Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-25T12:23:43.542Z Has data issue: false hasContentIssue false
  • English
  • Français

Implementation and evaluation of a community-based treatment for late-life hoarding

Published online by Cambridge University Press:  05 March 2020

James O. E. Pittman ,
Eliza J. Davidson ,
Mary E. Dozier ,
Brian H. Blanco ,
Kylie A. Baer ,
Elizabeth W. Twamley ,
Tina L. Mayes ,
David H. Sommerfeld ,
Tiffany Lagare  and
Catherine R. Ayers
James O. E. Pittman
Affiliation:
Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA, USA Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
Eliza J. Davidson
Affiliation:
San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA Research Service, VA San Diego Healthcare System, San Diego, CA, USA
Mary E. Dozier
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, CA, USA Department of Psychology, Mississippi State University, Starkville, MS, USA
Brian H. Blanco
Affiliation:
Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA Research Service, VA San Diego Healthcare System, San Diego, CA, USA
Kylie A. Baer
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, CA, USA
Elizabeth W. Twamley
Affiliation:
Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA Research Service, VA San Diego Healthcare System, San Diego, CA, USA
Tina L. Mayes
Affiliation:
Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA, USA Research Service, VA San Diego Healthcare System, San Diego, CA, USA
David H. Sommerfeld
Affiliation:
Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA
Tiffany Lagare
Affiliation:
Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, San Diego, CA, USA
Catherine R. Ayers*
Affiliation:
Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA, USA San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA Research Service, VA San Diego Healthcare System, San Diego, CA, USA Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, San Diego, CA, USA
*
Correspondence should be addressed to: Catherine R. Ayers, ABPP; 3350 La Jolla Village; Drive 116B; San Diego, CA92161. Email: cayers@ucsd.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

The objective of this paper was to examine the implementation and effectiveness of a community-based intervention for hoarding disorder (HD) using Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST).

Design:

This was a mixed-method, pre-post quasi-experimental study informed by the Practical, Robust Implementation and Sustainability Model for implementation science.

Setting:

Program activities took place in San Diego County, mainly within clients’ homes or community, with some activities in-office.

Participants:

Participants were aged 60 years or older, met eligibility for Medi-Cal or were uninsured, and met criteria for HD.

Intervention:

A manualized, mobile protocol that incorporated CREST was utilized.

Measurements:

The Clutter Image Rating and Hoarding Rating Scale were used as effectiveness outcomes. An investigator-created staff questionnaire was used to evaluate implementation.

Results:

Thirty-seven clients were reached and enrolled in treatment and 15 completed treatment during the initial 2 years of the program. There were significant changes in hoarding severity and clutter volume. Based on the initial 2 years of the program, funding was provided for expansion to cover additional San Diego County regions and hire more staff clinicians in year three.

Conclusion:

Preliminary data suggest that the CREST intervention can be successfully implemented in a community setting with positive results for older adults with HD.

