Performance-based Reinforcement to Enhance Cognitive Remediation Therapy

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

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

Conditions
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Substance-Related Disorders, Mental Disorders

Intervention / Treatment
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* Behavioral: Cognitive Remediation Therapy - Standard
* Behavioral: Cognitive Remediation Therapy plus Contingency Management


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: CRT-S<br>Cognitive Remediation Therapy - Standard | Behavioral: Cognitive Remediation Therapy - Standard<br>* Computerized cognitive remediation therapy provided three times per week for four weeks<br>|
| Experimental: CRT-CM<br>Cognitive Remediation Therapy plus Contingency Management | Behavioral: Cognitive Remediation Therapy plus Contingency Management<br>* Standard cognitive remediation therapy plus monetary incentives based on performance provided three times per week for four weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improvement in performance scores on computerized cognitive remediation tasks | Performance scores on various computerized cognitive remediation tasks will be measured repeatedly during the 4 week study. These scores include time to completion, number of errors, number of words correctly recalled, and percentage of task completed | 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improved cognitive function on neuropsychological tests | Change in cognitive function between baseline and post-treatment will be measured by performance on neuropsychological tests, such as Trail Making Test A & B, Wisconsin Card Sort Test, Digit Symbol Test from WAIS-IV, and the Continuous Performance Test-II (CPT-II). | 4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cognitive remediation therapy, substance abuse treatment