Acceptability of treatments and services for individuals with hoarding behaviors

Abstract

Objective To explore the acceptability of currently available treatments and services for individuals who self-report hoarding behaviors. Method Between 10/2013 and 8/2014, participants were invited to complete an online survey that provided them descriptions of eleven treatments and services for hoarding behaviors and asked them to evaluate their acceptability using quantitative (0 [not at all acceptable] -10 [completely acceptable]) Likert scale ratings. The a priori definition of acceptability for a given resource was an average Likert scale score of six or greater. Two well-validated self-report measures assessed hoarding symptom severity: the Saving Inventory-Revised and the Clutter Image Rating Scale. Results Two hundred and seventy two participants who self-reported having hoarding behaviors completed the questionnaire. Analyses focused on the 73% of responders (n=203) who reported clinically significant hoarding behaviors (i.e., Saving Inventory-Revised scores of ≥40). The three most acceptable treatments were individual cognitive behavioral therapy (6.2 ±3.1 on the Likert scale), professional organizing service (6.1 ±3.2), and use of a self-help book (6.0 ±3.0). Conclusion In this sample of individuals with self-reported clinically significant hoarding behaviors (n=203), only 3 out of 11 treatments and services for hoarding were deemed acceptable using an a priori score. While needing replication, these findings indicate the need to design more acceptable treatments and services to engage clients and maximize treatment outcomes for hoarding disorder.

Enhancing group cognitive‐behavioral therapy for hoarding disorder with between‐session Internet‐based clinician support: A feasibility study

“…Moreover, individual CBT for HD is highly time‐consuming, typically including around 30 in‐clinic and home‐based sessions (Steketee et al., ), and access to trained therapists specialized in CBT for HD is still very limited. CBT in a group setting might be a more cost‐effective alternative to individual CBT, with the additional benefits of providing social support (Rodriguez et al., ) and decreasing stigma (Schmalisch, Bratiotis, & Muroff, ). However, the modest treatment efficacy of CBT is similar in both individual and group CBT formats (Gilliam et al., ; Muroff et al., ).…”

Can Occupational Therapy Address the Occupational Implications of Hoarding?

“…Thus, previous interventions, which aim to readdress thinking and behaviours in people who hoard, appear to not be strongly substantiated. When decluttering is included as part of the intervention, Rodriguez et al [ 61 ] noted that the individual also experienced increased levels of emotional distress. The increased levels of emotional distress that occur from forcible removing possessions that have intrinsic, instrumental, and sentimental connections to the person and which represent parts of themselves through self-identity [ 13 ] are understandable, yet may not be considered within a decluttering intervention.…”

“…The increased levels of emotional distress that occur from forcible removing possessions that have intrinsic, instrumental, and sentimental connections to the person and which represent parts of themselves through self-identity [ 13 ] are understandable, yet may not be considered within a decluttering intervention. In addition, the outcome of the decluttering process results in a property that no longer represents the individual and their definition of home, with all items meaningful to them removed [ 61 ]. Home, according to Werner et al [ 62 ], is a place where people experience safety, are able to engage in home-making activities which are productive or relaxing, and that have family and cultural connection, with home being a place where the person and their home environment cannot be defined separately and are mutually defining.…”

“…As health care professionals, occupational therapists aim to enhance peoples' health and wellbeing; their practice adheres to principles of respect for client autonomy and prevention of harm, and they offer interventions which support the capacity of individuals to exercise choice [ 82 ]. Therefore, acknowledging that evidence shows that forced decluttering causes intense levels of emotional distress [ 61 ], occupational therapists would not want to engage in such actions as these would contravene their professional codes of conduct. In addition, further evidence notes that forced decluttering does not have good long-term outcomes with high rates of recidivism for the person retuning to hoarding activity [ 65 ].…”

Transtorno de acumulação: uma revisão

“…Os mais rejeitados foram tratamento medicamentoso, serviço de limpeza e remoção e curador designado pela Justiça. 57 …”