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Cited by 278Obsessive-Compulsive Spectrum DisordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPerfectionism, Procrastination, Anxiety Studies

Waitlist-controlled trial of cognitive behavior therapy for hoarding disorder

Open access
Steketee, Gail, Frost, Randy O., Tolin, David F., Rasmussen, Jessica, Brown, Timothy A.·2010·Depression and Anxiety
DOI 10.1002/da.20673PMC PMC2922687
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Abstract

OBJECTIVE: This study investigated a multicomponent cognitive behavioral treatment (CBT) for hoarding based on a model proposed by Frost and colleagues and manualized in Steketee and Frost (2007). METHOD: Participants with clinically significant hoarding were recruited from the community and a university-based anxiety clinic. Of the 46 patients randomly assigned to CBT or waitlist (WL), 40 completed the 12-week assessment and 36 completed 26 sessions. Treatment included education and case formulation, motivational interviewing, skills training for organizing and problem solving, direct exposure to nonacquiring and discarding, and cognitive therapy. Measures included the Saving Inventory-Revised (self-report), Hoarding Rating Scale-Interview, and measures of clinical global improvement. Between group repeated measures analyses using general linear modeling examined the effect of CBT versus WL on hoarding symptoms and moodstate after 12 weeks. Within group analyses examined pre-post effects for all CBT participants combined after 26 sessions. RESULTS: After 12 weeks, CBT participants benefited significantly more than WL patients on hoarding severity and mood with moderate effect sizes. After 26 sessions of CBT, participants showed significant reductions in hoarding symptoms with large effect sizes for most measures. At session 26, 71% of patients were considered improved on therapist clinical global improvement ratings and 81% of patients rated themselves improved; 41% of completers were clinically significantly improved. CONCLUSIONS: Multicomponent CBT was effective in treating hoarding. However, treatment refusal and compliance remain a concern, and further research with independent assessors is needed to establish treatment benefits and durability of gains.

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  • The Saving Inventory-Revised has good internal consistency (α = 0.92) and test-retest reliability (r = 0.86), and is sensitive to treatment response.

    “The SI-R has good internal consistency (α = 0.92) and test-retest reliability (r = 0.86), and it is sensitive to treatment response (Frost et al., 2004;Steketee et al., 2010).”

    From A naturalistic study of emotion regulation-enhanced cognitive-behavioral group therapy for hoarding disorder in a community setting (2022) · cites this paper as Steketee et al., 2010

    The Methods > Measures section says the SI-R has good internal consistency and test-retest reliability, but reports α = .88 for this trial’s baseline sample, not .92, and gives no r = .86 estimate. The Results > Pre-Mid-Post Changes section reports significant declines in SI-R scores during treatment, supporting sensitivity to treatment response. Page numbers were not available in our copy. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Hoarding may respond less well to treatment than other types of OCD, leading to development of type of CBT that appears specifically efficacious for hoarding problems.

    “For example, hoarding may respond less well to treatment than other types of OCD (Abramowitz et al., 2003; Rufer et al., 2006), leading to the development of a type of CBT that appears to be specifically efficacious for hoarding problems (Steketee et al., 2010).”

    From An update on the efficacy of psychological treatments for obsessive-compulsive disorder in adults (2013) · cites this paper as Steketee et al., 2010

  • Hoarding disorder has traditionally been considered challenging to treat.

    “HD has traditionally been considered challenging to treat (Frost et al., 2010;Steketee et al., 2010).”

    From A naturalistic study of emotion regulation-enhanced cognitive-behavioral group therapy for hoarding disorder in a community setting (2022) · cites this paper as Steketee et al., 2010

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Research works printed but not linked: 1

  1. [29]Steketee G Frost RO Compulsive hoarding and acquiring: Therapist guide New York Oxford University Press 2007

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Authors
Steketee, G., Frost, R. O., Tolin, D. F., Rasmussen, J., & Brown, T. A.
Affiliations
  • Boston University (US)
  • Smith College (US)
  • Yale University (US)
Corresponding author
Steketee, Gail
ORCID
Venue
Depression and Anxiety
Publisher
Hindawi Limited
Published
2010-03-24
Volume
27
Issue
5
Pages
476-484
ISSN
1091-4269 (ISSN-L)
DOI
10.1002/da.20673
PMC
PMC2922687
OpenAlex
W2004169031
Cited by
278
References
44
Citations by year
2026: 7 · 2025: 7 · 2024: 6 · 2023: 12 · 2022: 10 · 2021: 22 · 2020: 13 · 2019: 17 · 2018: 15 · 2017: 14 · 2016: 15 · 2015: 22 · 2014: 22 · 2013: 55 · 2012: 15
FWCI
32.98
Type
journal article
Language
en
Open access
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 1987 d)
Locations
  • Depression and Anxiety (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Smith ScholarWorks (Smith College) (submittedVersion)
Funders
National Institute of Mental Health (R21MH068539)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Perfectionism, Procrastination, Anxiety Studies
Keywords
hoarding disorder, cognitive behavioral therapy, motivational interviewing, exposure therapy, cognitive therapy, saving behavior, treatment refusal, medication adherence, mood improvement
MeSH terms
Female, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Surveys and Questionnaires, Severity of Illness Index, Waiting Lists, Cognitive Behavioral Therapy, Diagnostic and Statistical Manual of Mental Disorders

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