Effectiveness of cognitive-behaviour therapy for hoarding disorder in people with mild intellectual disabilities

Evaluations of cognitive behavioural interventions for hoarding for those with intellectual disabilities (ID) have not been previously attempted. This investigation therefore examined the acceptability and effectiveness of cognitive-behavioural therapy (CBT) in a sample of N=14 adults with mild ID. All participants had hoarding as their primary problem and received twelve individual CBT sessions, all conducted via domiciliary visits. The primary outcome measure was an environmental measure (Clutter Image Rating Scale), which was scored at baseline, end of treatment and at six-month follow-up. Acceptability of CBT was measured via the treatment refusal and dropout rate. Secondary self-report outcomes included measures of hoarding, depression and anxiety. Results demonstrate that hoarding significantly reduced following treatment on both self-report and environmental assessment. No participants refused or dropped out of treatment and that there was no evidence of relapse over the follow-up period. No adverse treatment incidences were reported. This open trial suggests that CBT may be a safe and effective intervention for hoarding difficulties in people with ID, but that the evidence base in this population needs urgent and detailed attention.