Specificity of Effects of Cognitive Behavior Therapy on Coping, Acceptance, and Distress Tolerance in a Randomized Controlled Trial for Smoking Cessation
Article first published online: 27 JUL 2012
© 2012 Wiley Periodicals, Inc.
Journal of Clinical Psychology
Volume 68, Issue 12, pages 1231–1240, December 2012
How to Cite
Kapson, H. S., Leddy, M. A. and Haaga, D. A. F. (2012), Specificity of Effects of Cognitive Behavior Therapy on Coping, Acceptance, and Distress Tolerance in a Randomized Controlled Trial for Smoking Cessation. J. Clin. Psychol., 68: 1231–1240. doi: 10.1002/jclp.21903
- Issue published online: 9 NOV 2012
- Article first published online: 27 JUL 2012
- smoking cessation;
- cognitive behavior therapy;
- depression proneness;
- compensatory coping;
- distress tolerance
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.
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).
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.
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.