A total of 3,228 men receiving treatment in 15 Department of Veterans Affairs substance abuse treatment programs were assessed at treatment entry and at or near discharge from inpatient programs that had desired lengths of stay of 21-28 days. Between intake and discharge, patients in 12-step programs improved more than did cognitive-behavioral (C-B) patients on proximal outcome variables assumed to be specific to 12-step treatment (e.g., attending 12-step meetings, taking steps), whereas patients in C-B programs made no greater change (and in a few cases, less change) than did 12-step patients on proximal outcome variables assumed to underlie C-B treatment (e.g., self-efficacy, coping skills). These findings suggest that the proximal outcomes thought to be specific to C-B treatment are actually general proximal outcomes of both 12-step and C-B treatment. Tables, references