Cognitive concerns and support needs among alcohol and other drug treatment clients

Purpose Cognitive impairment is common among people accessing alcohol and other drug (AOD) treatment and can adversely affect engagement and outcomes. However, little is known about clients’ subjective cognitive concerns. The purspose of this study was to examine AOD clients’ interest in cognitive training (practice-based activities targeting attention, memory and executive functions), or preferred intervention formats. Design/methodology/approach An anonymous cross-sectional survey was conducted with 163 clients from four public AOD services in New South Wales, Australia (December 2021–July 2023). Participants reported demographics, cognitive concerns, interest in cognitive training, preferred delivery modes and digital access and literacy. Analyses included descriptive statistics, chi-square and Fisher’s exact tests and non-parametric comparisons with post hoc corrections. Findings Most participants reported concerns about memory (76.7%) and thinking clearly (64.5%). Interest in cognitive training was high (96.9%), particularly among those seeking treatment for alcohol (86.4%) and opioid use (52.6%). Participants preferred cognitive training delivered individually, in weekly sessions of about 1 h. Smartphone access was high (89.9%) and smartphone literacy was moderate-to-high (76.6%). Computer access (41.1%) and literacy (50%) were more limited, especially among older clients and those seeking treatment for opioid use. Originality/value A one-size-fits-all approach to cognitive remediation is unlikely to meet client needs. Tailored interventions that combine individual support with digital and low-tech options, and that reflect client preferences and circumstances, may enhance engagement and accessibility in AOD services. Results offer practical guidance for clinicians and services aiming to integrate cognitive remediation into routine care.