Advertisement

Topics

Cognitive Remediation and Work Therapy in the Initial Phase of Substance Abuse Treatment

2015-02-09 19:23:23 | BioPortfolio

Summary

The initial phase of substance abuse treatment is a vulnerable period for relapse. Cognitive impairments are common during this phase and may reduce the ability to benefit from other forms of substance abuse and rehabilitation services. The study compares a rehabilitation program that combines work therapy with computer-based cognitive training of attention, memory and executive functions to work therapy alone in a 3 months outpatient substance abuse program. It is hypothesized that cognitive training will increase days of sobriety during the active intervention and better substance abuse outcomes at 6 month follow-up.

Description

This proposal aims to pilot test a cognitive remediation therapy (CRT) combined with work therapy (WT) as an adjunct to the initial phase of outpatient substance abuse treatment. There is ample research evidence of cognitive impairment across substance abuse disorders, particularly in the early phase of recovery. Cognitive impairment has been associated with poorer substance abuse treatment outcomes and may be remediated through programs of exercises that target these impairments. The investigators have previously reported on a model of providing CRT with work therapy (WT) in an outpatient context for people with psychotic disorders, which showed significant improvements in executive function and working memory, and in important functional outcomes such as work performance and sustained work activity. The investigators propose to apply this same approach to a sample of participants recruited from a 30-day residential program for substance abusers who are beginning their recovery. When they are discharged, they will be able to continue WT, which may encourage their engagement in CRT and in substance abuse outpatient services.

Our Specific Aims are: 1. Test the feasibility and tolerability of CRT & WT in the early phase of substance abuse treatment. 2. Obtain effect size for CRT & WT compared to WT alone on a primary substance abuse outcome measure (Days of Use) for a future R01 RCT submission. 3. Obtain effect sizes for secondary outcomes (e.g. neurocognition).

The investigators propose to accomplish these aims by randomizing 50 participants who wish to receive WT services into two conditions: 25 will be assigned to 15 hours of WT plus 5 hours of CRT each week (CRT+WT) and 25 will be assigned to an active control of 20 hours of WT. The active intervention will be for 13 weeks. CRT will be comprised of a repetitive training on a hierarchy of progressive visual and auditory exercise from Positscience. WT will involve paid work activity in a placement of their choosing on the medical center campus. Participants will be paid the same hourly rate (half federal minimum wage) for their time in CRT and WT. Comprehensive assessments will be performed at intake, 3 months and 6 months. These will include substance abuse, cognitive, and psychosocial outcomes as well as adherence to treatment. During the 3 months of active intervention participants will have weekly observed urine toxicology screens, breathalyzer tests and PDA assessments, as well as monthly work performance evaluations. Data analyses will include random effects regression models, as well as models of moderator and mediator effects on the primary outcome of PDA. If meaningful effects are found, these results will guide a subsequent R01 submission.

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment

Conditions

Substance Abuse

Intervention

Cognitive Training + Work Therapy, Work Therapy

Location

VA Connecticut Healthcare System
West Haven
Connecticut
United States
06516

Status

Completed

Source

Yale University

Results (where available)

View Results

Links

Published on BioPortfolio: 2015-02-09T19:23:23-0500

Clinical Trials [7127 Associated Clinical Trials listed on BioPortfolio]

Attention Training and Cognitive Therapy

The present study aimed to investigate the efficacy and process of change that occurs in Attention Training in comparison to an established treatment for social phobia, Cognitive Therapy. ...

Study Comparing Two Types of Psychotherapy for Treating Depression and Substance Abuse

The purpose of this study is to determine whether Integrated Cognitive Behavioral Therapy or Twelve Step Facilitation Therapy is most effective for treatment of dually diagnosed veterans w...

Working Memory Training in Adults With Substance Abuse and Executive Function Deficits.

The purpose of this study is to evaluate the effects of a computerized working memory training program on substance abuse, psychosocial functioning, cognitive performance and psychiatric ...

Modifying Group Therapy for Bipolar Substance Abusers - 1

The purpose of this study is to modify Integrated Group Therapy (IGT), which is has been found successful for patients with bipolar disorder (BD) and substance use disorder(SUD), so that i...

Cognitive Behavior Therapy and Work Outcome

This research studies the effects of Cognitive Behavior Therapy and Cognitive Remediation on work for persons with schizophrenia. Cognitive Behavior Therapy is a form of counseling that he...

PubMed Articles [28671 Associated PubMed Articles listed on BioPortfolio]

Evaluation of the Substance Abuse Research and Education Training (SARET) program: Stimulating health professional students to pursue careers in substance use research.

We developed and implemented the Substance Abuse Research Education and Training (SARET) program for medical, dental, nursing, and social work students to address the dearth of health professionals pu...

Baby Boomer's Substance Abuse and Researcher Indifference.

The current older adult population is more likely to need and seek treatment for alcohol and drug abuse than previous cohorts of older adults, which necessitates the need for age-appropriate substance...

Motivational Interviewing Training of Substance Use Treatment Professionals: A Systematic Review.

Through evaluations of training programs, systematic reviews, and meta-analyses, advances in identifying best practices for disseminating motivational interviewing (MI) have emerged. To advance this w...

Cognitive Therapy for Dementia Patients: A Systematic Review.

Cognitive therapy is a well-established intervention for treating elderly suffering from dementia. In particular, reality orientation and skills training seem to be effective interventions for reversi...

Quality of life of the work of physical therapy course teachers in Goiânia in the State of Goiás, Brazil.

The scope of this article is to analyze the quality of work life of the physical therapy course teachers in the city of Goiânia in the state of Goiás. It involved a cross-sectional study of 65 physi...

Medical and Biotech [MESH] Definitions

Health facilities providing therapy and/or rehabilitation for substance-dependent individuals. Methadone distribution centers are included.

Occupations of medical personnel who are not physicians, and are qualified by special training and, frequently, by licensure to work in supporting roles in the health care field. These occupations include, but are not limited to, medical technology, physical therapy, physician assistant, etc.

A direct form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior.

Preliminary cancer therapy (chemotherapy, radiation therapy, hormone/endocrine therapy, immunotherapy, hyperthermia, etc.) that precedes a necessary second modality of treatment.

Physiological or psychological effects of periods of work which may be fixed or flexible such as flexitime, work shifts, and rotating shifts.

More From BioPortfolio on "Cognitive Remediation and Work Therapy in the Initial Phase of Substance Abuse Treatment"

Advertisement
Quick Search
Advertisement
Advertisement

 

Relevant Topic

Hearing
Hearing, auditory perception, or audition is the ability to perceive sound by detecting vibrations, changes in the pressure of the surrounding medium through time, through an organ such as the ear. Sound may be heard through solid, liquid, or gaseous mat...


Searches Linking to this Trial