Cognitive Rehabilitation for Hoarding Disorder
(CREST Trial)
Trial Summary
What is the purpose of this trial?
Hoarding Disorder (HD) is serious and disabling in Veterans. Present in up to 7% of Veterans and even higher symptom rates in older Veterans; HD contributes to functional impairment and poor quality of life. Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) has shown promising functional improvement and symptom reduction. To reduce burdens and barriers to implementation of CREST, the proposed project will individualize CREST based on cognitive testing and participant preferences, provide all care in the participant's home through telemedicine and home visits, and shorten the timeframe of treatment. A randomized controlled trial comparing 24 sessions of Personalized-CREST to case management for 130 adult Veterans with HD is proposed. Multifaceted functional and recovery outcomes including quality of life, HD severity, and sustained recovery outcomes will be examined throughout treatment and follow-up. By advancing the knowledge of the rehabilitative care of HD, we can interrupt the trajectory of this chronic and debilitating condition.
Will I have to stop taking my current medications?
The trial requires that participants be stable on their medications for at least 6 weeks, so you will not need to stop taking your current medications.
What data supports the effectiveness of this treatment for hoarding disorder?
Research shows that Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) can be effective for hoarding disorder, especially in older adults, by improving organization and reducing clutter. Additionally, group cognitive-behavioral therapy (CBT) has been shown to help reduce hoarding symptoms and improve related issues like anxiety and depression.12345
Is Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) safe for humans?
How is the treatment Personalized-CREST different from other treatments for hoarding disorder?
Personalized-CREST is unique because it combines cognitive rehabilitation, which helps improve thinking skills, with exposure and sorting therapy, which involves practicing decision-making about keeping or discarding items. This approach specifically targets the cognitive and decision-making difficulties associated with hoarding disorder, unlike standard cognitive-behavioral therapy (CBT) that primarily focuses on changing thought patterns and behaviors.13456
Research Team
Catherine R Ayers, PhD
Principal Investigator
VA San Diego Healthcare System, San Diego, CA
Eligibility Criteria
This trial is for adult Veterans diagnosed with Hoarding Disorder (HD) as their primary condition. Participants must be stable on medications for at least six weeks, voluntarily consent to join, and not have any neurodegenerative diseases or current psychosis. They should also not be undergoing any exposure-based psychotherapy.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive Personalized-CREST or case management for 12 weeks, with 24 sessions delivered twice a week in the home
Follow-up
Participants are monitored for safety and effectiveness after treatment
Treatment Details
Interventions
- Case Management
- Personalized-CREST
Personalized-CREST is already approved in United States for the following indications:
- Hoarding Disorder
Find a Clinic Near You
Who Is Running the Clinical Trial?
VA Office of Research and Development
Lead Sponsor
San Diego Veterans Healthcare System
Collaborator