Acceptance and Commitment Therapy for Hoarding Disorder in an Older Adult - Pilot Study

Forming connections with objects can be a part of normal development; however, difficulties occur when this accumulation of items grows excessive or when the person finds it difficult to part with the collected items. Hoarding disorder (HD) can be characterised as an enduring difficulty to part with objects or items because of a need to collect them, coupled with considerable distress associated with disposing of them. Hoarding problems come under the clinical guidelines for obsessive-compulsive disorder (OCD), which recommend psychological intervention at the individual’s home. Cognitive-Behavioural Therapy (CBT) is the most widely used psychological therapy in treating HD currently. With dropout rates high and problems persisting for more than 50% of this population, there is a need for perhaps a different psychotherapeutic approach. Acceptance and Commitment Therapy (ACT) is based on mindful and values-guided action but has received very little attention in terms of the efficacy for treating HD in older adults. Exploring different therapy modalities for the treatment of HD in this population could provide useful insights in understanding, conceptualising and treating HD. This case study describes the use of ACT to treat “Emily,” a 69-year-old woman with HD. The case also explores the strengths of using ACT in HD, possible adaptations to the model moving forward and suggestions for future research.