Keywords

hoardingolder adultscognitive rehabilitationimplementationPRISMRE-AIM
Type
Original Research Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 9: Issue Theme: Implementation Science II , September 2021 , pp. 977 - 986
Copyright
© International Psychogeriatric Association 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). Washington, DC: American Psychiatric Publishing.Google Scholar
Ayers, C. R., Bratiotis, C., Saxena, S. and Wetherell, J. L. (2012a). Therapist and patient perspectives on cognitive-behavioral therapy for older adults with hoarding disorder: a collective case study. Aging & Mental Health, 16, 915–921. doi: 10.1080/13607863.2012.678480.CrossRefGoogle ScholarPubMed
Ayers, C. R. and Dozier, M. E. (2015). Predictors of hoarding severity in older adults with hoarding disorder. International Psychogeriatrics, 27, 1147–1156. doi: 10.1017/S1041610214001677.CrossRefGoogle ScholarPubMed
Ayers, C. R. et al. (2018). Cognitive rehabilitation and exposure/sorting therapy for hoarding disorder among older adults: a randomized controlled trial. The Journal of Clinical Psychiatry, 79, 85–93. doi: 10.4088/JCP.16m11072.CrossRefGoogle Scholar
Ayers, C. R., Dozier, M. E., Wetherell, J. L., Twamley, E. W. and Schiehser, D. M. (2016). Executive functioning in participants over age of 50 with hoarding disorder. American Journal of Geriatric Psychiatry, 24, 342–349. doi: 10.1016/j.jagp.2015.10.009.CrossRefGoogle ScholarPubMed
Ayers, C. R., Saxena, S., Espejo, E., Twamley, E. T., Granholm, E. and Wetherell, J. L. (2014). Novel treatment for geriatric hoarding disorder: an open trial of cognitive rehabilitation paired with behavior therapy. American Journal of Geriatric Psychiatry, 22, 248–252. doi: 10.1016/j.jagp.2013.02.010.CrossRefGoogle ScholarPubMed
Ayers, C. R., Saxena, S., Golshan, S. and Wetherell, J. L. (2010). Age at onset and clinical features of late life compulsive hoarding. International Journal of Geriatric Psychiatry, 25, 142–149. doi: 10.1002/gps.2310.CrossRefGoogle ScholarPubMed
Ayers, C. R., Schiehser, D., Liu, L. and Wetherell, J. L. (2012b). Functional impairment in geriatric hoarding participants. Journal of Obsessive-Compulsive and Related Disorders, 1, 263–266. doi: 10.1016/j.jocrd.2012.07.002.CrossRefGoogle Scholar
Ayers, C. R., Wetherell, J. L., Golshan, S. and Saxena, S. (2011). Cognitive-behavioral therapy for geriatric compulsive hoarding. Behaviour Research and Therapy, 49, 689–694. doi: 10.1016/j.brat.2011.07.002.CrossRefGoogle ScholarPubMed
Bayley, P. J., Frascino, J. C. and Squire, L. R. (2005). Robust habit learning in the absence of awareness and independent of the medial temporal lobe. Nature, 436, 550–553. doi: 10.1038/nature03857.CrossRefGoogle ScholarPubMed
Bratiotis, C. (2013). Community hoarding task forces: a comparative case study of five task forces in the United States. Health & Social Care in the Community, 21, 245–253. doi: 10.1111/hsc.12010.CrossRefGoogle ScholarPubMed
Bratiotis, C., Woody, S. and Lauster, N. (2019). Coordinated community-based hoarding interventions: evidence of case management practices. Families in Society, 100, 93–105. doi: 10.1177/1044389418802450.CrossRefGoogle Scholar
Brownson, R. C., Colditz, G. A. and Proctor, E. K. (2018). Dissemination and Implementation Research in Health: Translating Science to Practice. Oxford: Oxford University Press.Google Scholar
Cath, D. C., Nizar, K., Boomsma, D. and Mathews, C. A. (2017). Age-specific prevalence of hoarding and obsessive compulsive disorder: a population-based study. The American Journal of Geriatric Psychiatry, 25, 245–255. doi: 10.1016/j.jagp.2016.11.006.CrossRefGoogle ScholarPubMed
Corbin, J. and Strauss, A. (2008). Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory (3rd ed.). Thousand Oaks, CA: Sage Publications. doi: 10.4135/9781452230153.CrossRefGoogle Scholar
Dozier, M. E., Porter, B. and Ayers, C. R. (2016). Age of onset and progression of hoarding symptoms in older adults with hoarding disorder. Aging and Mental Health, 20, 736–742. doi: 10.1080/13607863.2015.1033684.CrossRefGoogle ScholarPubMed
Feldstein, A. C. and Glasgow, R. E. (2008). A Practical, Robust Implementation and Sustainability Model (PRISM) for integrating research findings into practice. The Joint Commission Journal on Quality and Patient Safety, 34, 228–243. doi: 10.1016/S1553-7250(08)34030-6.CrossRefGoogle Scholar
