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Alcohol and Drug Cognitive Enhancement (ACE) Program

The ACI will work to test a cognitive remediation (CR) intervention to demonstrate effectiveness and feasibility of scaling up and implementing the intervention in AOD treatment settings in NSW. A suite of evidence based, frontline resources to screen for, identify and address cognitive impairment will be developed to support the program.

Aim

All services working with clients who are seeking treatment for substance use, screen for and accommodate clients with cognitive impairment.

Goals

  • Improved client outcomes (e.g. mental health, quality of life)
  • Improved capacity in executive function
  • Improved completion of treatment
  • Reduced readmission to treatment
  • Improved capacity to attain set goals

Benefits

  • Increased staff and consumer knowledge of cognitive impairment in an AOD setting.
  • Increased staff skills to identify and respond appropriately to cognitive impairment.
  • Increased service capacity to accommodate and actively respond to consumers with cognitive impairment to work towards:
    • improved cognitive capacity, particularly in executive function
    • improved completion of treatment
    • improved capacity to attain set goals
    • improved client outcomes (e.g. mental health, quality of life).

Implementation

The ACI will work to scale up a previously trialled cognitive remediation intervention for its implementation and evaluation across a number of AOD services in NSW.

Two trials will be conducted in 2018.

  • A randomised controlled trial of a cognitive remediation intervention in residential AOD treatment services.
  • A feasibility study of a cognitive remediation intervention in AOD treatment outpatient services.

Background

It is estimated that up to 80% of clients accessing AOD treatment have a degree of cognitive impairment, yet no standard cognitive remediation intervention for this population exists.

Executive dysfunction, a common form of cognitive impairment in this population, affects an individual’s ability to plan, organise, set goals, solve problems, make effective decisions and regulate emotions. These capacities are required to facilitate positive behaviour change, which is a primary focus of AOD treatment.

Although cognitive remediation has been shown to be effective at improving cognitive functioning in acquired brain injury and psychiatric populations, little research has examined its benefits in an AOD treatment population.

Preliminary research has demonstrated that the treatment effects of cognitive remediation in an AOD population are at least as strong as those in other populations. As such, identifying risk for cognitive impairment at the point of entry into drug and alcohol services and implementing a cognitive remediation intervention is important to ensure that individuals are supported to be gaining the most from their treatment.

In 2015, a pilot group CR intervention, was successfully implemented with clients in a residential AOD treatment setting. This program is an extension of that pilot.

Contact

Antoinette Sedwell
Network Manager, Drug and Alcohol Network
Primary Care and Chronic Services
+61 2 9464 4634
antoinette.sedwell@health.nsw.gov.au

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