range 
From Medical to Holistic-Subordinate Theme: 
Self-Awareness
 Participants in the Knowledgeable group 
detailed the need for cognitive self-aware-
ness as a requirement for one to change. 

Quote 1:
I think it takes a lot of work and self-aware-
ness, but yeah, I think it's absolutely possible. 
(Participant 11)
Quote 2:
I think there has to be an awareness of what-
ever it is that you want to change.
(Participant 12)

 Although the knowledgeable group detailed 
a need for self-awareness of one’s issues in or-
der to change, it was not indicated in how that 
self-awareness can be obtained, nor how this may 
be linked to knowledge of brain malleability.
Comparison of Groups
 Despite the Non-knowledgeable group attesting 
to having no knowledge regarding neuroplasticity, a 
belief that change in one’s behaviors was possible, as 
well as their ability to recover from addiction, anxiety, 
and depression was recorded in all six interviews from 
this group. This belief was equally expressed in the 
Knowledgeable group, demonstrating that perception 
regarding the ability to change and recover existed. 
Originally, when assembling this study, it was supposed 
that the sentiment regarding the possibility of change 
would be more affirmative with the Knowledgeable 
group versus the Non-knowledgeable group, meaning 
the Non-knowledgeable group would thematically in-
dicate change wasn't always possible for adults. How-
ever, these findings recorded that regardless of knowl-
edge as it relates to neuroplasticity, the participants 
believed that the potential to recover from mental 
health disorders in individuals is present, and no dif-
ference in this point of view was perceived across the 
two groups (for instance, no participants responded 
to the question of the ability to change negatively). In 
total, the theme, “Overall, one’s ability to change their 
behaviors or recover from addiction, anxiety or de-
pression is not only possible, but promising,” received 
64 mentions across 10 interviews, with 41 mentions 
in the Knowledgeable versus 23 in the Non-knowl-

edgeable group. While the overall sentiment remained 
consistent, the greater number of mentions in the 
Knowledgeable group is worth examination as it per-
tains to this supposition and demonstrated a variance 
in prevalence from the Non-knowledgeable group.
 Of the original list of Superordinate themes, 
“Childhood development as a key-factor in one’s 
ability to change” was mentioned throughout both 
groups, but less frequently than the final Superordi-
nate themes selected, leading to its exclusion in the 
final Superordinate themes list. It was originally pre-
sumed that those who believed childhood events and 
experiences grossly affected one’s ability to change 
may have a lower sense of perceived self-efficacy when 
it came to the possibility of recovery, as this theme 
may imply a deterministic outcome set by the first few 
years of our lives. The theme of development (which 
oftentimes cited childhood upbringing or trauma in 
this study) insinuated that recovery is more difficult 
once we reach adulthood as we are coded from a young 
age. An example of this would be from Participant, 2, 
who stated, “Your ability to do that is the direct re-
sult of trauma. So, people who have suffered trauma 
fall into some behaviors to either self soothe or sur-
vive, and so I think those things are hard to change.”
 Of the Knowledgeable group, the theme of de-
velopment was mentioned 22 times across six inter-
views, and from the Non-knowledgeable group it 
was mentioned 17 times across six interviews. It was 
first suspected during the original read through of 
the transcripts that the equality of this theme’s im-
portance across both groups demonstrated a corre-
sponding sense of perceived self-efficacy despite the 
presence of knowledge. This was due to the theme 
of change being possible arising as a Superordinate 
theme in both groups, and development being a less 
mentioned theme in both groups. However, upon the 
second screening of the Superordinate themes across 
groups, key differences emerged and were noted.
 Firstly, the importance of will and self-deter-
mination in an individual was the major theme in 
the Knowledgeable group, with more mentions 
and a higher frequency than any other theme across 
both groups. Within the Knowledgeable group, 
this theme was mentioned 62 times, as opposed 
to the Non-knowledgeable group who mentioned 
it only 11 times, excluding it from an overall Su-
perordinate theme for the Knowledgeable group 

