James O E Pittman1,2,3, Eliza J Davidson4,5, Mary E Dozier5,6, Brian H Blanco1,5, Kylie A Baer5, Elizabeth W Twamley1,3,5, Tina L Mayes1,2,5, David H Sommerfeld1, Tiffany Lagare7, Catherine R Ayers1,2,4,5,7. 1. Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA. 2. Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA, USA. 3. Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA. 4. San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA. 5. Research Service, VA San Diego Healthcare System, San Diego, CA, USA. 6. Department of Psychology, Mississippi State University, Starkville, MS, USA. 7. Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, San Diego, CA, USA.
Abstract
OBJECTIVES: The objective of this paper was to examine the implementation and effectiveness of a community-based intervention for hoarding disorder (HD) using Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST). DESIGN: This was a mixed-method, pre-post quasi-experimental study informed by the Practical, Robust Implementation and Sustainability Model for implementation science. SETTING: Program activities took place in San Diego County, mainly within clients' homes or community, with some activities in-office. PARTICIPANTS: Participants were aged 60 years or older, met eligibility for Medi-Cal or were uninsured, and met criteria for HD. INTERVENTION: A manualized, mobile protocol that incorporated CREST was utilized. MEASUREMENTS: The Clutter Image Rating and Hoarding Rating Scale were used as effectiveness outcomes. An investigator-created staff questionnaire was used to evaluate implementation. RESULTS: Thirty-seven clients were reached and enrolled in treatment and 15 completed treatment during the initial 2 years of the program. There were significant changes in hoarding severity and clutter volume. Based on the initial 2 years of the program, funding was provided for expansion to cover additional San Diego County regions and hire more staff clinicians in year three. CONCLUSION: Preliminary data suggest that the CREST intervention can be successfully implemented in a community setting with positive results for older adults with HD.
OBJECTIVES: The objective of this paper was to examine the implementation and effectiveness of a community-based intervention for hoarding disorder (HD) using Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST). DESIGN: This was a mixed-method, pre-post quasi-experimental study informed by the Practical, Robust Implementation and Sustainability Model for implementation science. SETTING: Program activities took place in San Diego County, mainly within clients' homes or community, with some activities in-office. PARTICIPANTS: Participants were aged 60 years or older, met eligibility for Medi-Cal or were uninsured, and met criteria for HD. INTERVENTION: A manualized, mobile protocol that incorporated CREST was utilized. MEASUREMENTS: The Clutter Image Rating and Hoarding Rating Scale were used as effectiveness outcomes. An investigator-created staff questionnaire was used to evaluate implementation. RESULTS: Thirty-seven clients were reached and enrolled in treatment and 15 completed treatment during the initial 2 years of the program. There were significant changes in hoarding severity and clutter volume. Based on the initial 2 years of the program, funding was provided for expansion to cover additional San Diego County regions and hire more staff clinicians in year three. CONCLUSION: Preliminary data suggest that the CREST intervention can be successfully implemented in a community setting with positive results for older adults with HD.
Authors: Chelsea Leonard; Heather Gilmartin; Marina McCreight; Lynette Kelley; Brandi Lippmann; Ashlea Mayberry; Andrew Coy; Emily Lawrence; Robert E Burke Journal: J Gen Intern Med Date: 2019-05 Impact factor: 5.128
Authors: Borsika A Rabin; Julie Cakici; Caitlin A Golden; Paul A Estabrooks; Russell E Glasgow; Bridget Gaglio Journal: Implement Sci Date: 2022-09-24 Impact factor: 7.960