# Motivational Interviewing to Enhance Behavioral Change in Older Adults with Hoarding Disorder

> **NIH NIH R15** · MISSISSIPPI STATE UNIVERSITY · 2022 · $427,415

## Abstract

Project Summary
Hoarding disorder is a psychological condition with a unique constellation of consequences for older
adults, including increased risk of fire and dying in a fire, insect infestation, and medical problems.
Dangers related to cluttered living spaces are exacerbated by reduced executive functioning, attention,
and concentration. Hoarding psychopathology results from maladaptive cognitions (e.g., desire to keep
items others would discard) and maladaptive behavioral patterns (e.g., avoidance of sorting/discarding
items). Extant treatments for hoarding have targeted fear reduction as the mechanism of change, either
through cognitive-behavioral therapy focusing on cognitive restructuring or behavior therapy focusing on
exposure therapy. Older adults have a lackluster response to cognitive restructuring for hoarding, and,
although exposure therapy increases treatment response, both approaches require a lengthy six-month
dose. Our preliminary work suggests that fear reduction may not be a universally relevant target
mechanism for older adults, and that to be responsive to the specific needs of older adults, we need to
identify other mechanisms. Motivational interviewing is a technique that is already typically incorporated
into hoarding treatment and has been demonstrated to increase motivation for behavioral change across
a range of health conditions for older adults, including physical activity, diet, and disease management.
Because sorting/discarding is at its core a health behavior that hoarding patients lack the motivation to
engage in, motivational interviewing is likely to decrease hoarding severity by eliciting increased levels of
sorting/discarding. The proposed project will use a mechanistic clinical trials approach to determine if a
four-month intervention combining motivational interviewing with sorting practice can engage the
proposed target, motivation for behavioral change, when compared to a four-month dose of sorting
practice alone in a sample of rural-dwelling older adults. Rural-dwelling older adults with hoarding
disorder represent a particularly difficult to treat population, as they are less likely to experience external
motivating factors to seek treatment (e.g., complaints from neighbors/municipal officials). This project
would represent the first step in a broader course of research to investigate efficacious treatment targets
for late life hoarding. The long-term goal of this research is to determine if conceptualizing the
psychopathology of hoarding as a deficit in a health behavior can inform our development and
implementation of evidence-based treatment for geriatric hoarding across contexts.

## Key facts

- **NIH application ID:** 10436587
- **Project number:** 1R15MH127565-01A1
- **Recipient organization:** MISSISSIPPI STATE UNIVERSITY
- **Principal Investigator:** Mary Elizabeth Dozier
- **Activity code:** R15 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $427,415
- **Award type:** 1
- **Project period:** 2022-02-01 → 2026-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10436587

## Citation

> US National Institutes of Health, RePORTER application 10436587, Motivational Interviewing to Enhance Behavioral Change in Older Adults with Hoarding Disorder (1R15MH127565-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10436587. Licensed CC0.

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