title: Treating Hoarding Disorder in a real-world setting: Results from the Mental Health Association of San Francisco.
abstract: Hoarding Disorder (HD) is associated with substantial distress, impairment, and individual and societal costs. Cognitive-behavioral therapy (CBT) tailored to HD is the best-studied form of treatment and can be led by mental health professionals or by non-professionals (peers) with specific training. No previous study has directly compared outcomes for therapist-led and peer-led groups, and none have examined the effectiveness of these groups in a real-world setting. We used retrospective data to compare psychologist-led CBT groups (G-CBT) to groups led by peer facilitators using the Buried in Treasures workbooks (G-BiT) in individuals who sought treatment for HD from the Mental Health Association of San Francisco. The primary outcome was change in Hoarding Severity Scale scores. Approximate costs per participant were also examined. Both G-CBT and G-BiT showed improvement consistent with previous reports (22% improvement overall). After controlling for baseline group characteristics, there were no significant differences in outcomes between G-CBT and G-BiT. For G-CBT, where additional outcome data were available, functional impairment and severity of hoarding symptoms improved to a similar degree as compared to previous G-CBT studies, while hoarding-related cognition improved to a lesser degree (also consistent with previous studies). G-BiT cost approximately $100 less per participant than did G-CBT.
authors.affiliation: Department of Psychiatry, University of Florida, Gainesville, FL, USA; Department of Psychiatry, University of California, San Francisco, CA, USA. Electronic address: carolmathews@ufl.edu.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Mathews
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA, USA.
authors.forename: Soo
authors.initials: S
authors.lastname: Uhm
authors.affiliation: Mental Health Association of San Francisco, San Francisco, CA, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Chan
authors.affiliation: Mental Health Association of San Francisco, San Francisco, CA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Gause
authors.affiliation: Mental Health Association of San Francisco, San Francisco, CA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Franklin
authors.affiliation: Mental Health Association of San Francisco, San Francisco, CA, USA.
authors.forename: Julian
authors.initials: J
authors.lastname: Plumadore
authors.affiliation: Mental Health Association of San Francisco, San Francisco, CA, USA.
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Stark
authors.affiliation: Mental Health Association of San Francisco, San Francisco, CA, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA, USA.
authors.forename: Ofilio
authors.initials: O
authors.lastname: Vigil
authors.affiliation: Mental Health Association of San Francisco, San Francisco, CA, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Salazar
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA, USA.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Delucchi
authors.affiliation: Mental Health Association of San Francisco, San Francisco, CA, USA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Vega
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D000067836:Hoarding Disorder / Q000628:therapy*; D006801:Humans; D008297:Male; D008604:Mental Health Associations; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011615:Psychotherapy, Group / Q000379:methods*; D012189:Retrospective Studies; D012495:San Francisco; D012657:Self-Help Groups
keywords: Cognitive behavioral therapy; Outcome; Peer facilitation; Support group