Motivational Interviewing to Enhance Behavioral Change in Older Adults with Hoarding Disorder

NCT ID: NCT05237466

Last Updated: 2024-11-20

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-06-01
• Study Completion Date: 2025-10-31

Brief Summary

This study will compare two behavioral interventions for hoarding disorder in older adults.

Detailed Description

Hoarding disorder is a psychological condition with a unique constellation of consequences for older adults, including increased risk of fire and dying in a fire, insect infestation, and medical problems. Dangers related to cluttered living spaces are exacerbated by reduced executive functioning, attention, and concentration. Hoarding psychopathology results from maladaptive cognitions (e.g., desire to keep items others would discard) and maladaptive behavioral patterns (e.g., avoidance of sorting/discarding items).

Extant treatments for hoarding have targeted fear reduction as the mechanism of change, either through cognitive-behavioral therapy focusing on cognitive restructuring or behavior therapy focusing on exposure therapy. Older adults have a lackluster response to cognitive restructuring for hoarding, and, although exposure therapy increases treatment response, both approaches require a lengthy six-month dose. Our preliminary work suggests that fear reduction may not be a universally relevant target mechanism for older adults, and that to be responsive to the specific needs of older adults, other mechanisms need to be identified.

Motivational interviewing is a technique that is already typically incorporated into hoarding treatment and has been demonstrated to increase motivation for behavioral change across a range of health conditions for older adults, including physical activity, diet, and disease management. Because sorting/discarding is at its core a health behavior that hoarding patients lack the motivation to engage in, motivational interviewing is likely to decrease hoarding severity by eliciting increased levels of sorting/discarding.

The proposed project will use a mechanistic clinical trials approach to determine if a four-month intervention combining motivational interviewing with sorting practice can engage the proposed target, motivation for behavioral change, when compared to a four-month dose of sorting practice alone in a sample of rural-dwelling older adults with hoarding disorder.

Conditions

Hoarding Disorder

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

RECLAIM: Reducing Clutter and Increasing Meaning

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

Group Type: EXPERIMENTAL

RECLAIM: Reducing Clutter and Increasing Meaning

Intervention Type: BEHAVIORAL

Participants will receive 16 weekly 1-hour treatment sessions in their home delivered by Masters-level clinicians with the assistance of undergraduate researchers. Each treatment session will involve a combination of motivational interviewing (MI) and sorting practice. The rationale behind the sorting practice is to develop the skill of sorting and the formation of a daily sorting routine. The MI portion of the initial session will involve an evaluation of client strengths and individual biopsychosocial goals. The initial and subsequent sessions will include a variety of MI techniques, including decisional balancing, developing discrepancy, personalized feedback, and reinforcement of responsibility of sense of self-efficacy.

Sorting Practice

Participants will receive sorting practice only to reduce hoarding symptoms.

Group Type: ACTIVE_COMPARATOR

Sorting Practice

Intervention Type: BEHAVIORAL

Participants will receive 16 weekly 1-hour treatment sessions in their home delivered by Masters-level clinicians with the assistance of undergraduate researchers. Clinicians will encourage participants to sort objects during each session while refraining from use of any specific cognitive or motivational therapeutic techniques. Participants will be asked to record the frequency and duration of any sorting/ discarding they did during the previous week.

Interventions

RECLAIM: Reducing Clutter and Increasing Meaning

Participants will receive 16 weekly 1-hour treatment sessions in their home delivered by Masters-level clinicians with the assistance of undergraduate researchers. Each treatment session will involve a combination of motivational interviewing (MI) and sorting practice. The rationale behind the sorting practice is to develop the skill of sorting and the formation of a daily sorting routine. The MI portion of the initial session will involve an evaluation of client strengths and individual biopsychosocial goals. The initial and subsequent sessions will include a variety of MI techniques, including decisional balancing, developing discrepancy, personalized feedback, and reinforcement of responsibility of sense of self-efficacy.

Intervention Type: BEHAVIORAL

Sorting Practice

Participants will receive 16 weekly 1-hour treatment sessions in their home delivered by Masters-level clinicians with the assistance of undergraduate researchers. Clinicians will encourage participants to sort objects during each session while refraining from use of any specific cognitive or motivational therapeutic techniques. Participants will be asked to record the frequency and duration of any sorting/ discarding they did during the previous week.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Aged 60+
• Live within a 60-minute driving radius of Starkville, MS
• Have a primary psychiatric diagnosis of hoarding disorder

Exclusion Criteria

• Major cognitive impairment
• Active psychosis, drug use, or acute suicidal ideation
• Concurrent psychotherapy focused on hoarding
• Changed psychotropic medications within the past three months

• Minimum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Institute of Mental Health (NIMH)

NIH

Sponsor Role: collaborator

Mississippi State University

OTHER

Sponsor Role: lead

Responsible Party

Mary Dozier

Assistant Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Mississippi State University

Starkville, Mississippi, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Mary E Dozier, Ph.D.

Role: CONTACT

maryedozier@psychology.msstate.edu

(662) 325-0523

Facility Contacts

Mary E Dozier, Ph.D.

Role: primary

med362@msstate.edu

662-325-0523

Other Identifiers

1R15MH127565-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

21-561

Identifier Type: -

Identifier Source: org_study_id