Performance-based Reinforcement to Enhance Cognitive Remediation Therapy

Pilot Study of Performance-based Reinforcement to Enhance Cognitive Remediation Therapy for Substance Users

The purpose of this study is to investigate whether monetary reinforcement for performance will enhance the effects of cognitive remediation therapy for substance users seeking treatment at an outpatient facility.

Forty individuals seeking treatment for an alcohol or cocaine use disorder at the Substance Abuse Treatment Unit (SATU) will be randomized to receive cognitive remediation therapy with or without additional compensation based on performance. Participants will use the computerized cognitive remediation program (PSSCogRehab 2012) three times per week for four weeks. The primary outcome measure will be an improved performance on the computerized tasks, with secondary outcomes of changes in cognitive functioning (e.g., attention, concentration, memory) as measured by neuropsychological tests between baseline and post-treatment.

Inclusion Criteria:

• 18 to 60 years old
• Primary Alcohol and/or Cocaine Abuse/Dependence Diagnosis
• Abstinence from all drugs/alcohol for 30 days
• Mild cognitive impairment
• Sufficiently stable and plan to commit to 4 weeks of outpatient treatment
• Fluent in English and 6th grade reading ability

Exclusion Criteria:

• Severe cognitive impairment indicative of dementia
• Untreated bipolar or psychotic disorder
• Have current legal case pending such that incarceration during 4-week study is likely