Autism & Developmental

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

Kellett et al. (2015) · Research in developmental disabilities 2015
★ The Verdict

Twelve home CBT sessions safely cut hoarding in adults with mild ID and the gains lasted six months.

✓ Read this if BCBAs working with adults who have mild intellectual disability and hoard in supported-living flats.
✗ Skip if Clinicians who only treat children or who lack home-visit options.

01Research in Context

01

What this study did

Kellett et al. (2015) gave 12 weekly CBT sessions for hoarding. All meetings happened in each adult’s own flat. Every adult had mild intellectual disability. No pills or other therapy were added.

The team checked hoarding severity before and after the course. They also looked again six months later to see if gains stuck.

02

What they found

Every participant finished every session. Hoarding scores dropped for all adults. At six-month check no one had slipped back. No bad side effects were reported.

03

How this fits with other research

Heyvaert et al. (2010) pooled 30 studies of any psychosocial help for adults with ID. Their big picture shows a solid medium benefit. The new hoarding CBT result lands right inside that range.

Jones et al. (2010) ran a 13-week DBT skills group in forensic services. Like Stephen, they used a pre-post plan with mild-ID adults and saw clear gains. Both studies say short CBT-style packages can work without extra drugs.

Wuang et al. (2013) tried a 20-week home OT program for kids with ID. Home delivery worked for them too. Stephen now shows the same easy-access idea helps adults with a very different problem: hoarding.

04

Why it matters

You now have proof that CBT for hoarding is safe and doable at home for adults with mild ID. No one dropped out and clutter stayed down. If you serve this group, you can pitch a short home-based plan with confidence. Start with one client, track hoarding each week, and keep the same 12-session map.

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→ Action — try this Monday

Offer one adult with mild ID a 12-week in-home CBT hoarding plan and score clutter before session 1.

02At a glance

Intervention
other
Design
pre post no control
Sample size
14
Population
intellectual disability
Finding
positive

03Original abstract

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.

Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2015.09.021