During a recently taped video conversation between Dr. Judy Ho and Dr. Tonmoy Sharma, CEO Sovereign Health Group the topic of cognitive function and how it affects substance use disorders and mental illnesses was discussed. Dr. Sharma kicked off by first sharing that cognitive functioning is important because it is the basic brain function that allows us to think. These are functions such as memory, attention, reasoning and problem solving that we use every day to navigate through life. You learn a skill, it becomes cognitive, you transfer it to an automated system and it becomes procedural learning and then it gives you the capacity to learn new things. Cognition allows us to navigate through life on a day-to-day basis and we use these skills almost unconsciously. You have new information that comes to you, you pay attention to it, you are able to absorb that information, you decide sometimes to keep that information and decide what is important. Now there are sometimes you are not able to keep that information this is because your brain function has decreased perhaps due to illness or other circumstances such as substance abuse. Dr. Sharma shared that in the addiction field we are assessing attention, memory, reasoning and problem solving, motor function movements for example and working memory which is very short-term memory keeping information online for a very short period of time. It is like the ram in your computer or for those of us that are old enough to remember what yellow pages were. Cognitive impairment impacts response to treatment in a number of ways. For instance if judgment is impaired they are not able to look at what is wrong with them. But here is a basic issue that I think people don’t grasp, continued Dr. Tonmoy Sharma. Often addiction facilities are asked what sort of treatments are used. And the answer might be cognitive behavioral therapy (CBT). And what is CBT, it’s a process group. And what are process groups? It is somebody sitting down and absorbing information from someone else and making sense of that information and utilizing that information so that they can change behavior. However, if they’re not able to absorb information, make sense of that information and utilize that information then they’re really just a piece of the furniture in that room. Someone with cognitive impairments is not able to do anything in effect the process group is useless. The person seeking treatment is left to wonder, why am I in that process group if I cannot process information? Dr. Sharma believes that one of the biggest problems right across the U.S. is that we are putting people in process groups that cannot process information. First let’s improve their processing and then put them in a process group. It seems like it is so simple yet it is not happening. For many decades neuropsychologists and physicians have had the tools to assess brain functioning this is not brand new yet it is a revelation. Dr. Sharma concluded the discussion by asserting that the substance abuse treatment community should start assessment tools in a systematic way. Then the data can be analyzed and interpreted to inform treatment. Yet the community is stuck in a mindset and the unwillingness to change. The take-away is this, the patients don’t need to change, it is the providers that need to change their methods of assessment and establish measurement based assessment and standards of care.

For more detailed information on Dr. Tonmoy Sharma, CEO of Sovereign Health Group go to LinkedIn https://www.linkedin.com/in/tonmoysharmaceo

Dr Judy Ho, Ph. D., ABPP is a licensed and board certified Clinical Psychologist based in Los Angeles. She lends her psychology expertise as a panelist on a variety of national television shows and provides professional services in Psychological Testing and Forensic Expert work. She is a tenured professor of psychology at Pepperdine University.