Frost, R. O. and Hartl, T. L. (1996). A cognitive-behavioral model of compulsive hoarding. Behaviour Research and Therapy, 34, 341–350. doi: 10.1016/0005-7967(95)00071-2.CrossRefGoogle ScholarPubMed
Frost, R., Renaud, S., Steketee, G. and Tolin, D. (2008). Development and validation of the clutter image rating. Journal of Psychopathology and Behavioral Assessment, 30, 193–203. doi: 10.1007/s10862-007-9068-7.CrossRefGoogle Scholar
Glasgow, R. E. et al. (2019). RE-AIM planning and evaluation framework: adapting to new science and practice with a 20-year review. Frontiers in Public Health, 7. doi: 10.3389/fpubh.2019.00064.CrossRefGoogle ScholarPubMed
Leonard, C. et al. (2019). Operationalizing an implementation framework to disseminate a care coordination program for rural Veterans. Journal of General Internal Medicine, 34, 58–66. doi: 10.1007/s11606-019-04964-1.CrossRefGoogle ScholarPubMed
Marx, M. S. and Cohen-Mansfield, J. (2003). Hoarding behavior in the elderly: a comparison between community-dwelling persons and nursing home residents. International Psychogeriatrics, 15, 289–306. doi: 10.1017/S1041610203009542.CrossRefGoogle ScholarPubMed
McCreight, M. S. et al. (2019). Using the Practical, Robust Implementation and Sustainability Model (PRISM) to qualitatively assess multilevel contextual factors to help plan, implement, evaluate, and disseminate health services programs. Translational Behavioral Medicine, 9, 1002–1011. doi: 10.1093/tbm/ibz085.CrossRefGoogle ScholarPubMed
Nordsletten, A. E., de la Cruz, L. F., Pertusa, A., Reichenberg, A., Hatch, S. L. and Mataix-Cols, D. (2013). The Structured Interview for Hoarding Disorder (SIHD): development, usage and further validation. Journal of Obsessive-Compulsive and Related Disorders, 2, 346–350. doi: 10.1016/j.jocrd.2013.06.003.CrossRefGoogle Scholar
Palinkas, L. A., Aarons, G. A., Horwitz, S., Chamberlain, P., Hurlburt, M. and Landsverk, J. (2010). Mixed method designs in implementation research. Administration and Policy in Mental Health and Mental Health Services Research, 38, 44–53. doi: 10.1007/s10488-010-0314-z.CrossRefGoogle Scholar
Postlethwaite, A., Kellett, S. and Mataix-Cols, D. (2019). Prevalence of hoarding disorder: a systematic review and meta-analysis. Journal of Affective Disorders, 256, 309–316. doi: 10.1016/j.jad.2019.06.004.CrossRefGoogle ScholarPubMed
RE-AIM. (2020). About RE-AIM. Available at: http://www.re-aim.org/about/; last accessed 23 January 2020.Google Scholar
Roane, D. M., Landers, A., Sherratt, J. and Wilson, G. S. (2017). Hoarding in the elderly: a critical review of the recent literature. International Psychogeriatrics, 29, 1077–1084. doi: 10.1017/S1041610216002465.CrossRefGoogle ScholarPubMed
Rodriguez, C. I. et al. (2012). Prevalence of hoarding disorder in individuals at potential risk of eviction in New York City: a pilot study. The Journal of Nervous and Mental Disease, 200. doi: 10.1097/NMD.0b013e31823f678b.CrossRefGoogle ScholarPubMed
Santos, S. L. Z. et al. (2017). Adoption, reach, and implementation of a cancer education intervention in African American churches. Implementation Science, 12. doi: 10.1186/s13012-017- 0566-z.CrossRefGoogle ScholarPubMed
Sheehan, D. V. et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59, 22–33.Google ScholarPubMed
Steketee, G. and Frost, R. (2003). Compulsive hoarding: current status of the research. Clinical Psychology Review, 23, 905–927. doi: 10.1016/j.cpr.2003.08.002.CrossRefGoogle Scholar
Tolin, D., Frost, R. and Steketee, G. (2010). A brief interview for assessing compulsive hoarding: the hoarding rating scale-interview. Psychiatry Research, 178, 147–52. doi: 10.1016/j.psychres.2009.05.001.CrossRefGoogle ScholarPubMed
Tolin, D. F., Frost, R. O., Steketee, G., Gray, K. D. and Fitch, K. E. (2008). The economic and social burden of compulsive hoarding. Psychiatry Research, 160, 200–211. doi: 10.1016/j.psychres.2007.08.008.CrossRefGoogle ScholarPubMed
Tolin, D. F., Frost, R. O., Steketee, G. and Muroff, J. (2015). Cognitive behavioral therapy for hoarding disorder: a meta-analysis. Depression and Anxiety, 32, 158–166. doi: 10.1002/da.22327.CrossRefGoogle ScholarPubMed
Woody, S. R., Kellman-Mcfarlane, K. and Welsted, A. (2014). Review of cognitive performance in hoarding disorder. Clinical Psychology Review, 34, 324–336. doi: 10.1016/j.cpr.2014.04.002.CrossRefGoogle ScholarPubMed