Reducing hoarding behavior with individualized reinforcement and item return

Abstract

Treatment research on hoarding is generally limited to people without intellectual disabilities who have symptoms of obsessive compulsive disorder and respond favorably to cognitive-based therapies. We evaluated the effects of individualized reinforcement and item return procedures on hoarding behavior in a multiple baseline across three persons with severe mental retardation. Systematic preference assessment procedures identified items used in the individualized reinforcement procedures. Reductions in hoarding behavior occurred for each person when individualized treatment and item return procedures were applied. These reductions were maintained when direct support staff were trained to provide treatment.

Treatment of Psychopathology in People with Intellectual and other Disabilities

“…32 There are several small N experiments that have used behavioural packages [33][34][35] and DR of low rates of behaviour for OCD. 36,37 Owing to the small number of studies and their variable quality, the authors concluded that behavioural treatment for OCD met Chambless and Hollon's 38 criteria for a possibly efficacious but not an efficacious treatment. Their review also found no controlled studies of psychosocial treatment of PTSD and so failed to find any evidence-based practices for PTSD.…”

Effectiveness of cognitive-behaviour therapy for hoarding disorder in people with mild intellectual disabilities

“…The study demonstrates that people with ID can tolerate and benefit from a full course of CBT for their hoarding, when it is delivered in their own homes. The results from this research are a challenge to the previous opinion that people with ID and hoarding can only be treated via behavioural methods and that cognitively informed interventions 'are likely to be ineffective' (Berry & Schnell, 2006). Much further clinical and research work is required to develop both an understanding of ID hoarding prevalence, phenomenology and aetiology and build a robust evidence base for intervention.…”

“…No adverse events were noted during the study, which would suggest that the CBT received was a safe intervention. Berry and Schnell (2006) doubted the generalizability of the CBT hoarding model with ID populations. The current evidence would suggest that such reservations were unfounded.…”

“…Van Houten and Rolider (1988) showed reduced hoarding due to movement-suppression timeout and Lane et al (1989) taught appropriate discard through use of timeout. Berry and Schnell (2006) used a multiple baseline design with N=3 ID hoarders and showed reduced hoarding for each participant when item return procedures were instigated.…”