Cognitive Rehabilitation and Exposure Therapy for Hoarding Disorder
(CREST Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores new methods to assist individuals with hoarding disorder, a condition that makes discarding items difficult and can lead to significant life challenges. It evaluates two treatments: Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST), which teaches skills to enhance memory and problem-solving, and Case Management, which helps manage the stress of discarding items. Adults aged 50 and older with hoarding disorder who have been stable on their medications for at least eight weeks may be suitable candidates. The trial aims to determine the effectiveness of these treatments in reducing symptoms and improving daily life. As an unphased trial, it provides a unique opportunity to investigate innovative treatments that could greatly enhance quality of life.
Will I have to stop taking my current medications?
The trial requires that participants have been stable on their medications for at least 8 weeks, so you should not need to stop taking your current medications unless you are using benzodiazepines, which are not allowed.
Is there any evidence suggesting that this trial's treatments are likely to be safe?
Research has shown that Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) has been tested for its effects on hoarding disorder. One study demonstrated a significant reduction in hoarding symptoms, indicating substantial improvement for participants. Another study found that individuals using CREST improved by 36% in hoarding-related issues, compared to a 13% improvement in those receiving standard care.
Overall, CREST appears to be safe and effective. These studies reported no serious side effects, suggesting that CREST might be a safe option for reducing hoarding symptoms.12345Why are researchers excited about this trial?
Researchers are excited about CREST, or Cognitive Rehabilitation and Exposure/Sorting Therapy, because it combines cognitive training with exposure therapy to tackle hoarding disorder in a novel way. Unlike traditional treatments that might focus solely on behavioral interventions, CREST addresses cognitive impairments like memory and problem-solving skills, which are common in people with hoarding disorder. Furthermore, the exposure therapy component directly targets the distress associated with discarding and acquiring items by using real-life, in-home exercises. This dual approach not only aims to reduce clutter but also enhances cognitive flexibility, making it a promising alternative to existing options.
What evidence suggests that this trial's treatments could be effective for hoarding disorder?
Research shows that Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST), one of the treatments in this trial, significantly reduces hoarding disorder symptoms. In a study with older adults, participants experienced a substantial drop in hoarding severity after receiving this treatment. CREST also improved performance in tasks requiring focus-switching, outperforming other methods. This trial will compare CREST with Case Management (CM), another treatment option. Studies have found CREST more effective than CM for older adults, although both treatments offer benefits. Overall, CREST effectively reduces hoarding behaviors and enhances related cognitive skills.13467
Who Is on the Research Team?
Catherine Ayers, PhD
Principal Investigator
University of California, San Diego
Are You a Good Fit for This Trial?
This trial is for adults aged 50 or older who have been diagnosed with Hoarding Disorder (HD) as their primary condition and are stable on medications. They must understand and agree to participate voluntarily. People with current psychosis, substance use disorders, benzodiazepine use, suicidality, neurodegenerative diseases, or those already in exposure therapy cannot join.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) with 26 weekly sessions over 32 weeks
Mid-treatment Evaluation
Evaluation of treatment outcome, including hoarding severity and functional outcomes
End of Treatment Evaluation
Final evaluation of treatment outcome, including hoarding severity and functional outcomes
Follow-up
Participants are monitored for safety and effectiveness after treatment
What Are the Treatments Tested in This Trial?
Interventions
- Case Management
- Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST)
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of California, San Diego
Lead Sponsor