Randomised clinical trial of community-based peer-led and psychologist-led group treatment for hoarding disorder

Background Treatment for hoarding disorder is typically performed by mental health professionals, potentially limiting access to care in underserved areas. Aims We aimed to conduct a non-inferiority trial of group peer-facilitated therapy (G-PFT) and group psychologist-led cognitive-behavioural therapy (G-CBT). Method We randomised 323 adults with hording disorder 15 weeks of G-PFT or 16 weeks of G-CBT and assessed at baseline, post-treatment and longitudinally (>= 3 months post-treatment: mean 14.4 months, range 3-25). Predictors of treatment response were examined. Results G-PFT (effect size 1.20) was as effective as G-CBT (effect size 1.21; between-group difference 1.82 points, t = -1.71, d.f. = 245, P = 0.04). More homework completion and ongoing help from family and friends resulted in lower severity scores at longitudinal follow-up (t = 2.79, d.f. = 175, P = 0.006; t = 2.89, d.f. = 175, P = 0.004). Conclusions Peer-led groups were as effective as psychologist-led groups, providing a novel treatment avenue for individuals without access to mental health professionals. (c) The Royal College of Psychiatrists 2018.