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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
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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

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