Computer-Assisted Cognitive Rehabilitation Improves Substance-Abuse Treatment Response

BUFFALO, N.Y. -- "Brain exercises" originally developed for the rehabilitation of head-injury patients improve the cognitive functioning of individuals in substance-abuse treatment and their commitment to the treatment program, according to research conducted at the University at Buffalo's Research Institute on Addictions (RIA).

Those who participated in the cognitive rehabilitation exercises involving the use of computers stayed in treatment significantly longer than others and twice as many of them "graduated" from treatment.

The research, reported in the Winter 2003 issue of The Journal of Cognitive Rehabilitation, was funded by grants totaling $1 million from the National Institute on Drug Abuse.

Kerry Grohman, Ph.D., RIA research associate and lead investigator on the study, noted that "impaired cognitive functioning -- in memory, problem-solving, abstraction, and information processing -- is common in individuals who enter treatment for alcohol and drug dependence."

Cognitive functioning for many patients in substance-abuse treatment gradually improves over the first year of abstinence. Cognitive rehabilitation, Grohman said, is a way to accelerate cognitive recovery, so that patients have a better chance at successful treatment for addiction and functioning in life after treatment.

Cognitive-rehabilitation exercises improve cognitive functioning with tasks that focus on impaired skills (such as memory and attention) through repetition. Impaired memory and attention have been linked to poorer retention and results in treatment.

The RIA study included 120 patients (70 percent male) randomly assigned to three treatment interventions.

Those in the group that received computer-assisted cognitive rehabilitation plus standard treatment remained in a six-month residential treatment program for an average of 200 days, significantly longer than other patients. Patients in the computer-assisted rehabilitation group were required to participate in 50-minute sessions three times per week for two months.

Those in a typing tutorial plus standard treatment averaged 128 days and the control group that received only standard treatment, 132 days.

Improvements in functioning within the treatment structure seemed to improve the patients' commitment to the program and recovery. Thirty-eight percent of those in the cognitive-rehabilitation group graduated from treatment, compared with 18 percent in the typing group and 18 percent in the control group.

Collaborating with Grohman on the study was William Fals-Stewart, Ph.D., a clinical psychologist and RIA senior research scientist.

"This study shows the importance of cognitive rehabilitation to improved substance-abuse treatment," Fals-Stewart said. "Decreased lengths of stay in treatment and premature discharge have been linked with subsequent addiction-related problems. This treatment program provides a method to address at least some of the factors contributing to these problems."

Grohman and Fals-Stewart next will be following patients for one year after treatment, tracking substance use or abstinence, employment, incarceration and use of aftercare treatment services.

The Research Institute on Addictions has been a leader in the study of addictions since 1970 and a research center of the University at Buffalo since 1999.

The University at Buffalo is a premier research-intensive public university, the largest and most comprehensive campus in the State University of New York. UB's more than 27,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs.