A new drug and alcohol program will help clinicians address the impact brain function has on a client’s ability to stay in and complete treatment.
Launched this month by the ACI’s Drug and Alcohol Network, the Alcohol and Drug Cognitive Enhancement (ACE) program provides the tools for clinicians to screen for, identify and respond to cognitive impairment in their clients.
Research shows that approximately 50% of clients seeking treatment for alcohol or other drug use have cognitive impairment1. This can make staying in and benefiting from treatment more challenging.
“The ACE program helps improve a client’s brain function, which helps people engage with and stay in treatment longer,” explains Associate Professor and Senior Staff Specialist Apo Demirkol, Co-chair of the ACI Drug and Alcohol Network. “This greatly improves the likelihood of alcohol and drug treatment success.”
“It was profoundly rewarding for staff and clients to witness the dramatic improvement in concentration, memory recall and calmness that clients in the program experienced.”
The ACE program contains three components:
- Screening and assessment – a two-step screening and assessment process (including validation papers) to screen for risk of, and then assess, cognitive impairment.
- Brief intervention – a fact sheet and strategies for clinicians to work with clients (delivered if the full cognitive remediation program is not possible or warranted).
- Cognitive remediation – the primary component of the ACE program, 12 group sessions are delivered by video, PowerPoint slides, and participant and facilitator manuals.
Training manuals and videos for clinicians delivering each component of the program are provided.
“The program is a collaboration between the ACI, Advanced Neuropsychological Treatment Services (ANTS), and We Help Ourselves (WHOS),” credits Associate Professor Demirkol. “The National Drug and Alcohol Research Centre (NDARC), University of Wollongong, Macquarie University and the University of Newcastle are also key partners.”
Developing the ACE program
The program is the first initiative from the ACI’s Drug and Alcohol Network. It was brought to the network in 2016 by WHOS, ANTS and Wollongong University, who had been developing the program since identifying a gap in alcohol and other drug treatment in relation to cognitive impairment in 2010.
The program was selected by clinicians and network members from a number of worthy projects to pursue and develop for wider use in the health sector.
It was piloted and trialled in partnership with ANTS, WHOS and Macquarie University at 10 sites in NSW, with more than 500 clients. The trial showed excellent results, with most of the sites now incorporating the program into their business-as-usual processes.
Through the trial, the cognitive remediation program component helped to:
- nearly halve the number of clients who had cognitive impairment, falling from 53% to 27%
- improve treatment completion, with a 28% increase in treatment retention rates.
Marion Pozniak, a counsellor at Jarrah House, participated in the trial and said the ACE program highlighted the challenges their clients faced and helped resolve them.
“The ACE program helped our service and clients by teaching us about the cognitive difficulties some clients were experiencing in their daily lives, due to substance use or traumatic brain injury,” says Ms Pozniak. “The program also gave us the language and tools to address these challenges during treatment.
“It was profoundly rewarding for staff and clients to witness the dramatic improvement in concentration, memory recall and calmness that clients in the program experienced.”
The ACE tools have been validated for use in both inpatient and outpatient treatment settings, and the cognitive remediation program has been shown to be effective in reducing cognitive impairment and improving treatment retention.
The full suite of ACE resources are now available for use by all alcohol and drug services and clinicians across NSW.
Network update
We’d like to sincerely thank Ms Olga Christine who recently stepped down from the Drug and Alcohol Network Executive Committee to take on a new role outside of NSW Health. Olga’s dedication and commitment to the network and the ACE program has been exceptional and we wish her every success in her new role.
- Copersino ML, Fals-Stewart W, Fitzmaurice GS, et al. Rapid cognitive screening of patients with substance use disorders. Exp Clin Psychopharmacol. 2009 Oct;17(5):337-44. doi: 10.1037/a0017260