The causal impact of attributions and coping self-efficacy on adjustment to abortion was examined. Two hundred and eighty-three women were randomly assigned prior to their abortion to 1 of 3 counseling interventions: 1 designed to alter attributions for unwanted pregnancy (ATT-INT), 1 designed to raise coping expectations (EXP-INT), or a control (standard counseling) group. Depression, mood, anticipated consequences, and physical complaints were assessed postabortion. Women in the ATT-INT or EXP-INT group were better adjusted immediately postabortion than women in the control group. The EXP-INT group was also less depressed than the ATT-INT group. Three individual difference factors were also related to better adjustment: high coping self-efficacy, low self-character blame, and low other-blame. Self-efficacy also predicted adjustment 3 weeks postabortion. Implications for theories of adjustment to major life events, therapeutic interventions to assist coping with such events, and public policy on abortion are discussed.