(treatment as usual, TAU). This trial demonstrated significant differences in drug free urines by condition (Carroll, Ball, Martino, Nich, Babuscio, Nuro, et al., 2008) as well as continuing improvement for those assigned to CBT4CBT through a 6-month follow-up (Carroll, Ball, et al., 2009). In addition, a role play assessment of acquisition of coping skills demonstrated that assignment to CBT4CBT was associated with a significant increase in the quality of coping skills from pre- to post-treatment relative to standard treatment, with continuing improvement for the CBT4CBT group through the 6-month follow-up (Kiluk, Nich, Babuscio, & Carroll, 2010a). Mediational analyses indicated that acquisition of coping skills accounted for the effect of CBT4CBT versus TAU treatment on substance use outcomes, pointing to the effect of CBT4CBT on skills training as a potential mechanism of action for CBT4CBT (Kiluk et al., 2010a). Thus, data from this initial pilot trial suggested that key features of traditional, clinician-delivered CBT appeared to be retained in its conversion to an easily disseminable web-based format, in that CBT4CBT appeared to improve the targeted skills and was associated with enduring effects. Secondary analyses of data from this trial also indicated (1) relative benefits of CBT4CBT over TAU in increasing self-reported
