This study was conducted before hoarding disorder (HD) became a separate diagnosis in the DSM-5 in 2013.
At the time, research identified four problems that people with hoarding symptoms had: 1. Problems with processing information and decision-making; 2. Possessing an emotional attachment to objects; 3. Avoiding decision-making associated with possessions and suffering distress; and 4. Mistaken beliefs about the nature of objects. An early form of cognitive behavioral therapy (CBT) was developed to help people with hoarding symptoms make prudent decisions about their possessions and reduce the clutter in their living spaces.
This study by Drs. Frost and Steketee focused on refining the treatment and testing its effectiveness for seven patients with primary hoarding problems. The treatment was implemented in a group format for six people and individually for one person. It included weekly visits to patients at their homes and focused on five strategies: providing education about hoarding, practicing making decisions, training on organizing, behavioral exposure, and cognitive therapy. Most participants experienced moderate success during this pilot study, which ultimately served as the basis for developing and testing a full manualized CBT for hoarding disorder (HD) (Steketee, G. & Frost, R.O. (2013). Treatment for hoarding disorder: Therapist guide (2nd ed.). Oxford University Press.)
Steketee, G., Frost, R.O., Wincze J., Greene, K.A.I. & Douglas, H. (2000). Group and individual treatment of compulsive hoarding: A pilot study. Behavioral and Cognitive Psychotherapy, 28, 259-268.