Feasibility and Efficacy of a Cognitive-Behavioral Based Intervention for Relapse Prevention in Patients with Mild to Moderate Alcohol-Related Cognitive Disorders: a Pilot Study

Gwenny Janssen, Vincent van Gogh, Venray, Netherlands
Roy Kessels, Vincent van Gogh, Venray, Netherlands


Cognitive disorders are highly prevalent in people with chronic alcohol misuse: prevalence estimates vary between 50 % and 80 %. Impairments are an important source of individual difference affecting many aspects of treatment. A patients inability to receive, encode, integrate, and employ information related to reducing the likelihood and severity of relapse may complicate long term abstinence and full recovery of alcohol addiction. In this pilot study we aim to explore the feasibility and efficacy of a newly developed cognitive-behavioral based treatment intervention for relapse prevention, designed to be inclusive of patients with mild to moderate alcohol related cognitive disorders.

Participants and Methods:

In order to gain first evidence for the efficacy of the Relapse Prevention for Alcohol-related Cognitive Disorders (RP-ACD) a one group pretest-posttest design was used. RP-ACD aims to promote and increase appropriate coping skills, enhance self-efficacy in achieving alcohol abstinence and reduce craving. Sessions involve psycho-education, copings skills training and identifying and avoiding high risk situations. Adjustments to account for neurocognitive impairments include techniques that aid information processing skills and environmental adaptation. A total of 28 participants participated in this study (21 men; age M = 56.3; SD = 9.45). All patients completed 12 x one hour group sessions over six weeks. Participants were recruited from the Centre of Excellence  for Korsakoff and Alcohol-Related Cognitive Disorders, diagnosed in accordance with DSM-5-TR criteria and were at least six weeks abstinent from alcohol prior to the start of the intervention. Primary outcomes measures included self-efficacy (measured with the Alcohol Abstinence Self-Efficacy- 12 items: AASE-12), craving (assessed with Bohn’s Alcohol Urge Questionnaire ; AUQ) and perceived social support (as measured with the Social Support Questionnaire- Short Form; SSQ6). Data were analyzed using t-tests for dependent samples and feasibility was assessed based on an in-house developed short evaluation questionnaire.


Results showed a significant improvement between baseline (M= 29.0, SD=10.3) and post intervention (M =23.2, SD= 9.3) scores on AASE-12 (t (26) =4.03; p <.001) suggesting an increase in participant’s confidence in abstaining from drinking and resisting the temptation of using alcohol. Although there was a general trend towards a decrease in the level of alcohol craving (AUQ) between baseline (M = 15.2; SD = 1.5) and post intervention (M = 12.3; SD = 1.2) scores, results did not reach significance. The degree of perceived social support (SSQ6) remained almost the same (baseline M = 10.8 ; SD = 3.7 ; post intervention M = 9.6 ; SD = 3.7). The feasibility of the intervention was evaluated positively.


Our pre-post pilot study provided first evidence for the efficacy of the RP-ACD intervention. After the intervention, higher levels of self-efficacy were found. Although drinking urges did decline, results did not reach significance. Participants rated the intervention and materials highly. These first results suggest that the RP-ACD intervention stands as a potentially effective group-based treatment to prevent relapse in alcohol use for patient with mild to moderate alcohol-related cognitive disorders. A randomized controlled study is required next to establish the efficacy and effectiveness of the RP-ACD. 

Category: Drug/Toxin-Related Disorders (including Alcohol)

Keyword 1: alcohol
Keyword 2: mild cognitive impairment
Keyword 3: Korsakoff's syndrome/Wernicke’s encephalopathy