The primary aim of the current study is a preliminary investigation of the efficacy of contingency management (CM) in the treatment of hoarding disorder (HD). CM is a highly efficacious treatment that has been used to treat issues such as substance use disorders, medication/ medical regimen nonadherence, and schizophrenia. While the current best-practice treatment for HD (cognitive behavioral therapy; CBT) is efficacious in that it results in significant symptom reduction, many patients continue to have high levels of functional impairment and distressing symptoms after treatment completion. We strongly feel that CM is able to address many of the issues that arise in the context of CBT for hoarding and we feel that the addition of CM to as CBT will result in significant pre- to post-treatment decreases in severity of hoarding symptoms and impairment, and significant increases in quality of life.
Aim 1: To test the efficacy of contingency management for patients with hoarding disorder (HD).~Hypothesis 1. Participants completing CM will show significant pre- to post-treatment decreases in severity of hoarding symptoms and clinician-rated impairment, and significant increases in quality of life.~Exploratory analyses will examine whether effect sizes compare with those of prior trials of cognitive-behavioral therapy (CBT) for HD conducted within our clinic, whether problem severity at follow-up is predicted by hoarding severity measured immediately after treatment completion, and whether readiness for change improves with treatment.