Specificity of Effects of Cognitive Behavior Therapy on Coping, Acceptance, and Distress Tolerance in a Randomized Controlled Trial for Smoking Cessation

• Published in: Journal of clinical psychology Vol. 68; no. 12; pp. 1231 - 1240
• Main Authors: Kapson, Heather S., Leddy, Meaghan A., Haaga, David A. F.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.12.2012; Wiley Periodicals Inc
• Subjects: Acceptance; Adaptation, Psychological - physiology; Adjustment; Adult; Behavior; Clinical psychology; Clinical trials; cognitive behavior therapy; Cognitive Behavioral Therapy - methods; compensatory coping; Depression - psychology; depression proneness; distress tolerance; Female; Humans; Male; Middle Aged; Patient Acceptance of Health Care - psychology; Psychotherapy; Smoking cessation; Smoking Cessation - methods; Smoking Cessation - psychology; specificity; Stress, Psychological - psychology; Treatment Outcome
• ISSN: 0021-9762; 1097-4679
• DOI: 10.1002/jclp.21903

Objective Although there is extensive evidence of the efficacy of cognitive‐behavioral therapy (CBT), it is less certain what potential mechanisms of change are specifically affected by CBT interventions. This study was intended to test the specific effects of CBT on compensatory coping skills, acceptance, and distress tolerance or persistence. Method Using data from a randomized controlled trial of 8‐session group CBT and a time‐matched comparison condition for cigarette smokers, we evaluated CBT effects on compensatory coping skills, self‐rated acceptance and behavioral markers of persistence and distress tolerance. Because depression proneness had moderated treatment response in the parent clinical trial (Kapson & Haaga, 2010), we tested not only main effects (CBT vs. comparison condition) but also moderated effects (treatment condition X depression proneness). Results CBT significantly improved compensatory coping skills only among the less depression‐prone participants, who were the subset of smokers who did not benefit from CBT in terms of smoking cessation outcomes. There were no specific effects of CBT on acceptance or behavioral persistence. Conclusions To the extent that CBT had specific effects on compensatory coping skills, it was for the participants who did not benefit clinically from the intervention. Much more theory‐driven research on multiple candidate change mechanisms is needed to clarify how effective and specific treatments have their effects, for either patients in general or subsets of patients as in moderated effects.