As practitioners, we would hope to enhance task-specific self-efficacy and promote positive behavior change, particularly as a result of rehabilitation. Indeed, previous studies have devised such tools to demonstrate that specific, rather than generalized, expectations can mediate behavior change in patients with COPD.3 However, the knowledge and skills that a rehabilitation program imparts may also promote a change in self-efficacy, which may expand into other areas of our patients’ lives, assisting their ability to cope overall. In this context, the measurement of general self-efficacy seems prudent. It is interesting that Drs DePew and Benzo raise the issue of general self-efficacy with physical activity. Although an improvement in physical activity is a core element of PR, we strongly believe that the overall effect of the program achieves much more than this: behavioral change, self monitoring, problem solving, action planning, goal setting, education, and social interaction. These effects are more likely to be observed by asking general questions, and so perhaps a task-specific tool may not be sufficient for such a holistic intervention.