Cognitive Rehabilitation for Hoarding Disorder

This trial tests a 20-week group course that combines cognitive rehabilitation (learning new thinking skills) and exposure therapy (gradually facing fears about items) to help reduce compulsive hoarding behaviors. The goal is to determine if these methods can decrease the distress and difficulty in making decisions about keeping or discarding possessions. It suits English-speaking individuals with noticeable hoarding issues who are not dealing with severe cognitive or substance-related problems. Participants should not currently be in other therapy or have recently changed their mental health medications. As an unphased trial, this study offers a unique opportunity to explore innovative treatments for hoarding behaviors.

The trial does not specify if you need to stop taking your current medications, but you may be excluded if you have changed your psychotropic medications (medications affecting the mind) within three months of starting the trial.

Research has shown that Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) for hoarding disorder is generally safe. Studies have not identified any specific safety issues with this treatment. Participants in earlier studies found it helpful in reducing hoarding symptoms and improving thinking and decision-making skills. This suggests that the treatment is well-tolerated by those who have tried it. The available data reports no major side effects, which is reassuring for those considering joining a trial.¹²³⁴⁵

Researchers are excited about the Cognitive Rehabilitation and Exposure-based Class for Compulsive Hoarding because it combines cognitive training with exposure therapy, offering a unique dual approach. Unlike standard treatments like cognitive-behavioral therapy alone, this method starts with cognitive training to enhance decision-making skills, helping participants learn new strategies to manage their hoarding behaviors. The exposure therapy component gradually introduces participants to the anxiety-provoking process of discarding, aiming to reduce distress and improve their ability to make choices about possessions over time. This innovative combination targets both cognitive processes and emotional responses, potentially providing more comprehensive relief for those with hoarding disorder.

Research has shown that Cognitive Rehabilitation and Exposure Therapy (CREST), which participants in this trial will receive, helps reduce hoarding symptoms. One study found that CREST was more effective than standard care for older adults in reducing these symptoms. Specifically, 77% of those who completed the treatment had much lower hoarding severity scores, indicating significantly less severe symptoms. Additionally, 62% of participants showed significant improvement. These results suggest that this combined approach can help individuals make better decisions about their belongings and feel less stressed when organizing or discarding items.²⁴⁶⁷⁸