The Effectiveness of the Dutch Cognitive-Behavioral Therapy Protocol for Hoarding Disorder: A Pilot Study

Authors

    Puck Duits * Altrecht Academic Anxiety Centre, Altrecht GGz, Nieuwe Houtenseweg 2, 3524 SH Utrecht, the Netherlands p.duits@altrecht.nl
    Mae Dorothea Nuijs Altrecht Academic Anxiety Centre, Altrecht GGz, Nieuwe Houtenseweg 2, 3524 SH Utrecht, the Netherlands
    Marijda Fournier Altrecht Academic Anxiety Centre, Altrecht GGz, Nieuwe Houtenseweg 2, 3524 SH Utrecht, the Netherlands

Keywords:

Hoarding disorder, CBT, Treatment effect, Clutter

Abstract

In this pilot study, the effectiveness of the Dutch cognitive-behavioral therapy (CBT) protocol for hoarding disorder was investigated for the first time in adult patients with hoarding disorder (N=36). A rather unique feature of this protocol is the intensive collaboration with home counselors. Results demonstrated a significant decline in hoarding related symptoms during treatment (d = .87)), including reduced acquisition of items (d = 0.88), reduced clutter (d = .98), and less difficulty discarding items (d = .0.77). Furthermore, patients reported significantly less excessive acquisition of items post-treatment (d = 0.30). Moreover, there were significant changes in underlying hoarding cognitions from pre- to post-treatment (d = 0.34). More specifically, there was a significant decrease in beliefs related to 1) identity and attachment (d = 0.53), 2) responsibility for objects (d = 0.48), and 3) using items as memory aids (d = 0.54) from pre- to post-treatment. No significant change was observed during treatment in the patients' cognitions related to the need for control over personal possessions (p = .086; d = 0.28). Furthermore, there was no significant decrease in symptoms of psychopathology from pre- to post-treatment (p = .586; d = 0.11). Finally, additional analyses indicated that whether patients were having a relationship and/or were having children was not significantly related to treatment outcome (all p’s > .052). This pilot study is a first step in mapping the effect of CBT in Dutch patients with hoarding disorder, which will hopefully contribute to making treatment more widely available for these patients in the long term.

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Published

2026-03-01

Submitted

2025-11-13

Revised

2025-12-12

Accepted

2026-01-27

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Articles

How to Cite

Duits, P., Nuijs, M. D. ., & Fournier , M. (2026). The Effectiveness of the Dutch Cognitive-Behavioral Therapy Protocol for Hoarding Disorder: A Pilot Study. Psychological Research in Individuals With Exceptional Needs, 1-13. https://journals.kmanpub.com/index.php/prien/article/view/4725