About the program
The Alcohol and Drug Cognitive Enhancement (ACE) program has been in the making since 2010. It began as a single research project at WHOS Residential Rehabilitation with involvement from Advanced Neuropsychological Treatment Services (ANTS) and the University of Wollongong. This led to multiple research projects, involving hundreds of clients across government and non-government residential and non-residential alcohol and other drug (AOD) treatment services.
Since 2016, the ACE Program has been piloted and trialled at 10 sites with more than 500 people. During the trials, people who participated in cognitive remediation showed an increase in treatment completion rates (from 34% to 63%). Those who completed the full 12-session program had a large reduction in rates of cognitive impairment, from 53% before the program to 27% afterwards.
Approximately 50% of clients accessing alcohol and drug treatment have a degree of cognitive impairment, yet no standard cognitive remediation intervention for this group of people was available.
Executive dysfunction, a common form of cognitive impairment in people seeking alcohol or drug use treatment, affects someone’s ability to plan, organise, set goals, solve problems, make effective decisions and regulate emotions. These abilities are used when making positive behaviour changes, which is a primary focus of AOD treatment.
Although cognitive remediation has been shown to be effective at helping people with brain injury or psychiatric conditions improve their cognitive functioning, little research had examined its benefits in AOD treatment.
Our research has demonstrated that the effects of cognitive remediation in people seeking AOD treatment are at least as strong. As a result, we recommend identifying the risk of cognitive impairment when people enter into drug and alcohol services, and implementing a cognitive remediation intervention. This will help ensure people are supported to remain in and get the most benefit from their treatment.
Tool development and validation
Project recognition and awards
- Winner of the 2021 NSW Health Keeping People Healthy Award.
- Network of Alcohol and other Drug Agencies Research Award 2018 - Certificate of Commendation.
- Agency for Clinical Innovation Drug and Alcohol Network Innovation Forum 2016 - Project chosen for upscaling.
- Berry J, Jacomb I, Lunn J, et al. A stepped wedge cluster randomised trial of a cognitive remediation intervention in alcohol and other drug (AOD) residential treatment services. BMC Psychiatry. 2019;19(1):70. doi: 10.1186/s12888-019-2044-4.
- Berry J, Shores EA, Lunn J, et al. The Alcohol and Drug Cognitive Enhancement (ACE) Screening Tool: A simple and brief questionnaire to screen for cognitive impairment in substance use disorder treatment services. Appl Neuropsychol Adult. 2021:1-8. doi: 10.1080/23279095.2021.1888727.
- Berry J, Shores EA, Nardo T, et al. Brief executive-function assessment tool: A new cognitive impairment screening tool for alcohol and other drug services. Appl. Neuropsychol. Adult. 2021. doi: 10.1080/23279095.2021.1895791.
- Marceau E, Berry J, Lunn J, et al. Cognitive remediation improves executive functions, self-regulation and quality of life in residents of a substance use disorder therapeutic community. Drug Alcohol Depend. 2017;178:150-158. doi: 10.1016/j.drugalcdep.2017.04.023.
- arbias: Assistance for people with an acquired brain injury.
- Intellectual Disability Rights Service (IDRS): Legal advocacy for people with cognitive impairment.
- NSW Health Alcohol and other drugs information: Strategies, programs, warnings and information.
- Substance Abuse and Brain Injury (SUBI) Project: Information and resources related to substance use and brain injury (Canada).
- Synapse: Specialist services for people with a brain injury.
- Your Room: A place to get facts about alcohol and other drugs.