AGONIS



19

while being excluded in the final list of Superor-
dinate themes for the Non-knowledgeable group. 
 Self-efficacy is defined as an individual's belief in 
their ability to complete behaviors or tasks to attain a 
certain performance (Bandura, 1977). From the study’s 
metrics and definitions described, it is worth further 
investigation if those with knowledge of neuroplasti-
city may also believe that a person has a higher ability 
to change if they have the will to do so. A link between 
will and perceived self-efficacy may possibly imply that 
ability to recover from the mental health disorders of 
addiction, anxiety, and depression via this capability 
lies more under their control than under other outlying 
factors, but this would need to be examined further.
 When it came to the Superordinate theme of 
“Environment playing a key role,” beliefs in how the 
environmental factors influenced one’s ability to re-
cover from mental health disorders varied across the 
Knowledgeable and Non-knowledgeable group. For 
the Non-knowledgeable group, the environment's 
sub-themes included an acknowledgement of priv-
ilege regarding having access to basic needs, such 
as housing and healthcare, possibly indicating that 
the ability to change is affected by external factors 
as opposed to internal ones. Factors of basic needs 
were not recorded in the Knowledgeable group, 
meaning the Subordinate theme of privilege did not 
arise. The presence of this Subordinate theme in the 
Non-knowledgeable group, versus the presence of 
the Subordinate theme of will in the Knowledgeable 
group, signaled a variation in the perception of what 
is within one’s control versus out of one’s control. 
 It was also found that despite not having formal 
knowledge regarding neuroplasticity, the Non-knowl-
edgeable group believed that the brain was “re-codable” 
or malleable through action. While contemporary sci-
ence largely steers away from nativist claims, it may be 
implied from the records of the Non-knowledgeable 
group that an innate understanding potentially exists 
regarding brain malleability. This is worth further 
consideration separate from this study. It is unclear 
where exactly this understanding stemmed from, and 
whether it was assumed or taught to these participants 
under some other name, or induced through sublim-
inal, cultural messages (such as the popularization of 
sayings like “I think, therefore I am” by Descartes).
 Finally, the lengthened average of interviews 
from the Knowledgeable group presented addition-

al codes, and heightened support behind those codes 
by a higher frequency of mentions. Returning to the 
research behind metacognition and biofeedback, sci-
ence currently accepts that witnessing feedback re-
garding one's performance can assist in the advance-
ment of an individual aiming to change a sensation 
or ability. While both groups expressed a belief in 
adults’ abilities to recover and change, the record of 
longer talk times combined with the supposition that 
will plays a major factor in ability indicates a differ-
ence between the groups. This supports the justifica-
tion for quantitative research on how knowledge of 
neuroplasticity may influence perceived self-efficacy 
in recovery from addiction, anxiety, or depression.

Discussion
 As presented, a difference in themes was demon-
strated regarding the perception of self-efficacy from 
mental health recovery between groups of adults who 
have knowledge of neuroplasticity and those who 
don’t. Themes related to internal factors (such as will) 
were more present in the Knowledgeable group and 
themes related to external factors (such as environ-
ment) were more present in the Non-knowledgeable 
group. Locus of control, which is the term describ-
ing an expectation of one’s influence on an outcome 
being more internal or external, was not examined 
as a factor in this study during the research process 
(Nieben et al., 2022). However, based on the themes 
presented between the groups, it may be relevant to 
examine perceived locus control in participants in 
addition to perceived self-efficacy in future studies. 
Following the conclusion of this study, overarch-
ing questions to ask for psychology at large may be:
1. Should there be a focus on knowledge of neu-

roplasticity as an agent of change?
2. Is it possible that knowledge regarding brain 

malleability is innate?
3. Does knowledge of neuroplasticity affect 

one’s locus of control?
 Regarding the question of focusing on neuro-
plasticity as an agent of change, there is room for 
quantitative examinations regarding education of 
neuroplasticity as a self-regulation tool, particularly 
given the themes recorded in this initial qualitative 
study and the previous successful demonstration of 
biofeedback, CBT, and metacognition as regulation 
tools. As discussed in the introduction, evolution-

NEUROPLASTICITY KNOWLEDGE AND PERCEIVED SELF-EFFICACY 



20

ary-based mental health disorders remain prevalent 
in the modern day, especially when set against a land-
scape of challenges in accessing clinical assistance. 
Through these questions, science can potentially de-
velop additional quantitative studies which examine 
the components behind utilization of knowledge of 
neuroplasticity as an agent for recovery from mental 
health disorders, and not just as an agent for recov-
ery from cognitive function due to brain damage.
Limitations
 As this was a preliminary qualitative study, only 
12 participants were interviewed total, with six in the 
Knowledgeable and six in the Non-knowledgeable 
group. As mentioned, during the thematic analysis, 
to accurately represent the importance of each code, 
the comments were quantitatively ranked by not only 
marking the codes mentioned, but also by counting 
the total number of mentions. However, the number 
of participants and the methodology doesn’t qualify 
for statistical relevance, and so for this hypothesis to 
be validated in a statistical format, additional quantita-
tive studies would need to be conducted. Considering 
the research as a qualitative study, whose purpose was 
to lay a groundwork for further research, no statistical 
analysis was completed due to a low-level of partici-
pants. Additionally, as this research was conducted as 
part of a student thesis, there was only one reviewer 
analyzing the codes, which may have left an individu-
al bias in how the system was coded. Should another 
qualitative study be conducted to further examine this 
subject matter, it would be recommended to have ad-
ditional researchers reviewing the codes and determin-
ing a final list of codes and themes in tandem. While 
no mention of neuroplasticity was made during the in-
terviews themselves, since the survey sent out prior to 
the study as well as the information sheet included the 
term, it is possible that participants had done their own 
investigation and that had influenced their interviews.
 Finally, the pool of participants ranged be-
tween three countries and a wide age range of adults, 
each of which may have their own cultural influ-
ences when it comes to their perception of recov-
ery. It is possible that with a quantitative analysis 
we would see themes differ across demographics.
Practical Implications
 The findings of this study suggest there may be 
a difference in how those with knowledge of brain 
malleability (Knowledgeable group) regard perceived 

