We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Treatment for hoarding disorder is typically performed by mental health professionals, potentially limiting access to care in underserved areas.
Aims
We aimed to conduct a non-inferiority trial of group peer-facilitated therapy (G-PFT) and group psychologist-led cognitive–behavioural therapy (G-CBT).
Method
We randomised 323 adults with hording disorder 15 weeks of G-PFT or 16 weeks of G-CBT and assessed at baseline, post-treatment and longitudinally (≥3 months post-treatment: mean 14.4 months, range 3–25). Predictors of treatment response were examined.
Results
G-PFT (effect size 1.20) was as effective as G-CBT (effect size 1.21; between-group difference 1.82 points, t = −1.71, d.f. = 245, P = 0.04). More homework completion and ongoing help from family and friends resulted in lower severity scores at longitudinal follow-up (t = 2.79, d.f. = 175, P = 0.006; t = 2.89, d.f. = 175, P = 0.004).
Conclusions
Peer-led groups were as effective as psychologist-led groups, providing a novel treatment avenue for individuals without access to mental health professionals.
Declaration of interest
C.A.M. has received grant funding from the National Institutes of Health (NIH) and travel reimbursement and speakers’ honoraria from the Tourette Association of America (TAA), as well as honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. K.D. receives research support from the NIH and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. R.S.M. receives research support from the National Institute of Mental Health, National Institute of Aging, the Hillblom Foundation, Janssen Pharmaceuticals (research grant) and the Alzheimer's Association. R.S.M. has also received travel support from the National Institute of Mental Health for Workshop participation. J.Y.T. receives research support from the NIH, Patient-Centered Outcomes Research Institute and the California Tobacco Related Research Program, and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. All other authors report no conflicts of interest.
The states that comprise the Gulf Cooperation Council - Oman, Bahrain, the United Arab Emirates, Kuwait, Qatar, and Saudi Arabia - are not a security community. Nor do we anticipate their becoming a security community in the near future. Indeed, for most of its history the Gulf Cooperation Council (GCC) demands a realist reading and little else. The proximate causes of the formation of the GCC are to be found not in deep social structural factors pushing toward integration but in immediate regime security needs; specifically, the GCC was born in the circumstances of Iranian Revolution and the ongoing and escalating Iraq-Iran War, suggesting little more than a classic security alliance. The fifteen years since its birth also favor a strict and secular realism. As the Iran-Iraq War progressed the GCC states experimented with some modest, but for all practical purposes inconsequential, military cooperation. The end of the Iran-Iraq War abruptly halted such experimentation. The 1990–91 Gulf War produced a shortterm upswing in group cohesion but the post-war period was characterized by increasing rivalries, a halt to any meaningful militarycoordination and a return of border disputes among the GCC states. The GCC's trajectory seems consistent with alliance formation - formed in response to specific security threats, enduring as those threats endure, and fraying as those threats recede. In general, statism and realism mark the history of the GCC states.
Recommend this
Email your librarian or administrator to recommend adding this to your organisation's collection.