Objective: The Buried in Treasures (BIT) workshop is a promising treatment for hoarding disorder (HD), though many participants struggle with home uncluttering. This randomized waitlist-controlled trial investigated the efficacy of a version of BIT, augmented with in-home uncluttering practice (BIT+).
Method: Adults (N = 41) with hoarding disorder were recruited from the community and randomly assigned to BIT+ or waitlist. BIT+ consisted of 16 sessions of the BIT workshop and 10 uncluttering home visits over 18 weeks. Outcome measures included the Saving Inventory-Revised (self-report) and the Clutter Image Rating Scale (self and independent evaluator rated). Between group repeated measures analyses using general linear modeling examined the effect of BIT+ vs waitlist control on hoarding symptoms after 18 weeks. Within group analyses examined pre-post effects for all BIT+ participants combined after 18 weeks.
Results: After 18 weeks, BIT+ participants benefited significantly more than waitlist controls on hoarding severity with large effect size (Cohen's d = 1.5, p < .001). BIT+ was also associated with improvement reductions in hoarding symptoms, clutter, and functional impairment.
Conclusions: The BIT+ intervention offers promise as a treatment option for hoarding. Adding in-home uncluttering practice may incrementally improve discarding practices. Future controlled trials are warranted.
Competing Interests: Declaration of competing interest In the last 3 years, Dr. Rodriguez has served as a consultant for Biohaven Pharmaceuticals, Osmind, and Biogen; and receives research grant support from Biohaven Pharmaceuticals, a stipend from American Psychiatric Association Publishing for her role as Deputy Editor at The American Journal of Psychiatry, a stipend for her role as Deputy Editor at Neuropsychopharmacology, and book royalties from American Psychiatric Association Publishing. The other authors report no additional financial or other relationships relevant to the subject of this manuscript.
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