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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests two behavioral methods to assist older adults with hoarding disorder. One group will receive a combination of motivational interviewing (a type of supportive conversation) and sorting practice to address hoarding behaviors. The other group will focus solely on sorting practice. It is designed for individuals aged 60 and older who live near Starkville, MS, and have been diagnosed with hoarding disorder. As an unphased trial, this study provides a unique opportunity to contribute to research that could enhance treatment options for hoarding disorder.

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.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that the treatments under study for hoarding disorder in older adults are generally safe. The RECLAIM approach, which includes motivational interviewing and sorting practice, was tested in a small study with older adults and received positive feedback. Participants engaged in the treatment without major issues.

For sorting practice alone, evidence from various studies shows it can effectively reduce hoarding symptoms. These studies reported no major safety concerns, indicating it is a safe option for participants.

Overall, both treatments seem well-tolerated, with no significant negative effects reported. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Motivational Interviewing for Hoarding Disorder trial because it explores a unique approach to tackling hoarding symptoms. Unlike standard treatments such as cognitive-behavioral therapy (CBT) or medication, this trial combines motivational interviewing with sorting practice to help participants reduce clutter by increasing personal motivation and engagement. The trial also investigates the impact of sorting practice alone, offering insights into its effectiveness compared to the combined approach. This innovative method could provide a more personalized and empowering way to address hoarding behavior, potentially leading to more sustainable results.

What evidence suggests that this trial's treatments could be effective for hoarding disorder?

Research has shown that using motivational interviewing along with sorting practice, as in the RECLAIM: Reducing Clutter and Increasing Meaning arm of this trial, can greatly help people with hoarding disorder. One study found that older participants who used this method reduced their clutter by 20% and experienced improved mental well-being. Another study found that these techniques increased willingness to change and reduced attachment to belongings.

Sorting practice alone, tested in a separate arm of this trial, has also proven effective. A community-based study reported a 43% reduction in hoarding symptoms and a 28% decrease in clutter. Both treatments appear effective, but combining motivational interviewing with sorting might offer additional benefits. ^{1 2 3 4 6}

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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]

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 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]

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]

Citations

1.

faculty.msstate.edu

faculty.msstate.edu/med362/research

Research | MSState Faculty

The overall goal of this project is to test the ability of Motivational Interviewing (MI) to increase sorting and discarding behaviors in 60 older adults with ...

2.

clinicaltrials.gov

clinicaltrials.gov/study/NCT05237466

Motivational Interviewing to Enhance Behavioral Change ...

This study will compare two behavioral interventions for hoarding disorder in older adults. ... Hoarding disorder is a psychological condition with a unique ...

3.

msstate.edu

msstate.edu/newsroom/article/2024/11/hoarding-young-people-older-adults-tackled-msu-researcher

Hoarding by young people, older adults tackled by MSU ...

According to Dozier's pilot study, older participants decreased their clutter by 20% and reported improved mental health and a healthier ...

4.

journals.sagepub.com

journals.sagepub.com/doi/10.1177/15346501251349171

Using Motivational Interviewing to Treat Hoarding ...

Over the course of 16 sessions, the participant demonstrated an increased level of readiness for change and lower levels of object attachment.

5.

researchgate.net

researchgate.net/publication/383358893_Home-based_motivational_interviewing_for_late-life_rural_hoarding_disorder_a_pilot_study

Home-based motivational interviewing for late-life rural ...

Dozier and Nix (2025) found significant improvement in hoarding symptoms (including 20% reduction in object attachment) and positive affect (6% increase).

6.

aging.senate.gov

aging.senate.gov/imo/media/doc/the_consequences_of_clutter.pdf

The Consequences of Clutter - Senate Committee On Aging

outcomes for everyone. Often, hoarding disorder is identified in older adults meaning the level of clutter is higher, physical limitations may be a factor ...