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Completed

NCT Number: NCT05237466

Motivational Interviewing to Enhance Behavioral Change in Older Adults With Hoarding Disorder

This study will compare two behavioral interventions for hoarding disorder in older adults.

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Key information

Conditions

Hoarding Disorder Anxiety Disorders Mental Disorders Obsessive-Compulsive Disorder

Age range

60 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Mississippi State University

Starkville, Mississippi, 39762, United States

About this study

Hoarding disorder is a psychological condition with a unique constellation of consequences for older adults, including increased risk of fire and dying in a fire, insect infestation, and medical problems. Dangers related to cluttered living spaces are exacerbated by reduced executive functioning, attention, and concentration. Hoarding psychopathology results from maladaptive cognitions (e.g., desire to keep items others would discard) and maladaptive behavioral patterns (e.g., avoidance of sorting/discarding items).

Extant treatments for hoarding have targeted fear reduction as the mechanism of change, either through cognitive-behavioral therapy focusing on cognitive restructuring or behavior therapy focusing on exposure therapy. Older adults have a lackluster response to cognitive restructuring for hoarding, and, although exposure therapy increases treatment response, both approaches require a lengthy six-month dose. Our preliminary work suggests that fear reduction may not be a universally relevant target mechanism for older adults, and that to be responsive to the specific needs of older adults, other mechanisms need to be identified.

Motivational interviewing is a technique that is already typically incorporated into hoarding treatment and has been demonstrated to increase motivation for behavioral change across a range of health conditions for older adults, including physical activity, diet, and disease management. Because sorting/discarding is at its core a health behavior that hoarding patients lack the motivation to engage in, motivational interviewing is likely to decrease hoarding severity by eliciting increased levels of sorting/discarding.

The proposed project will use a mechanistic clinical trials approach to determine if a four-month intervention combining motivational interviewing with sorting practice can engage the proposed target, motivation for behavioral change, when compared to a four-month dose of sorting practice alone in a sample of rural-dwelling older adults with hoarding disorder.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Aged 60+
  • Live within a 60-minute driving radius of Starkville, MS
  • Have a primary psychiatric diagnosis of hoarding disorder

Exclusion criteria

  • Major cognitive impairment
  • Active psychosis, drug use, or acute suicidal ideation
  • Concurrent psychotherapy focused on hoarding
  • Changed psychotropic medications within the past three months

Treatment and study plan

RECLAIM: Reducing Clutter and Increasing Meaning

Behavioral

Participants will receive 16 weekly 1-hour treatment sessions in their home delivered by Masters-level clinicians with the assistance of undergraduate researchers. Each treatment session will involve a combination of motivational interviewing (MI) and sorting practice. The rationale behind the sorting practice is to develop the skill of sorting and the formation of a daily sorting routine. The MI portion of the initial session will involve an evaluation of client strengths and individual biopsychosocial goals. The initial and subsequent sessions will include a variety of MI techniques, including decisional balancing, developing discrepancy, personalized feedback, and reinforcement of responsibility of sense of self-efficacy.

Sorting Practice

Behavioral

Participants will receive 16 weekly 1-hour treatment sessions in their home delivered by Masters-level clinicians with the assistance of undergraduate researchers. Clinicians will encourage participants to sort objects during each session while refraining from use of any specific cognitive or motivational therapeutic techniques. Participants will be asked to record the frequency and duration of any sorting/ discarding they did during the previous week.

Primary outcomes

  1. Frequency of Sorting/Discarding Behavior

    Time frame: Four months

    As a behavioral indicator of motivation to engage in sorting/discarding behavior, participants will be asked to report at their weekly treatment sessions the frequency of sorting/discarding items in the previous week. Data were analyzed as percentage of days sorted between sessions (assessed at sessions 2-16). Mixed effects models were used to analyze data such that participants with at least one timepoint were included in the analyses.

  2. University of Rhode Island Change Assessment Questionnaire

    Time frame: Four months

    The University of Rhode Island Change Assessment Questionnaire (URICA) is a 32-item Likert scale that assesses readiness for change. Scores for readiness for change are calculated by subtracting pre contemplation items from the other summed items. Scores range from -2 to 14, with higher scores indicating greater readiness for change.

  3. Apathy Evaluation Scale

    Time frame: Four months

    The Apathy Evaluation Scale is an 18-item measure of an individual's deficits in goal-directed thoughts and behavior. Scores range from 18-72, with higher scores reflecting more apathy.

Secondary outcomes

  1. Treatment Acceptability/ Adherence Scale

    Time frame: Immediately after session 1

    The Treatment Acceptability/ Adherence Scale is a 10-item self-report measure of a patient's perception of the acceptability of a treatment as well as their anticipated adherence to the protocol. Scores range from 10-70, with higher scores indicating greater acceptability and perceived adherence.

  2. Saving Inventory-Revised

    Time frame: Four months

    The Saving Inventory-Revised is a 23-item measure of the three core hoarding symptoms (urges to save, difficulty discarding, and excessive clutter). Scores range from 0 to 92, with higher scores indicating greater symptom severity.

Other outcomes

  1. Clutter Image Rating

    Time frame: Four months

    The Clutter Image Rating is a three-item pictorial rating scale of clutter level in the bedroom, kitchen, and living room. Assessor ratings of the CIR will be used for the proposed project. Scores of the three rooms are averaged to create a composite score ranging from 1-9, with higher scores indicating greater clutter levels.

  2. Behavioral Approach Task for Sorting/Discarding

    Time frame: Four months

    The Behavioral Approach Task for sorting/discarding involves the participant sorting items in a cluttered part of their home for 15 minutes. The speed of sorting (# of items sorted) will be used as a behavioral indicator of hoarding severity. The lower limit is 0 items sorted; there is no upper limit of number of items to be sorted.

Sponsors and collaborators

Lead sponsor

Mississippi State University

Other

Collaborators

  • National Institute of Mental Health (NIMH)

Registry information

Important dates

Study start
2022
Primary completion
2025
Study completion
2025
First posted
Feb 14, 2022
Registry last updated
Jul 16, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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