Part II – Importance of cognitive assessment and remediation in treatment and recovery from alcoholism
Despite the prevalence and seriousness of cognitive impairment in alcoholism, together with the fact that it can be reversed, cognitive assessment and remediation is not always included in treatment programs for alcoholism. Not only should cognitive impairment in alcoholism be addressed because it is a common and serious adverse affect of the condition, but also to ensure holistic recovery from alcoholism, a good quality of life and relapse prevention.
Impaired cognitive functioning can prevent complete recovery of the patient and negatively impact on their quality of life. An individual, who has undergone treatment for alcoholism but continues to suffer from its negative affects on cognition, might have difficulty holding a job or even with day to day functioning. Impaired memory, executive functioning – decision making, problem solving, concept shifting, etc. are bound to impact the individual’s life – social and occupational. Restoring the individual’s functioning and quality of life is an important goal of any treatment program. Neglecting cognitive deficits would hinder complete recovery of the individual.
Another reason why it is important to address brain damage and cognitive impairment is because it has been implicated as a contributing factor in the progression of alcoholism, as well as in the effectiveness of the treatment program. If brain damage contributes to the progression of alcoholism and goes untreated, it would only increases the chances of relapse.
Lastly, cognitive impairment might impact the effectiveness of the overall treatment program itself, especially in the early stages. Impaired cognitive functioning may make treatment, especially the educational and skill development components, ineffective during the initial few weeks of abstinence. Patients may have difficulty comprehending what is being taught, or recalling what has been taught later.
Identifying the levels of cognitive impairment before beginning treatment, as well as addressing impairment during treatment, could make the treatment program more effective. For instance if it is established that cognitive function is so severely impaired that the individual may be unable to comprehend or capitalize on what is being done at the start of the treatment process, then the more complex components of the program can be scheduled for later, when the patient’s cognitive functioning is improved. Alternatively, in patients with less severe cognitive functioning, certain components of the treatment program – e.g. educational – might be repeated towards the end of the program.
Assessing and treating cognitive deficits can maximize the effectiveness of treatment and recovery from alcoholism.