title: Comparison of a peer facilitated support group to cognitive behavior therapy: Study protocol for a randomized controlled trial for hoarding disorder.
abstract: Although individual and group cognitive-behavioral therapy (CBT) is the standard treatment approach for hoarding disorder (HD), it requires trained mental health professionals with specialization in HD. There is a need to offer additional options and services due to the limited number of professionals with advanced training, combined with the high prevalence rate of individuals with HD. A structured support group led by trained facilitators or lay professionals using a facilitator's manual and participant workbook (Buried in Treasures or BiT), addresses this need and increases accessibility. Prior studies of BiT groups have shown decreased hoarding symptoms. Only one retrospective study compared BiT and CBT outcomes in a naturalistic setting and showed no difference. Thus, a well-powered randomized controlled trial is needed to directly compare these forms of treatment. This paper presents a non-inferiority controlled trial protocol that compares group CBT to group BiT. Three hundred participants with HD, 18years or older, are being recruited for a 16-week treatment study. Participants are randomly assigned to either the CBT or BiT group. The primary outcome is reduction in hoarding symptom severity. Secondary outcomes include reduction in other indices of hoarding symptomology, including functional impairment, physical clutter, cognition, and changes in neuropsychological functioning.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, California, USA.
authors.forename: Soo Y
authors.initials: SY
authors.lastname: Uhm
authors.affiliation: Department of Psychiatry, University of California, San Francisco, California, USA.
authors.forename: Janice Y
authors.initials: JY
authors.lastname: Tsoh
authors.affiliation: Department of Psychiatry, University of California, San Francisco, California, USA.
authors.forename: R Scott
authors.initials: RS
authors.lastname: Mackin
authors.affiliation: Mental Health Association of San Francisco, San Francisco, California, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Gause
authors.affiliation: Mental Health Association of San Francisco, San Francisco, California, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Chan
authors.affiliation: Mental Health Association of San Francisco, San Francisco, California, USA.
authors.forename: John
authors.initials: J
authors.lastname: Franklin
authors.affiliation: Department of Nursing and Health Sciences, California State University, East Bay, California, USA.
authors.forename: Monika
authors.initials: M
authors.lastname: Eckfield
authors.affiliation: Mental Health Association of San Francisco, San Francisco, California, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Salazar
authors.affiliation: University of California Davis Health System, California, USA.
authors.forename: Ofilio
authors.initials: O
authors.lastname: Vigil
authors.affiliation: Mental Health Association of San Francisco, San Francisco, California, USA.
authors.forename: David
authors.initials: D
authors.lastname: Bain
authors.affiliation: Mental Health Association of San Francisco, San Francisco, California, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Stark
authors.affiliation: Mental Health Association of San Francisco, San Francisco, California, USA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Vega
authors.affiliation: Department of Psychiatry, University of California, San Francisco, California, USA.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Delucchi
authors.affiliation: Department of Psychiatry, University of California, San Francisco, California, USA; College of Medicine, University of Florida, Florida, USA. Electronic address: carolmathews@ufl.edu.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Mathews
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D057186:Comparative Effectiveness Research; D005260:Female; D000067836:Hoarding Disorder / Q000628:therapy*; D006801:Humans; D008297:Male; D012107:Research Design; D012657:Self-Help Groups / Q000458:organization & administration*; D012720:Severity of Illness Index
keywords: Cognitive behavioral therapy; Community partnership; Comparative effectiveness trial; Hoarding