Motivational Interviewing for Hoarding Disorder

Overseen By Mary E Dozier, Ph.D.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Mississippi State University

Must not be taking: Psychotropics

Disqualifiers: Cognitive impairment, Psychosis, Drug use, others

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

Compensation: Varies

Number of Visits: Unknown

Duration: 16 weeks

60 Participants Needed

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. ^{1 2 3 4 5}

How 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. ^{6 7 8 9 10}

Eligibility 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.

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

Treatment Details

Interventions

• RECLAIM: Reducing Clutter and Increasing Meaning
• Sorting Practice

Trial Overview 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.

Participant Groups

Group I: RECLAIM: Reducing Clutter and Increasing Meaning Experimental Treatment 1 Intervention

Participants will receive a combination of motivational interviewing and sorting practice to reduce hoarding symptoms.

Group II: Sorting Practice Active Control 1 Intervention

Participants will receive sorting practice only to reduce hoarding symptoms.

Who Is Running the Clinical Trial?

Mississippi State University

Lead Sponsor

Trials

8

Recruited

3,300+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Findings from Research

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 Hoarding Rating Scale-Interview (HRS-I) is a reliable and valid tool for assessing compulsive hoarding, developed through interviews with 136 adults, including those with hoarding disorder, OCD, and non-clinical controls.

The HRS-I effectively distinguishes between hoarding and non-hoarding individuals and correlates well with other hoarding measures, making it a promising option for evaluating the severity of compulsive hoarding.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A brief interview for assessing compulsive hoarding: the Hoarding Rating Scale-Interview. Tolin, DF., Frost, RO., Steketee, G.[2022]

Specialized cognitive-behavioral treatment that combines motivational interviewing, skills training, and cognitive restructuring is effective in treating hoarding disorder, addressing its unique challenges.

Early psychotherapy methods were less effective than this targeted approach, highlighting the importance of using specific strategies tailored to hoarding behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive-behavioral therapy for hoarding in the context of contamination fears. Steketee, G., Tolin, DF.[2018]

A brain-injured male successfully reduced his hoarding behavior through a two-phase treatment involving positive reinforcement for collecting baseball cards and structured trash collection tasks.

The intervention effectively suppressed hoarding behavior within just 8 days by using a combination of rewards and brief time-outs when hoarding occurred.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teaching socially appropriate behavior to eliminate hoarding in a brain injured adult. Lane, IM., Wesolowski, MD., Burke, WH.[2019]

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]

Motivational interviewing (MI) has shown a strong short-term effectiveness in promoting readiness for change, with an average effect size of 0.77 across 72 clinical trials, although this effect diminishes to 0.30 at follow-ups up to one year.

The effectiveness of MI is notably higher among ethnic minority populations and when not strictly following a manual, indicating that flexibility in its application may enhance its impact.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational interviewing. Hettema, J., Steele, J., Miller, WR.[2022]

Motivational interviewing (MI) has expanded beyond its initial focus on addictions and health-related behaviors, now being applied to a variety of clinical issues such as anxiety, depression, and intimate partner violence.

The article series includes case reports demonstrating the effectiveness of MI in addressing diverse problems, highlighting its versatility and potential benefits in clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Introduction to the special series on motivational interviewing and psychotherapy. Arkowitz, H., Westra, HA.[2009]

Clients perceive motivational interviewing (MI) as a complex interaction that significantly influences their thoughts and feelings about alcohol abuse, highlighting the therapy's impact on personal change.

Key therapeutic elements identified by clients, such as a non-confrontational approach and the development of discrepancies between beliefs and behaviors, align with established MI principles and emphasize the importance of the therapist-client relationship in the effectiveness of therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Client experiences of motivational interviewing: An interpersonal process recall study. Jones, SA., Latchford, G., Tober, G.[2016]

Motivational interviewing (MI) is an effective technique for helping patients recognize the need for change in their habits, such as alcohol dependence, by moving them from complacency to a desire for improvement.

The collaborative nature of MI involves using tools like the decisional balance sheet to help patients weigh the pros and cons of their habits, facilitating a personalized approach to treatment based on their readiness for change.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Psychiatrist's Guide to Motivational Interviewing. Griffith, LJ.[2021]

Motivational interviewing (MI) shows promising effectiveness in increasing readiness and motivation to change among individuals with eating disorders, based on a review of 13 studies.

There is a need for more standardized study designs and treatment fidelity measures in future research to better assess the impact of MI in treating eating disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The use of motivational interviewing in eating disorders: a systematic review. Macdonald, P., Hibbs, R., Corfield, F., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

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

2. Ireland pubmed.ncbi.nlm.nih.gov

A brief interview for assessing compulsive hoarding: the Hoarding Rating Scale-Interview. [2022]

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

Cognitive-behavioral therapy for hoarding in the context of contamination fears. [2018]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Teaching socially appropriate behavior to eliminate hoarding in a brain injured adult. [2019]

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

Motivational interviewing. [2022]

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

Introduction to the special series on motivational interviewing and psychotherapy. [2009]

8. England pubmed.ncbi.nlm.nih.gov

Client experiences of motivational interviewing: An interpersonal process recall study. [2016]

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

The Psychiatrist's Guide to Motivational Interviewing. [2021]

10. Ireland pubmed.ncbi.nlm.nih.gov

The use of motivational interviewing in eating disorders: a systematic review. [2022]