Cognitive Rehabilitation and Exposure Therapy for Geriatric Hoarding (CREST)
Hoarding Disorder, Obsessive-Compulsive Disorder
About this trial
This is an interventional treatment trial for Hoarding Disorder focused on measuring older adult, executive dysfunction, hoarding, OCD, exposure therapy, cognitive rehabilitation
Eligibility Criteria
Inclusion Criteria:
- adults age 50 and older
- voluntary informed consent for participation
- DSM-5 diagnosis of HD
- HD as a primary, most severe diagnosis
- stable on medications for at least 8 weeks
Exclusion Criteria:
- current psychosis or mania as measured by the Mini-International
- current or history of any neurodegenerative disease
- substance use disorder
- current use of benzodiazepine medication
- suicidality
- current participation in exposure-based therapy
Sites / Locations
- Guava Hall
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST)
Case Management (CM)
Compensatory Cognitive Training (CCT) Modules (7 sessions). Compensatory Cognitive Training is a manualized, low-tech, cognitive training intervention designed to target cognitive impairments common in people with psychiatric illnesses. The CCT modules specifically selected for CREST map onto known areas of HD neurocognitive impairments and include training in prospective memory, prioritizing, problem solving, planning, and cognitive flexibility. Exposure to Discarding and Acquiring Modules (19 sessions). Symptoms of acquiring and saving are themselves avoidance behaviors to avoid internal distress related to negative thoughts and emotions. ET utilizes in vivo exposure exercises taking place in the home to enhance generalization of their new skills. Fear hierarchies typically start with a space that has low clutter volume or there is less of an urge to save a particular type of item in that environment.
Case Management (CM). CM consists of a set of well-established strategies commonly used in community service settings to address serious and complex problems in particularly vulnerable and often marginalized populations such as those with HD.