Data were collected from intake interviews, a neuropsychological test battery, the Staff Rating Scale, and admission and discharge information obtained from clinical charts. The findings showed that residents with neuropsychological deficits tended to be older, to have more extensive drug use histories, to be viewed less favorably by staff members, to be removed from the program more often for failure to obey rules, and to stay in residence fewer days than their counterparts. The researcher noted that program rules are presented during the earliest phase of treatment, even though cognitive functioning is lowest during the first few weeks of drug abstinence. These cognitive impairments, induced by abuse of psychoactive substances, include decreased speed and efficiency of information processing, distractibility, and difficulty with problem solving. These initial problems may make it difficult for clinicians to establish an effective therapeutic relationship with cognitively impaired residents. Recognizing their functional restrictions could change the general approach to case management of these individuals. Outcome rates could also be improved through a cognitive processing remediation program. 1 table, 1 figure, and 49 references