Self-reported helpfulness of Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) for hoarding disorder

Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) is a promising treatment for hoarding disorder (HD) that incorporates exposure for sorting with compensatory cognitive training (CCT) tailored to reduce cognitive difficulties associated with hoarding. A randomized controlled trial of CREST found it to be favorable to case management for reducing hoarding symptoms and improving executive functioning. The purpose of this investigation was to evaluate participant feedback about CREST and the perceived helpfulness of each aspect of treatment: individual CCT skills, exposure, and relapse prevention. We evaluated quantitative and qualitative data from 21 older adults who completed CREST. Most CREST modules were rated as being quite a bit helpful. The modules with the highest helpfulness ratings were using a calendar, making to-do lists, and practicing sorting. Higher helpfulness ratings of practicing sorting and using a calendar were associated with greater decreases in functional limitations at post-treatment. Participants commonly identified their therapist as the most helpful aspect of treatment, assessments as the least helpful, and expressed CREST could be improved upon with additional relapse prevention and/or aftercare. Our results suggest that in addition to being efficacious, CREST is perceived to be a highly useful treatment by older adults with HD.

Automated summary

CREST is an effective treatment for hoarding disorder that combines exposure for sorting and cognitive training, with participants finding therapists to be the most helpful aspect of treatment.