Developing practical tools for identifying and supporting treatment-relevant cognitive dys/functions

Background: While there are effective treatment interventions for substance use disorders, there is substantial scope for enhancing client outcomes. Cognition is understood as a factor that can contribute to key outcomes in substance use treatment. The National Institute on Drug Abuse has summarised much of its work on cognitive factors into the ‘Addictions Neuroclinical Assessment’ framework, which describes negative emotionality, incentive salience and executive function as the essential cognitive functions associated with client’s treatment outcomes. However, there is a substantial gap between these theoretical neuroscience-based frameworks and what can be practically implemented in treatment services. This is because these cognitive domains are broadly defined and often require excessive time, specialist skills and expensive equipment to assess. Description of Model of Care/Intervention: We have conducted systematic reviews on how these cognitive domains are defined and evaluated. In collaboration with experts working in D&A treatment services in Australia, we have developed a simple, brief, and open-access battery to assess the core cognitive domains: attentional bias, distress tolerance and inhibition, which we will demonstrate. Conclusion and Next Steps: Current and future steps include working with clinicians and people with lived experience of substance use to develop appropriate automated feedback for this battery. It will be personalised based on individuals' obtained scores and will include practical interventional approaches that can enhance people’s skills in these targeted cognitive domains. After testing its acceptability, this package might complement existing approaches to substance use treatment to help improve outcomes.