Patients diagnosed with substance abuse and comorbid psychiatric disorders (dual disorders), typically have poor treatment outcomes. The primary goal of this K23 application is to provide additional research training for the PI who, as a clinical psychologist, has used various therapeutic interventions with dual disordered patients, and whose clinical experiences have led to the development of a promising technique to improve treatment adherence. One key component of the motivational interviewing procedures is the use of personalized feedback, but early informal clinical observations by the candidate suggested that dual disordered patients who were provided feedback were more likely to attend group therapy, than those without such feedback. These informal observations led to the development of a """"""""Neuropsychological Assessment Feedback Intervention"""""""" which included very concrete examples of patients' cognitive strengths and weaknesses, and encouraged discussion of how their substance use and psychiatric disorder might have affected their neuropsychological test performance. Results from a small-scale feasibility study have provided more systematic evidence that neuropsychological assessment feedback can improve treatment adherence.
The aims of this application include the following: (1) refine a theoretically based Neuropsychological Assessment Feedback Intervention with depressed cocaine addicted patients; (2) test the hypothesis that this intervention will lead to higher rates of attendance in partial hospital treatment, and will be associated with decreased substance use and psychiatric symptoms, as compared to """"""""treatment as usual"""""""" with no neuropsychological feedback. Mentors and consultants will provide the candidate with additional research training to prepare him to ultimately conduct large-scale behavioral treatment intervention clinical trials.