In-home decluttering support for treating hoarding disorder

In-home Decluttering Augmentation of Group Cognitive-behavior Therapy for Hoarding Disorder: The Joining Forces Randomized Controlled Trial

This study tests if getting help to declutter your home along with therapy can improve the lives of adults with hoarding disorder.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 90 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Karolinska Institutet (Academic / other)
• Locations: 1 site (Stockholm)
• Trial ID: NCT04712474 on ClinicalTrials.gov

What this trial studies

This trial aims to evaluate the effectiveness of combining in-home decluttering assistance with group cognitive behavioral therapy (CBT) for adults suffering from hoarding disorder (HD). Participants will first undergo 12 sessions of CBT, after which they will be randomly assigned to receive either 10 home visits focused on decluttering or be placed on a waitlist. The study will assess the impact of this augmented intervention on hoarding symptoms, clutter levels, and daily functioning. Additionally, the trial will explore the cost-effectiveness of the combined approach.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older diagnosed with hoarding disorder who live within a one-hour commute from the social services office in Stockholm, Sweden.

Not a fit: Patients currently receiving CBT for hoarding disorder or those with severe home conditions that pose risks to staff may not benefit from this study.

Why it matters

Potential benefit: If successful, this intervention could significantly reduce hoarding symptoms and improve daily functioning for individuals with hoarding disorder.

How similar studies have performed: Previous research has indicated that in-home decluttering can be a promising intervention when combined with CBT, but this specific approach has not yet been tested in a randomized controlled trial.

Eligibility criteria

Inclusion Criteria:

1. Age 18 years or older.
2. Hoarding disorder as primary psychiatric condition.
3. Willing and able to understand and complete consent and study procedures.
4. Living in the Stockholm county (Sweden) and within a 1-hour commute by public transport from the social services office.

Exclusion Criteria:

1. Concurrent CBT or having received CBT for HD during the last two years, for a minimum of 8 sessions including active strategies for reducing acquisition and practice of discarding with a qualified therapist or 8 previous in-home decluttering sessions with a qualified social worker.
2. Unable or unwilling to allow study staff into home for home assessment.
3. Animal hoarding or squalid (i.e. extremely unhygienic) home conditions that are deemed to put the personnel at risk during the in-home decluttering.
4. A diagnosis of organic brain disorder, intellectual disability, psychosis, bipolar disorder without stable medication or with symptoms within the last 6 months, anorexia nervosa or alcohol/substance dependence or abuse.
5. Major medical or neurological conditions that increase the risk of participation or that would prevent completing assigned behavioral practice tasks.
6. Immediate risk to self or others, requiring urgent medical attention, such as high suicidality risk.
7. Participant not able to read and communicate in Swedish.
8. Currently at high risk for eviction (for instance having received a "rättelseanmaning" by the housing company or Swedish court).
9. Potential participant lives in the same household as an already included participant.

Where this trial is running

Stockholm

• M46: Karolinska Universitetssjukhuset, Psykiatri Sydväst Stockholm, Huddinge, Sweden, 141 86 — Stockholm, Sweden (Recruiting)

Study contacts

• Principal investigator: Volen Ivanov, PhD — Karolinska Institutet
• Study coordinator: Sofia Jägholm, MSc

Conditions Hoarding Disorder; hoarding; clutter