3 - (SYM 37) Acceptability and Effectiveness of a Group-based CBT and Harm-minimisation Program for Hoarding Disorder

Hoarding disorder (HD) is a chronic and impairing condition associated with substantial functional disability and heightened safety risks, including increased fire hazard. Although cognitive behaviour therapy (CBT) is the most empirically supported treatment for HD, access, engagement, and acceptability remain significant barriers, particularly for individuals requiring long-term, resource-intensive care. The present study evaluated the acceptability and effectiveness of a brief, group-based CBT program incorporating harm-minimisation principles, with an emphasis on equitable and sustainable delivery.

Adults with a diagnosis of HD completed a 10-week CBT-based group program delivered in routine clinical practice. The program was designed to fit within existing publicly funded health-care reimbursement structures, with the aim of improving access to care and supporting sustainable implementation in community settings. Participants completed standardised self-report measures pre- and post-treatment, including the Savings Inventory–Revised (SI-R), the Savings Cognitions Inventory–Revised (SCI-R), and the Depression Anxiety Stress Scales (DASS-21). Participants also completed questions assessing fire safety knowledge and confidence in harm-minimisation strategies following a targeted psychoeducation session.

Pre–post analyses demonstrated large and statistically significant reductions in hoarding severity on the SI-R, along with significant reductions in responsibility-related hoarding cognitions. Changes in depression, anxiety, and stress were small and non-significant. Participant feedback indicated high acceptability of the program, increased awareness of fire risk, and perceived usefulness of harm-minimisation strategies.

These findings suggest that group-based CBT incorporating harm-minimisation principles can be an acceptable and effective approach for reducing hoarding symptoms while addressing real-world safety concerns. Such approaches may support more affirming, accessible, and sustainable delivery of evidence-based CBT for hoarding disorder across diverse health-care systems.