Cognitive training and remediation: How to apply evidence and expert endorsed interventions in clinical practice

Background: People with substance use disorders have cognitive and emotion regulation deficits that are meaningfully and consistently associated with poor prognosis but are not directly targeted by current mainstream treatments. 

Methods: We assembled an international expert committee and used a Delphi approach to (1) identify psychological and neuroscience-informed cognitive training and remediation interventions with potential to improve the outcomes of addiction treatment; (2) envisage pathways and potential barriers for clinical translation and implementation of the expert-endorsed interventions.  

Results: The experts (1) identified four cognitive training and remediation interventions capable of improving treatment outcomes, namely: cognitive bias modification, contingency management, cognitive remediation and emotion regulation training (Verdejo-Garcia, Garland, Wiers et al., Addiction, 2023); (2) established a knowledge-to-action gap by which these interventions are not routinely applied in clinical services due to limited opportunities for workforce training (Verdejo-Garcia, Garland, Wiers et al., World Psychiatry, 2024). Based on these findings, this workshop aims to train and upskill addiction researchers, clinicians, service providers and peer workers with the basic skills needed to co-produce, implement, and evaluate these novel intervention approaches, learning from the first-hand experience of their developers and ambassadors in the field (Wiers, Garcia-Fernandez, Garland, Verdejo-Garcia).

Conclusion: This workshop will address the unmet need of providing training opportunities for the addiction treatment workforce to learn about and apply cognitive training and remediation interventions in clinical settings. Individual talks will provide a practical guide to incorporating cognitive bias modification, contingency management, emotion regulation training and cognitive remediation into clinical practice. The expected outcome is to increase knowledge, skills, and perceived self-competence among participants from a broad workforce audience about the feasibility, practical steps for implementation, and potential benefits of incorporating these innovative interventions in day-to-day practice.

References

Verdejo-Garcia A, Rezapour T, …, Garland EL, …, Wiers R, et al. Cognitive training and remediation interventions for substance use disorders: a Delphi consensus study. Addiction. 2023; 118(5): 935-951. doi: 10.1111/add.16109.

Verdejo-Garcia A, Berry J, …, Garland EL, …, Wiers R, et al. Clinical translation of expert-endorsed cognitive rehabilitation interventions for substance use disorders. World Psychiatry 2024; 23(2): in press.