(PS7-30) Using Telehealth – Delivered Motivational Interviewing for Hoarding Disorder in a Rural-Dwelling Older Adult: A Case Study

Abstract Text: Hoarding Disorder (HD) is a chronic condition linked to functional and health problems (Ayers et al., 2015). Motivational Interviewing (MI) is a treatment that focuses on the patient’s values and explores the discrepancies between their current behaviors and their intended goals to help them change their behavior (Miller & Rollnick, 2013). A home-based MI intervention for hoarding disorder, Project RECLAIM (Reduce Clutter and Increase Meaning), has been found to reduce hoarding symptoms in as few as six sessions (Dozier & Nix, 2025). Older adults in rural areas have limited access and face multiple barriers to engaging in HD treatment. Therefore, the purpose of this study was to evaluate the preliminary efficacy of a telehealth version of RECLAIM using a case example. Ms. A is a White woman in her mid-50s who was enrolled in the pilot telehealth trial for Project RECLAIM. Treatment involved sorting items in her home while talking to the telehealth clinician. The first session also included a discussion of strengths, values, and goals (short-term and long-term); at the final session, Ms. A reported that she had accomplished her goals for treatment. Outcome measures included perceived person-item interconnectedness on the Relationship between Self and Items (RSI; Dozier, 2022), clutter level on the Clutter Image Rating (CIR; Frost et al., 2008), the PROMIS Emotional Distress- Anxiety and Depression Short Forms, and the NIH Toolbox Emotion Battery General Self-Efficacy and Positive Affect short forms. Additionally, at baseline, Ms. A completed measures of working memory and delayed memory from the NIH Toolbox Cognition Battery; results suggest she has above-average cognitive functioning. Ms. A reported a decrease in scores on the RSI (-43%; 7 to 4) and CIR (-11%; 3 to 2.67), no change on Anxiety (+5%; 64.5 to 67.7) or Depression (-1.5%; 58.8 to 57.9), and increases on General Self-Efficacy (+19%; 35.3 to 42.0) and Positive Affect (+24%; 33.9 to 42.2). Thus, following only six sessions of telehealth using MI, Ms. A had a significant improvement in hoarding symptoms as well as an increase in positive affect and general self-efficacy. Teletherapy may be an option to treat individuals in rural areas who would otherwise not have access to evidence-based treatment for hoarding.