self-efficacy when it comes to the recovery of men-
tal health disorders versus those without knowledge 
of neuroplasticity (Non-knowledgeable group). As 
this study only utilized a small sample, it doesn’t 
hold a statistical relevance, and so there are no im-
mediate suggestions regarding practical changes in 
the administration of mental health care. Addition-
al studies and analyses should measure the impact 
of these suggestions prior to practical applications 
being suggested for the adult population at large.
Suggestions for Further Research
 Based on the study’s f indings from the 
Non-knowledgeable group, it was perceived that those 
without knowledge of neuroplasticity still held a belief 
that the brain can be re-coded through activity. While 
concepts regarding innate knowledge aren’t popular-
ized in modern-day psychology, it may be worthwhile 
to investigate where this seemingly “innate” under-
standing regarding malleability comes from - wheth-
er it is subliminal societal cues or education regarding 
brain plasticity occurring in subliminal formats. From 
this, we may understand better if this belief is indeed 
generally understood or if it is induced through learn-
ing. It would also be worthwhile to conduct such in-
terviews across various cultures, as it is possible the 
answer would differ depending on different groups. 
 Furthermore, as indicated in the background 
section of this study, visualization (which as far as we 
understand isa faculty particular to humans) is a use-
ful tool when it comes to re-arrangement of cognitive 
thoughts. Depending on the findings from any further 
studies on this topic, it may be beneficial to conduct 
an experiment of visualizing the re-routing of neu-
ral pathways as a mechanism for changing behavior. 
 Additionally, it is possible that individuals have 
received non-explicit affirmative feedback regard-
ing brain malleability through experience. This may 
have been achieved through introspection following 
the changing of behavior over time or through the 
reward of society followingdemonstrated improve-
ment (such as loved ones supporting an individual 
going through therapy). A further examination on 
how the topic of brain malleability may be sublimi-
nally shared in the west will help science understand 
the implications of this study. Finally, studies may 
ask in what ways can we quantitatively test the im-
pact knowledge of neuroplasticity has on self-effica-
cy regarding recovery from mental health disorders.

AGONIS



21

Conclusion
 Due to the perceived success of recovery and/
or management of addiction, anxiety, or depression 
through CBT, biofeedback, and metacognition, this 
study’s aim was to examine if adults with knowledge 
of their biological makeup may have a stronger per-
ception in their ability to self-regulate their recovery 
from the above-mentioned mental health afflictions 
which may be evolutionarily induced. As presented, 
the findings between the Non-knowledgeable and 
Knowledgeable groups have recorded a variation in 
themes regarding sense of self-efficacy when it comes 
to recovery from mental health disorders of addiction, 
anxiety, and depression. These differences included:
• The Knowledgeable group’s themes hold-

ing a focus on internal control, and the 
Non-knowledgeable group’s themes holding 
a focus on external control.

• A higher sense that individual will plays a key 
role in the ability to change from the Knowl-
edgeable group.

• A higher sense that privilege and access to ba-
sic needs is a major contribution to the abil-
ity to change from the Non-knowledgeable 
group.

• More lengthy interviews and ability to discuss 
the possibility to change from the Knowl-
edgeable group

 As this study had a small sample across three 
countries, we cannot yet state that there is statisti-
cal power regarding a heightened sense of perceived 
self-efficacy being associated with knowledge of neu-
roplasticity. However, the differences recorded in this 
study lay the foundation for further analyses which 
can explore a link between knowledge regarding brain 
malleability and the ability to self-regulate mental 
health disorders, as the Knowledgeable group gen-
erated codes relating to will and self-determination 
more frequently than the Non-knowledgeable group, 
and were able to discuss recovery at greater length.

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Table 1

Overall Superordinate and Subordinate Themes 

AGONIS



25

Table 2

Superordinate and Subordinate Themes for Non-knowledgeable Group

NEUROPLASTICITY KNOWLEDGE AND PERCEIVED SELF-EFFICACY 



26

AGONIS



27

Table 3

Superordinate and Subordinate Themes for Knowledgeable Group

NEUROPLASTICITY KNOWLEDGE AND PERCEIVED SELF-EFFICACY 



28

AGONIS



29

NEUROPLASTICITY KNOWLEDGE AND PERCEIVED SELF-EFFICACY 




