In-home Decluttering Augmentation of Group CBT for HD
Study Details
Study Description
Brief Summary
The primary aim of trial is to determine the clinical efficacy of in-home decluttering augmentation of group CBT for reducing hoarding severity in adults with HD. The trial takes place in Sweden.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Cognitive behavioral therapy (CBT) is the current evidence-based treatment for HD but the majority of sufferers remain symptomatic after CBT with impairing levels of clutter in their homes. Home visits, with a focus on in-home decluttering, have in previous research been shown to be a promising intervention when combined with CBT. However, augmenting CBT with subsequent home visits has not yet been tested in a randomized controlled trial (RCT). In response to this, in this trial, we aim to investigate the efficacy of a coordinated intervention, consisting of CBT and in-home decluttering for HD, in an RCT. In this trial, 90 participants with HD will initially receive 12 sessions of CBT through a psychiatric outpatient service. After CBT, participants will be randomized to receive either 10 home visits in 10 weeks, or to a wait list condition. Our hypothesis is that augmenting CBT with home visits will lead to a reduction in hoarding symptoms and clutter and improved daily functioning compared to wait list. We will also investigate the cost-economical aspects of the intervention. Results from this trial have the potential to reveal whether in-home decluttering should be added to CBT in order to reduce symptoms of hoarding and improve function in indviduals with HD.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: In-home decluttering Study participants receive weekly sessions of in-home decluttering for 10 weeks. |
Behavioral: In-home decluttering practice
The in-home decluttering intervention comprises 10, 1.5-hour home-visits over the course of 10 weeks.
These home visits are personalized, goal-oriented and focused on decluttering. They include 1) a brief check-in, 2) guided unclutter time 3) a reflective period during which participants share their thoughts and objectives for the coming week, and 4) homework assignments.
|
| No Intervention: Delayed treatment Study participants receive weekly session of in-home decluttering after a 10 week delay. |
Outcome Measures
Primary Outcome Measures
- Saving Inventory-Revised (SI-R) [Change from baseline (week 0) to post-treatment (week 10),]
The SI-R is a 23-item questionnaire with 3 sub-scales: 1) difficulty discarding, 2) excessive clutter, and 3) excessive acquisition.
- Clutter Image Rating Scale (CIR) [Change from baseline (week 0) to post-treatment (week 10).]
Three sets of photographs, each comprising 9 photos of a room with varying levels of clutter. A selection is made as to which photograph best resembles the room of the participant.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Age 18 years or older.
-
Hoarding disorder as primary psychiatric condition.
-
Willing and able to understand and complete consent and study procedures.
-
Living in the Stockholm county (Sweden) and within a 1-hour commute by public transport from the social services office.
Exclusion Criteria:
-
Concurrent CBT or having received CBT for HD during the last two years, for a minimum of 8 sessions including active strategies for reducing acquisition and practice of discarding with a qualified therapist or 8 previous in-home decluttering sessions with a qualified social worker.
-
Unable or unwilling to allow study staff into home for home assessment.
-
Animal hoarding or squalid (i.e. extremely unhygienic) home conditions that are deemed to put the personnel at risk during the in-home decluttering.
-
A diagnosis of organic brain disorder, intellectual disability, psychosis, bipolar disorder without stable medication or with symptoms within the last 6 months, anorexia nervosa or alcohol/substance dependence or abuse.
-
Major medical or neurological conditions that increase the risk of participation or that would prevent completing assigned behavioral practice tasks.
-
Immediate risk to self or others, requiring urgent medical attention, such as high suicidality risk.
-
Participant not able to read and communicate in Swedish.
-
Currently at high risk for eviction (for instance having received a "rättelseanmaning" by the housing company or Swedish court).
-
Potential participant lives in the same household as an already included participant.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | M46: Karolinska Universitetssjukhuset, Psykiatri Sydväst Stockholm, Huddinge, Sweden, 141 86 | Stockholm | Sweden | 141 86 |
Sponsors and Collaborators
- Karolinska Institutet
- Region Stockholm
- City of Stockholm
- Swedish Council for Working Life and Social Research
Investigators
- Principal Investigator: Volen Ivanov, PhD, Karolinska Institutet
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2020-05798