Web Training and Support on Evidence-based Practice for Compulsive Hoarding

DESCRIPTION (provided by applicant): With this SBIR application, the New England Research Institutes (NERI) aims to develop a highly innovative clinician training and support product that is based upon a landmark, empirically-supported Oxford University Pr ess therapist guide and workbook for compulsive hoarding. Compulsive hoarding is a prevalent and potentially devastating disorder which is under-recognized and inadequately managed by most clinicians. The disorder is associated severe personal impairment a nd with high societal costs from lost work productivity, mental health service utilization, non-psychiatric medical costs, and demands on over-burdened housing authorities, visiting nurse agencies, and public health workers. A readily-available training an d support product is in very high demand by mental health providers who are frustrated by the ineffectiveness of current treatments available and who feel ill-equipped to treat clients who hoard. NERI will develop the web-based training product in collabor ation with the researchers and authors of the compulsive hoarding manual (G. Steketee, R. Frost). An innovative plan is proposed to systematically evaluate the impact on clinician's knowledge, practice skills, and fidelity to the method, as well. Phase II will incorporate web-based methods to assist the clinician in adhering to this evidence-based practice. A web format is particularly appropriate as it can be constantly updated as new research on effective treatment methods is completed and diffusion of ne w technology provides other tools for monitor clinician adherence to the training approach. This SBIR program addresses directly an NIMH's priority to use information technologies and the internet in health services and intervention delivery . This produc t will advance the state of practice in five major, innovative ways: (1) It addresses an urgent, but universally under-recognized mental health problem (compulsive hoarding) that practitioners are wholly unprepared to treat. (2) The manual-based treatment approach which provides the program's foundation is unique and path-breaking. (3) The evaluation design and active ingredients of the web instructional program are unparalleled in mental health training. (4) The investigator team is uniquely multi-discipli nary and qualified, combining the best of academe, clinical practice, research, and commercial knowledge. (5) NERI has a unique blend of strong empirical research resources and commitment to advancing evidence-based clinical practice. Thus, this product st rives to provide the cutting edge in evidence-based mental health training, monitoring of fidelity, and the evaluation of training. NERI will recruit in Phase I 60 mental health clinicians from diverse practice settings to a randomized controlled trial (de layed-intervention) to evaluate the feasibility of the web-based program, relative to the therapist guide alone, and to pilot test the elements of the Phase II effectiveness evaluation, with measures o these key outcomes: a) knowledge gain; b) skill acquis ition and adherence; c) engagement in and satisfaction with the learning experience; d) attitude change; and, e) intent to treat more clients with compulsive hoarding problems. PUBLIC HEALTH RELEVANCE: The overall AIM for this SBIR is to develop, implement and evaluate an innovative program for mental health clinicians that trains in and supports continued use of an empirically-supported treatment for compulsive hoarding using specialized cognitive and behavioral interventions. The full SBIR program will in crease clinical awareness of how to recognize and diagnose compulsive hoarding, translate the only evidence-based therapist manual that exists into a highly accessible and engaging web-based format, and create an innovative way to measure and increase clin ician adherence to recommended practices.