At Enterhealth, our advanced assessment protocols include neuropsychological testing. This evaluation is beneficial for individuals who have difficulties with cognitive abilities resulting from substance abuse or medical conditions like head injury, stroke, cirrhosis of the liver, attention deficit disorder/hyperactivity disorder (ADD/HD) and depression.
A neuropsychological assessment includes testing for:
- Learning ability
- Intellectual ability
- Academic abilities
- Psychomotor speed
- Information processing speed
- Attention and concentration
- Language and verbal skills
- Executive functioning
- Visuospatial skills
- Sensory ability
Tests in these areas are important because almost half of individuals with an alcohol use disorder have detectable cognitive or motor impairments and two-thirds of patients in rehabilitation for Traumatic Brain Injury (TBI) or Substance Use Disorder (SUD) have a history of both TBI and substance misuse.
Impairments are generally mild to moderate and are a specific pattern of deficit rather than simply associated with general decline in all cognitive domains. One area most consistently affected is executive functioning which corresponds to problem solving, response inhibition, decision making, abstraction, working memory, psychomotor and processing speed. These deficits can lead to inability to inhibit inappropriate behaviors, make sound decisions or handle planning and organizing tasks. The level of executive dysfunction has been associated with increased incidence of relapse and even with extended sobriety, individuals who suffer from SUD commonly show a pattern of executive dysfunction.
The goal of neuropsychological testing is to evaluate the cognitive functioning of the individual and identify areas where tools and treatment can be used to enhance underperforming areas that can affect both work performance and interpersonal relationships. The relevant clinical findings from these evaluations are incorporated into the patient’s individualized treatment plan so they can be addressed and implemented while in inpatient and outpatient therapy.
For instance, the following therapies are associated with positive outcomes for patients suffering from cognitive deficiency caused by SUD:
Cognitive Behavioral Therapy (CBT) - Understand connection between thoughts, emotions and use of drugs and alcohol
Motivational Interviewing (MI) - Resolve ambivalence about stopping drug and alcohol use and taking part in treatment (i.e., explore the cost/benefits of quitting) by eliciting motivation without imposing it from the outside
12-Step Facilitation Therapy (TSF) - Linking patients with current 12-step members and helping them overcome the barriers and challenges that they face.
Contingency Management - Encourage positive behavior by providing incentives for abstinence, attending counseling sessions, and meeting goals.
Behavioral Couples and Family Therapies - Work on better communication, problem solving, and finding activities that don’t involve substance use
As examples of how the neuropsychological evaluations can be used, if a patient is found to have ADD/HD, time of engagement per session will be a big factor in approaching therapeutic recommendations; 30-minute sessions might be more effective than hour long sessions of any of these modalities. If a patient is found to have an auditory processing disorder, means of working toward therapeutic goals will be more written-based since retention from lectures will not be as effective.
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