Can Occupational Therapy Address the Occupational Implications of Hoarding?

Evaluation of an educational programme for people who have difficulty decluttering and organising: A randomised controlled trial in Japan

Home clutter can adversely affect work performance, health and well-being. Clinical-level hoarding disorders usually manifest during early adolescence, so early detection and prevention of subclinical hoarding tendencies are essential. This study aimed to evaluate a community-based programme for individuals with poor organising and decluttering skills who volunteered to receive education on how to organise their homes. We conducted an open-label randomised controlled trial beginning in January 2016 in Tokyo. We enrolled 61 volunteers aged 12-55 years with problems with organising and decluttering. A workshop and home visit group (n = 30) attended four workshop sessions on organising skills and received a visit from a home organiser. The home visit only group (n = 31) only received the home organiser visit. The primary outcome was Saving Inventory-Revised (SI-R; Japanese version) scores. The secondary outcomes were Clutter Image Rating Scale and Rosenberg Self-Esteem Scale (Japanese version) scores. Between-group changes from baseline to 7 months were analysed using a general linear model. At follow-up, the SI-R scores of both groups had improved. The mean change from baseline in SI-R scores was -20.8 (standard deviation = 9.8) and -13.1 (standard deviation = 14.3) in the workshop and home visit and home visit only groups, respectively. The estimated between-group difference in SI-R score changes from baseline (adjusted for baseline SI-R score) was non-significant at -5.7 (95% confidence interval, -12.4 to 0.9; p = .089). However, the difference was significant in the univariate model: -7.2 (95% confidence interval, -13.7 to -0.8; p = .029). Although both groups improved, after adjusting for baseline values and participant characteristics, there was no significant difference between the groups. Our results suggest that a workshop-style educational intervention and assistance and advice from professional organisers may help to improve the living conditions of people with hoarding tendencies.