At St. Gregory Retreat Centers, the amount of information our clients have to learn can seem overwhelming—not necessarily because of the quantity of information, but because of something called neurocognitive impairment.
We understand that before we can focus on what you need to learn, we need to help you repair your ability to learn. When someone abuses substances and creates damage to the brain’s normal information pathways, deficits evolve in the ability to process information.
People who began abusing substances before their brain was fully developed tend not to have the normal processing skills that most of us learn simply by maturing and living our lives. These deficiencies often result in poor self-esteem, lack of motivation, and difficulty with normal life-skills—which of course can bring about erratic behaviors, including substance abuse and continued dependency.
The areas most affected by substance abuse damage are recent memory, problem solving, planning, executive skills, and visuospatial skills.
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Our program is one of only a few in the world that recognize this and take proactive steps to repair these deficiencies. The effects of neurocognitive impairment often lead to treatment professionals misdiagnosing their clients and mistaking their behaviors for noncompliance, lack of goal-directed behavior, and unwillingness to participate. At St. Gregory Retreat Centers, we work with our clients to rebuild and relearn these skills.
Neurocognitive Therapy is a crucial part of our program and our clients’ abilities to gain a solid understanding of the skills and tools they learn here. Through cognitive exercises focusing on memory skills, executive skills and visuospatial skills, our clients are more prepared to apply the tools they will learn in our program to their lives when they return home. After all, home is where the real change begins.
Why does this matter?
If you have been in other recovery programs, you more than likely have been diagnosed with mood/behavioral disorders while undergoing treatment and prescribed medications. Unfortunately, most programs’ perceptions of neurocognitively impaired patients are often less accurate than their perceptions of cognitively intact patients in other programs, and impairment is usually mistaken for motivational and behavioral problems characterized as a lack of goal-directed behavior, noncompliance, unwillingness to participate during groups, and inability to adhere to inpatient rules.
This can be extremely damaging to how people view themselves and can seriously affect the positions of their support network—all because the treatment program was unable to accurately understand the real issues. Families are often told their loved one is just socially insensitive and is uninterested in learning the skills necessary to success, despite patient statements to the contrary. A study was conducted examining clinicians’ abilities to accurately identify cognitive impairment based on information collected during the standard screening and evaluation process and found that, compared with patient performance on a neuropsychological battery, clinicians’ perceptions were usually just wrong!
The St. Gregory staff is dedicated to ensuring that each individual is properly tested and that specific needs are met appropriately.
Several studies suggest that more than 50 percent of substance-abusing patients may suffer from measurable cerebral dysfunction, or cognitive impairment (Butters & Cermak, 1980; Grant et al., 1978). With certain notable exceptions (e.g., Wernicke-Korsakoff Syndrome, alcohol-related dementia), cognitive impairment among clients in substance abuse treatment has been shown to have a period of recovery following abstinence. Conventional treatment, however, fails to address this issue and clients are often discharged from treatment before the individual has recovered the skills necessary to integrate what they have learned. Post-treatment functioning, including abstinence, would certainly be negatively affected by this treatment mismatch.
Relationship of neuropsychological deficits to recovery
One of the primary reasons neurocognitive impairment hinders treatment response is that most programs for substance abuse are verbally mediated (e.g., AA 12-Step, motivational interviewing, cognitive behavioral therapy) and require a great amount of cognitive processing and learning to facilitate change (Goldman, 1990).
A typical session in many programs may appear to have a simple and clear agenda; however, the patient is required to utilize a complex system of attention, memory, problem solving, and abstraction to implement the tools learned from the treatment (McCrady & Smith, 1986). Even in the best of most recovery programs, the neurocognitively impaired clients need to exercise both sustained and selective attention in a 45-minute verbal treatment session, retain information (often without the aid of written materials), and apply what is learned in the session to their life.
This is an immense task for neurocognitively impaired individuals, and thus cognitive impairment may be one of the factors contributing to the high recidivism rate in other programs.
Other than the St. Gregory Retreat Centers, treatment programs are not usually able to provide screenings for patients and instead rely on treatment perceptions, which as described above are often wrong. At St. Gregory Retreat Centers, we address neurocognitive impairments in specialized and adjunctive cognitive rehabilitation early in treatment so that patients may more fully profit from the cognitive treatment program.