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

Abstract

OBJECTIVES:

The objective of this paper was to examine the implementation and effectiveness of a community-based intervention for hoarding disorder (HD) using Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST).

DESIGN:

This was a mixed-method, pre-post quasi-experimental study informed by the Practical, Robust Implementation and Sustainability Model for implementation science.

SETTING:

Program activities took place in San Diego County, mainly within clients' homes or community, with some activities in-office.

PARTICIPANTS:

Participants were aged 60 years or older, met eligibility for Medi-Cal or were uninsured, and met criteria for HD.

INTERVENTION:

A manualized, mobile protocol that incorporated CREST was utilized.

MEASUREMENTS:

The Clutter Image Rating and Hoarding Rating Scale were used as effectiveness outcomes. An investigator-created staff questionnaire was used to evaluate implementation.

RESULTS:

Thirty-seven clients were reached and enrolled in treatment and 15 completed treatment during the initial 2 years of the program. There were significant changes in hoarding severity and clutter volume. Based on the initial 2 years of the program, funding was provided for expansion to cover additional San Diego County regions and hire more staff clinicians in year three.

CONCLUSION:

Preliminary data suggest that the CREST intervention can be successfully implemented in a community setting with positive results for older adults with HD.

• Authors: James O E Pittman, Eliza J Davidson, Mary E Dozier, Brian H Blanco, Kylie A Baer, Elizabeth W Twamley, Tina L Mayes, David H Sommerfeld, Tiffany Lagare, Catherine R Ayers
• Journal: International psychogeriatrics (Int Psychogeriatr) Vol. 33 Issue 9 Pg. 977-986 (09 2021) ISSN: 1741-203X [Electronic] England
• PMID: 32131916 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Cognitive Behavioral Therapy
• Hoarding (therapy)
• Hoarding Disorder (therapy)
• Humans
• Surveys and Questionnaires