In contrast to the ample evidence regarding CBT’s efficacy, far less is known regarding the mechanisms of how it exerts its effects (Kazdin, 2007). As one of the primary elements of CBT is cognitive and behavioral skills training, most early studies of possible mechanisms of CBT focused on the improvement of these skills as a mediator of treatment effects. However, a seminal review by Morgenstern and Longabaugh (2000) concluded there was very little support for improvement in coping skills as a unique mechanism in CBT for alcohol use disorder. In the years since, some promising evidence has emerged supporting the acquisition and improvement in cognitive and behavioral control skills, as well as self-efficacy, as mediators (and potential mechanisms) of CBT’s effect on treatment outcomes. For example, improvement in the quality of individuals’ coping skills following computerized CBT was found to mediate treatment effects on abstinence from drugs, satisfying all criteria in the causal chain (Kiluk, Nich, Babuscio, & Carroll, 2010b). Also, increased self-efficacy has been found to mediate the relationship between drink refusal training (a specific ingredient of CBT) and
