An interventional study of RECLAIM: Reducing Clutter and Increasing Meaning and Sorting Practice in Hoarding Disorder, sponsored by Mississippi State University. Completed at 1 site in United States. Open to participants aged 60 Years and older. Per ClinicalTrials.gov, last updated 2026-07-16.
Sponsored by Mississippi State University · Not applicable, Interventional, and Treatment
This study will compare two behavioral interventions for hoarding disorder in older adults.
Hoarding disorder is a psychological condition with a unique constellation of consequences for older adults, including increased risk of fire and dying in a fire, insect infestation, and medical problems. Dangers related to cluttered living spaces are exacerbated by reduced executive functioning, attention, and concentration. Hoarding psychopathology results from maladaptive cognitions (e.g., desire to keep items others would discard) and maladaptive behavioral patterns (e.g., avoidance of sorting/discarding items).
Extant treatments for hoarding have targeted fear reduction as the mechanism of change, either through cognitive-behavioral therapy focusing on cognitive restructuring or behavior therapy focusing on exposure therapy. Older adults have a lackluster response to cognitive restructuring for hoarding, and, although exposure therapy increases treatment response, both approaches require a lengthy six-month dose. Our preliminary work suggests that fear reduction may not be a universally relevant target mechanism for older adults, and that to be responsive to the specific needs of older adults, other mechanisms need to be identified.
Motivational interviewing is a technique that is already typically incorporated into hoarding treatment and has been demonstrated to increase motivation for behavioral change across a range of health conditions for older adults, including physical activity, diet, and disease management. Because sorting/discarding is at its core a health behavior that hoarding patients lack the motivation to engage in, motivational interviewing is likely to decrease hoarding severity by eliciting increased levels of sorting/discarding.
The proposed project will use a mechanistic clinical trials approach to determine if a four-month intervention combining motivational interviewing with sorting practice can engage the proposed target, motivation for behavioral change, when compared to a four-month dose of sorting practice alone in a sample of rural-dwelling older adults with hoarding disorder.
32 studies on the registry are indexed under Hoarding Disorder; 5 are open to participants now.
This study's enrollment of 48 is above the median of 37 across 28 interventional studies indexed under Hoarding Disorder.
Browse Hoarding Disorder studies →Mississippi State University is the lead sponsor of 5 studies on the registry; 1 is open to participants now.
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Exclusion Criteria:
Participants will receive a combination of motivational interviewing and sorting practice to reduce hoarding symptoms.
Behavioral: RECLAIM: Reducing Clutter and Increasing Meaning
Participants will receive sorting practice only to reduce hoarding symptoms.
Behavioral: Sorting Practice
Participants will receive 16 weekly 1-hour treatment sessions in their home delivered by Masters-level clinicians with the assistance of undergraduate researchers. Each treatment session will involve a combination of motivational interviewing (MI) and sorting practice. The rationale behind the sorting practice is to develop the skill of sorting and the formation of a daily sorting routine. The MI portion of the initial session will involve an evaluation of client strengths and individual biopsychosocial goals. The initial and subsequent sessions will include a variety of MI techniques, including decisional balancing, developing discrepancy, personalized feedback, and reinforcement of responsibility of sense of self-efficacy.
Participants will receive 16 weekly 1-hour treatment sessions in their home delivered by Masters-level clinicians with the assistance of undergraduate researchers. Clinicians will encourage participants to sort objects during each session while refraining from use of any specific cognitive or motivational therapeutic techniques. Participants will be asked to record the frequency and duration of any sorting/ discarding they did during the previous week.
Frequency of Sorting/Discarding Behavior
As a behavioral indicator of motivation to engage in sorting/discarding behavior, participants will be asked to report at their weekly treatment sessions the frequency of sorting/discarding items in the previous week. Data were analyzed as percentage of days sorted between sessions (assessed at sessions 2-16). Mixed effects models were used to analyze data such that participants with at least one timepoint were included in the analyses.
Time frame: Four months
University of Rhode Island Change Assessment Questionnaire
The University of Rhode Island Change Assessment Questionnaire (URICA) is a 32-item Likert scale that assesses readiness for change. Scores for readiness for change are calculated by subtracting pre contemplation items from the other summed items. Scores range from -2 to 14, with higher scores indicating greater readiness for change.
Time frame: Four months
Apathy Evaluation Scale
The Apathy Evaluation Scale is an 18-item measure of an individual's deficits in goal-directed thoughts and behavior. Scores range from 18-72, with higher scores reflecting more apathy.
Time frame: Four months
Treatment Acceptability/ Adherence Scale
The Treatment Acceptability/ Adherence Scale is a 10-item self-report measure of a patient's perception of the acceptability of a treatment as well as their anticipated adherence to the protocol. Scores range from 10-70, with higher scores indicating greater acceptability and perceived adherence.
Time frame: Immediately after session 1
Saving Inventory-Revised
The Saving Inventory-Revised is a 23-item measure of the three core hoarding symptoms (urges to save, difficulty discarding, and excessive clutter). Scores range from 0 to 92, with higher scores indicating greater symptom severity.
Time frame: Four months
Clutter Image Rating
The Clutter Image Rating is a three-item pictorial rating scale of clutter level in the bedroom, kitchen, and living room. Assessor ratings of the CIR will be used for the proposed project. Scores of the three rooms are averaged to create a composite score ranging from 1-9, with higher scores indicating greater clutter levels.
Time frame: Four months
Behavioral Approach Task for Sorting/Discarding
The Behavioral Approach Task for sorting/discarding involves the participant sorting items in a cluttered part of their home for 15 minutes. The speed of sorting (# of items sorted) will be used as a behavioral indicator of hoarding severity. The lower limit is 0 items sorted; there is no upper limit of number of items to be sorted.
