Do patients change in the ways we intend? Assessing acquisition of coping skills among cocaine-dependent patients

Few studies have evaluated whether substance users show changes associated with the hypothesized mechanisms of action of the treatments they receive. The Cocaine Risk Response Test (CRRT) is a role-play assessment of coping s kills for high-risk situations associated with cocaine and other substance use. Initial psychometric analyses, using data from a series of randomized controlled trials, indicated very good interrater reliability and internal consistency, as well as significant increases from pre- to posttreatment in number, quality, and specificity of coping skills. Participants who had re ceived different types of treatment were more likely to respond with coping skills characteristic of their assigned treatment, suggesting the measure may tap hypothesized mechanisms of treatment change.