Cognitive and Behavioral Treatment – TCH (NIMH)

This project directed by Dr. Gail Steketee at Boston University was also a collaborative study with Dr. Randy Frost at Smith College and Dr. David Tolin at Hartford Hospital. The study is now completed, and findings are being analyzed under the direction of Dr. Timothy Brown at Boston University. The project developed and tested a multi-component treatment that was based on the features of hoarding we had observed and on our theoretical model of this complex syndrome. During the course of this three-year study, we developed a therapy that includes motivational interventions, training in organizing and decision-making skills, cognitive therapy, and exposure to removing unwanted items to reduce clutter.

In our first test of this therapy in 10 clients with compulsive hoarding, we achieved good results—approximately 50% of clients who received 26 sessions of treatment over a period of 9–12 months were considered much or very much improved after treatment [Tolin, Frost & Steketee, 2007). We then revised the manual, which is available as a therapist guide and client workbook and published by Oxford University Press.

We tested the treatment in a second study compared to a wait list control condition. Eighteen clients were placed on a wait list for 12 weeks (no treatment) while another 18 clients received active treatment. The clients in the active therapy condition improved significantly more than those on the wait list, even after the relatively short period of 12 weeks. After everyone in both groups had received the full 26 sessions of hoarding treatment we examined how well they did—this time 70% were considered much or very much improved. We are writing these results for publication and will soon be examining factors that predict whether clients benefit from this therapy.