Category: Obsessive Compulsive and Related Disorders

Symposium

Internet-Supported Group CBT for People With Hoarding Disorder: Feasibility and Efficacy

Saturday, November 18
8:30 AM - 10:00 AM
Location: Indigo Ballroom E, Level 2, Indigo Level

Keywords: Hoarding | Treatment Integrity / Adherence / Compliance | Internet
Presentation Type: Symposium

Although cognitive-behavioral therapy (CBT) for Hoarding disorder (HD) is an effective treatment, the majority of patients remain symptomatic even after treatment. Low treatment engagement and difficulties with homework compliance are proposed barriers that contribute to the limited efficacy of CBT. One potential way of overcoming these barriers is to provide patients with increased therapist support during treatment. In an effort to increase efficacy and adherence to CBT, we developed and pilot tested a novel treatment consisting of group CBT combined with an Internet-support system for people with HD. Twenty patients with HD, recruited through self- and clinical referral were treated at two clinics in Stockholm, Sweden. The self-rated Saving Inventory – Revised (SI-R) was used as the primary outcome measure. Patients also completed measures of treatment acceptability and satisfaction and levels of clutter were rated by blinded raters. The treatment consisted of a sixteen-week manualized group CBT combined with an Internet-support system (COMMIT) which enabled patients to communicate with their therapist on a daily basis through e-mails and to upload photos of their home using a smart phone or digital camera. Therapists provided individualized feedback and encouragement to the patients and guided them in decluttering their homes. The treatment was associated with significant reductions on almost all outcome measures and participants reported a high rate of treatment acceptability and satisfaction at post-treatment assessment.All treatment gains at post-treatment were maintained at the 3-month follow up. The preliminary results of this pilot study support the feasibility and efficacy of adding Internet-support to group CBT for HD. A randomized controlled trial of this treatment approach is warranted. Implications for clinical practice and future research are reviewed.

Volen Ivanov

Karolinska Institutet

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