Time frame: Four months
| Milestone | RECLAIM: Reducing Clutter and Increasing Meaning | Sorting Practice |
|---|---|---|
| Started | 18 | 18 |
| Completed | 9 | 7 |
| Not completed | 9 | 11 |
As a behavioral indicator of motivation to engage in sorting/discarding behavior, participants will be asked to report at their weekly treatment sessions the frequency of sorting/discarding items in the previous week. Data were analyzed as percentage of days sorted between sessions (assessed at sessions 2-16). Mixed effects models were used to analyze data such that participants with at least one timepoint were included in the analyses.
| Percent of days sorted between sessions | RECLAIM: Reducing Clutter and Increasing Meaning | Sorting Practice |
|---|---|---|
| Frequency of Sorting/Discarding Behavior | 38.6 ± 39.2 | 29.1 ± 19.3 |
The University of Rhode Island Change Assessment Questionnaire (URICA) is a 32-item Likert scale that assesses readiness for change. Scores for readiness for change are calculated by subtracting pre contemplation items from the other summed items. Scores range from -2 to 14, with higher scores indicating greater readiness for change.
| score on a scale | RECLAIM: Reducing Clutter and Increasing Meaning | Sorting Practice |
|---|---|---|
| University of Rhode Island Change Assessment Questionnaire | 10 ± 1.3 | 10 ± 1.5 |
The Apathy Evaluation Scale is an 18-item measure of an individual's deficits in goal-directed thoughts and behavior. Scores range from 18-72, with higher scores reflecting more apathy.
| score on a scale | RECLAIM: Reducing Clutter and Increasing Meaning | Sorting Practice |
|---|---|---|
| Apathy Evaluation Scale | 58 ± 7.8 | 63 ± 5.8 |
The Treatment Acceptability/ Adherence Scale is a 10-item self-report measure of a patient's perception of the acceptability of a treatment as well as their anticipated adherence to the protocol. Scores range from 10-70, with higher scores indicating greater acceptability and perceived adherence.
| score on a scale | RECLAIM: Reducing Clutter and Increasing Meaning | Sorting Practice |
|---|---|---|
| Treatment Acceptability/ Adherence Scale | 55 ± 6.9 | 55 ± 8.2 |
The Saving Inventory-Revised is a 23-item measure of the three core hoarding symptoms (urges to save, difficulty discarding, and excessive clutter). Scores range from 0 to 92, with higher scores indicating greater symptom severity.
| score on a scale | RECLAIM: Reducing Clutter and Increasing Meaning | Sorting Practice |
|---|---|---|
| Saving Inventory-Revised | 33 ± 11.0 | 36 ± 11.6 |
The Clutter Image Rating is a three-item pictorial rating scale of clutter level in the bedroom, kitchen, and living room. Assessor ratings of the CIR will be used for the proposed project. Scores of the three rooms are averaged to create a composite score ranging from 1-9, with higher scores indicating greater clutter levels.
| score on a scale | RECLAIM: Reducing Clutter and Increasing Meaning | Sorting Practice |
|---|---|---|
| Clutter Image Rating | 2.9 ± 3.2 | 2.2 ± 2.2 |
The Behavioral Approach Task for sorting/discarding involves the participant sorting items in a cluttered part of their home for 15 minutes. The speed of sorting (# of items sorted) will be used as a behavioral indicator of hoarding severity. The lower limit is 0 items sorted; there is no upper limit of number of items to be sorted.
| number of items | RECLAIM: Reducing Clutter and Increasing Meaning | Sorting Practice |
|---|---|---|
| Behavioral Approach Task for Sorting/Discarding | 63 ± 40.3 | 59.2 ± 25.9 |
Collected over From Enrollment to end of treatment. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| RECLAIM: Reducing Clutter and Increasing Meaning | 0/18 (0%) | 0/18 (0%) | 0/18 (0%) |
| Sorting Practice | 0/18 (0%) | 0/18 (0%) | 0/18 (0%) |
| Age, Continuous(Year) | RECLAIM: Reducing Clutter and Increasing Meaning | Sorting Practice | Total |
|---|---|---|---|
| Mean | 70 ± 7.6 | 69 ± 6.2 | 70 ± 6.9 |
| Sex: Female, Male(Participants) | RECLAIM: Reducing Clutter and Increasing Meaning | Sorting Practice | Total |
|---|---|---|---|
| Female | 11 | 10 | 21 |
| Male | 7 | 8 | 15 |
| Race (NIH/OMB)(Participants) | RECLAIM: Reducing Clutter and Increasing Meaning | Sorting Practice | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 0 | 0 | 0 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 2 | 4 | 6 |
| White | 14 | 14 | 28 |
| More than one race | 2 | 0 | 2 |
| Unknown or Not Reported | 0 | 0 | 0 |
| Savings Inventory-Revised(score on a scale) | RECLAIM: Reducing Clutter and Increasing Meaning | Sorting Practice | Total |
|---|---|---|---|
| Mean | 44.22 ± 15.21 | 49.53 ± 11.76 | 46.80 ± 13.71 |
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: Yes — All data collected will be shared using the NIMH Data Archive (NDA) following safe harbor requirements for de-identification. Data dictionaries currently available in NDA will be used for most measures assessed (e.g., PROMIS measures), but new data dictionaries will be created for unique data elements (e.g., reported frequency of sorting behavior) and standardized measures not currently entered in the NDA (e.g., Clutter Image Rating). Data will be deposited in the NDA twice per year over the course of the study and once the study is complete. Each manuscript based off the study will have specific analytic files deposited to the NDA once the manuscript is accepted for publication.
This study is completed, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.
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Mississippi State University