In-Home Sorting and Decluttering for Hoarding Disorder

(BITS Trial)

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Must not be taking: Psychotropic medication

Disqualifiers: Bipolar, Psychotic, Eating disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

60 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, if you are a healthy control, you cannot have a history of using psychotropic medication.

What data supports the effectiveness of the treatment Buried in Treasures Workshop (BIT) for hoarding disorder?

Research shows that the Buried in Treasures Workshop (BIT), a structured group program using cognitive-behavioral therapy principles, has been effective in reducing hoarding symptoms. Studies indicate that BIT achieves similar improvement rates to therapist-led cognitive-behavioral therapy, and adding in-home uncluttering sessions can further enhance its effectiveness. ^{1 2 3 4 5}

Is the Buried in Treasures Workshop safe for humans?

The Buried in Treasures Workshop (BIT) has been used in studies for hoarding disorder and has shown improvements in symptoms without reported safety concerns, suggesting it is generally safe for humans. ^{1 2 3 6 7}

How is the Buried in Treasures Workshop treatment different from other treatments for hoarding disorder?

The Buried in Treasures Workshop is unique because it is a structured support group that uses cognitive-behavioral therapy principles but is led by non-professional facilitators, making it more accessible and affordable than traditional therapy. It also includes in-home uncluttering sessions, which have shown to further reduce hoarding symptoms and improve living conditions. ^{1 2 3 4 7}

What is the purpose of this trial?

The proposed study aims to investigate the efficacy of adding in-home decluttering practice to Buried in Treasures Workshop (BIT) facilitated group treatment for hoarding disorder.

Research Team

Carolyn Rodriguez, MD, PhD

Principal Investigator

Stanford University

Eligibility Criteria

This trial is for physically healthy adults aged 18 to 70 with Hoarding Disorder as their primary condition. Participants must understand and complete consent and study procedures, speak English, and can be of any gender or ethno-racial group.

Inclusion Criteria

Individuals with Hoarding Disorder: Willing and able to understand and complete consent and study procedures

I am a healthy individual from any gender or ethnic background.

Individuals with Hoarding Disorder: Hoarding Disorder primary condition

Exclusion Criteria

Healthy Controls: Metal in body or any other contraindication for MRI

I do not have major health or brain conditions that would stop me from completing tasks.

I do not have major health issues like unstable high blood pressure, seizures, or serious head injuries.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Immediate Treatment

Facilitated group therapy with behavioral practice for hoarding disorder

18 weeks

Delayed Treatment

Facilitated group therapy with behavioral practice for hoarding disorder after a delay

18 weeks (after a 18-20 week delay)

Follow-up

Participants are monitored for changes in hoarding symptoms and clutter levels after treatment

16 weeks

Treatment Details

Interventions

• Buried in Treasures Workshop (BIT)

Trial Overview The study tests if adding personalized in-home sorting and decluttering practice improves the effectiveness of a facilitated group therapy program called Buried in Treasures Workshop (BIT) over an 18-week period.

Participant Groups

Group I: Immediate Treatment Experimental Treatment 1 Intervention

Facilitated group therapy with behavioral practice; 18 weeks

Group II: Delayed Treatment Experimental Treatment 1 Intervention

Facilitated group therapy with behavioral practice; 18 weeks (after a 18-20 week delay)

Group III: Healthy Control Active Control 1 Intervention

This group is matched to the immediate treatment group on age and gender. They do not receive an active treatment.

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Findings from Research

Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) was found to be more effective than geriatric case management (CM) in reducing hoarding symptoms among older adults, with a 38% decrease in symptoms for CREST participants compared to a 25% decrease for CM participants.

Both treatments showed lasting benefits, as improvements were maintained at a 6-month follow-up, indicating that while CREST is more efficacious, CM also provides meaningful support for individuals with hoarding disorder.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) for Hoarding Disorder in Older Adults: A Randomized Clinical Trial. Ayers, CR., Dozier, ME., Twamley, EW., et al.[2021]

A non-inferiority trial is being conducted to compare the effectiveness of group cognitive-behavioral therapy (CBT) and a structured support group called Buried in Treasures (BiT) for treating hoarding disorder, involving 300 participants over 16 weeks.

The primary goal of the study is to assess whether BiT can effectively reduce hoarding symptoms to a level comparable to that of traditional CBT, potentially increasing treatment accessibility for individuals with hoarding disorder.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of a peer facilitated support group to cognitive behavior therapy: Study protocol for a randomized controlled trial for hoarding disorder. Uhm, SY., Tsoh, JY., Mackin, RS., et al.[2022]

A small study involving 5 participants showed that adding personalized, in-home uncluttering sessions to the Buried in Treasures (BIT) Workshop, a structured cognitive behavioral therapy program, led to significant reductions in hoarding symptoms and clutter.

The treatment response rate from this approach was comparable to other BIT studies, indicating that in-home sessions can enhance the effectiveness of existing therapies for hoarding disorder.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Augmenting Buried in Treasures with in-home uncluttering practice: Pilot study in hoarding disorder. Linkovski, O., Zwerling, J., Cordell, E., et al.[2020]

The community-based intervention using Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) showed significant improvements in hoarding severity and clutter volume among older adults with hoarding disorder, with 15 out of 37 participants completing the treatment in the first two years.

The successful implementation of the CREST intervention in clients' homes and community settings led to funding for program expansion, indicating its effectiveness and potential for broader application in San Diego County.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementation and evaluation of a community-based treatment for late-life hoarding. Pittman, JOE., Davidson, EJ., Dozier, ME., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) for Hoarding Disorder in Older Adults: A Randomized Clinical Trial. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Comparison of a peer facilitated support group to cognitive behavior therapy: Study protocol for a randomized controlled trial for hoarding disorder. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Augmenting Buried in Treasures with in-home uncluttering practice: Pilot study in hoarding disorder. [2020]

4. England pubmed.ncbi.nlm.nih.gov

Novel treatment for geriatric hoarding disorder: an open trial of cognitive rehabilitation paired with behavior therapy. [2021]

5. England pubmed.ncbi.nlm.nih.gov

Implementation and evaluation of a community-based treatment for late-life hoarding. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Group Cognitive Rehabilitation and Exposure/Sorting Therapy: A Pilot Program. [2022]

7. England pubmed.ncbi.nlm.nih.gov

The Buried in Treasures Workshop: waitlist control trial of facilitated support groups for hoarding. [2022]