Motivational Interviewing for Hoarding Disorder
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Mississippi State University
Must not be taking: Psychotropics
Disqualifiers: Cognitive impairment, Psychosis, Drug use, others
No Placebo Group
Trial Summary
What is the purpose of this trial?This trial is testing two methods to help older adults with hoarding disorder. One method combines motivational talks with sorting practice, while the other uses sorting practice alone. The goal is to see if motivational talks can make people more willing to clean up their homes.
Do I need to stop my current medications to join the trial?
The trial does not specify if you need to stop your current medications, but you must not have changed your psychotropic medications (medications affecting mood, perception, or behavior) in the past three months.
What data supports the effectiveness of the treatment RECLAIM: Reducing Clutter and Increasing Meaning for hoarding disorder?
Research shows that cognitive-behavioral therapy (CBT) methods, including motivational interviewing and skills training, are effective for hoarding disorder. A study found that adding in-home uncluttering sessions to a structured group therapy improved hoarding symptoms and reduced clutter, suggesting that similar approaches in RECLAIM could be beneficial.
12345How is the treatment RECLAIM for hoarding disorder different from other treatments?
RECLAIM is unique because it incorporates motivational interviewing, a technique that helps individuals find their own reasons to change by resolving mixed feelings about decluttering. This approach is client-centered and focuses on enhancing the person's readiness to change, which is different from more directive or prescriptive treatments.
678910Eligibility Criteria
This trial is for older adults aged 60 and above who have been diagnosed with hoarding disorder. Participants must live within a 60-minute drive of Starkville, MS. They should not be in another hoarding-focused therapy, have major cognitive issues, active psychosis or drug problems, or recent changes in their psychotropic medications.Inclusion Criteria
Live within a 60-minute driving radius of Starkville, MS
I have been diagnosed with hoarding disorder.
I am 60 years old or older.
Exclusion Criteria
Major cognitive impairment
Active psychosis, drug use, or acute suicidal ideation
I have not changed my mental health medications in the last 3 months.
+1 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive a four-month intervention combining motivational interviewing with sorting practice or sorting practice alone
16 weeks
Weekly sessions
Follow-up
Participants are monitored for safety and effectiveness after treatment
4 weeks
Participant Groups
The study is comparing two behavioral treatments designed to help with hoarding disorder: 'RECLAIM' which aims to reduce clutter and increase life meaning, and 'Sorting Practice' that focuses on organizing items. The goal is to see which method works better for these individuals.
2Treatment groups
Experimental Treatment
Active Control
Group I: RECLAIM: Reducing Clutter and Increasing MeaningExperimental Treatment1 Intervention
Participants will receive a combination of motivational interviewing and sorting practice to reduce hoarding symptoms.
Group II: Sorting PracticeActive Control1 Intervention
Participants will receive sorting practice only to reduce hoarding symptoms.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Mississippi State UniversityStarkville, MS
Loading ...
Who Is Running the Clinical Trial?
Mississippi State UniversityLead Sponsor
National Institute of Mental Health (NIMH)Collaborator
References
Augmenting Buried in Treasures with in-home uncluttering practice: Pilot study in hoarding disorder. [2020]Hoarding disorder is characterized by difficulty parting with possessions and by clutter that impairs the functionality of living spaces. Cognitive behavioral therapy conducted by a therapist (individual or in a group) for hoarding symptoms has shown promise. For those who cannot afford or access the services of a therapist, one alternative is an evidence-based, highly structured, short-term, skills-based group using CBT principles but led by non-professional facilitators (the Buried in Treasures [BIT] Workshop). BIT has achieved improvement rates similar to those of psychologist-led CBT. Regardless of modality, however, clinically relevant symptoms remain after treatment, and new approaches to augment existing treatments are needed. Based on two recent studies - one reporting that personalized care and accountability made treatments more acceptable to individuals with hoarding disorder and another reporting that greater number of home sessions were associated with better clinical outcomes, we tested the feasibility and effectiveness of adding personalized, in-home uncluttering sessions to the final weeks of BIT. Participants (n = 5) had 15 sessions of BIT and up to 20 hours of in-home uncluttering. Reductions in hoarding symptoms, clutter, and impairment of daily activities were observed. Treatment response rate was comparable to rates in other BIT studies, with continued improvement in clutter level after in-home uncluttering sessions. This small study suggests that adding in-home uncluttering sessions to BIT is feasible and effective.
A brief interview for assessing compulsive hoarding: the Hoarding Rating Scale-Interview. [2022]This article describes the development and validation of the Hoarding Rating Scale-Interview (HRS-I), a brief (5-10 min) five-item semi-structured interview that assesses the features of compulsive hoarding (clutter, difficulty discarding, acquisition, distress and impairment). Trained interviewers administered the HRS-I to 136 adults (73 compulsive hoarding, 19 OCD, 44 non-clinical controls) along with a battery of self-report measures. An initial assessment was conducted in the clinic, and a second assessment was conducted in participants' homes. The HRS-I showed high internal consistency and reliability across time and context. The HRS-I clearly differentiated hoarding and non-hoarding participants, and was strongly associated with other measures of hoarding. It is concluded that the HRS-I is a promising measure for determining the presence and severity of compulsive hoarding.
Cognitive-behavioral therapy for hoarding in the context of contamination fears. [2018]Difficulty discarding and excessive acquiring can be treated using specialized cognitive-behavioral treatment that includes motivational interviewing, skills training, practice sorting and discarding, and cognitive restructuring. Early psychotherapy efforts to treat hoarding have proved less effective than this combination of methods targeted at the characteristic features of hoarding. Treatment strategies are illustrated through a case example of a woman struggling with both hoarding and contamination concerns.
Teaching socially appropriate behavior to eliminate hoarding in a brain injured adult. [2019]A brain injured male hoarded large quantities of unuseable items at every opportunity. The treatment consisted of two phases. First, he was taught to collect baseball cards. Second, after each meal, the client was provided with an apron and a glove and asked to pick up trash in the area and deposit the trash in an appropriate receptacle. If he hoarded, he was told not to pick up trash without his apron and glove and escorted to a quiet area for about 10 seconds. The procedure was successful in suppressing the behavior within 8 days.
Implementation and evaluation of a community-based treatment for late-life hoarding. [2022]The objective of this paper was to examine the implementation and effectiveness of a community-based intervention for hoarding disorder (HD) using Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST).
Motivational interviewing. [2022]Motivational interviewing (MI) is a client-centered, directive therapeutic style to enhance readiness for change by helping clients explore and resolve ambivalence. An evolution of Rogers's person-centered counseling approach, MI elicits the client's own motivations for change. The rapidly growing evidence base for MI is summarized in a new meta-analysis of 72 clinical trials spanning a range of target problems. The average short-term between-group effect size of MI was 0.77, decreasing to 0.30 at follow-ups to one year. Observed effect sizes of MI were larger with ethnic minority populations, and when the practice of MI was not manual-guided. The highly variable effectiveness of MI across providers, populations, target problems, and settings suggests a need to understand and specify how MI exerts its effects. Progress toward a theory of MI is described, as is research on how clinicians develop proficiency in this method.
Introduction to the special series on motivational interviewing and psychotherapy. [2009]Clinical and research applications of motivational interviewing (MI) have grown at a remarkable pace over the past 25 years. Most of this work has targeted the addictions and health-related behaviors. The series of articles in this issue highlight a rapidly accelerating recent trend: the application of MI to other problems typically seen in clinical practice. This introductory article describes MI, its core principles, treatment methods, and the variety of ways in which it has been employed. The 6 case reports in this issue are then described. They illustrate how MI can be employed with generalized anxiety, adolescent depression, lifestyle changes, social anxiety disorder, suicidality, and intimate partner violence. The series of articles in this issue concludes with a commentary on the cases and a practice-friendly review of outcome research on MI.
Client experiences of motivational interviewing: An interpersonal process recall study. [2016]To explore clients' experience of the therapy process in motivational interviewing (MI) for alcohol abuse.
The Psychiatrist's Guide to Motivational Interviewing. [2021]Motivational interviewing (MI) is a technique that can be used to inspire patients who have virtually any level of enthusiasm for change, from almost none to nearly enough, to move toward improvements that can make their life better. The driving goal in MI is to move the patient from a position of complacency to one of more ambivalence about their particular version of toxic habit and then on to a personal desire for change. The approach of MI is one of collaboration in which the psychiatrist seeks to evoke the patient's own recognition of the desirability of change. The technique of the decisional balance sheet to lay out both sides of a patient's ambivalence will be exemplified, using alcohol dependence as one example. The stages of treatment are discussed, with associated interventions that reflect the patients' locations in their journeys toward change.
The use of motivational interviewing in eating disorders: a systematic review. [2022]This review examines the effectiveness of interventions that include the principles and techniques of motivational interviewing (MI) and its adaptations in the treatment of eating disorders. The aims are (1) to examine both the context and effectiveness of MI and Motivational Enhancement Therapy (MET) when used with either patients or carers of people with eating disorders, (2) to identify limitations and/or difficulties in this process and (3) to identify further research needs in this area. Electronic databases were searched up until April 2012. Articles were screened according to predetermined inclusion and exclusion criteria. Thirteen studies were finally selected for inclusion. A wide range of participants, interventions and outcomes were measured which made comparative analysis difficult. Promising results were found for interventions that included MI, particularly with regards to its use in increasing a readiness and motivation to change. Consequently, there is potential for using MI in the field of eating disorders, particularly with respect to 'readiness for change'. More homogeneity in study design and delivery of MI is needed along with some markers of treatment fidelity, including information as to how adherence to the intervention is assured.