Virtual reality therapy may help people with hoarding disorder declutter

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For individuals struggling with hoarding disorder, the reluctance to part with possessions can reach debilitating levels.

A recent pilot study conducted by researchers at Stanford Medicine suggests that virtual reality (VR) therapy may offer a promising solution by allowing individuals with hoarding disorder to practice decluttering in a simulated environment mirroring their own homes.

This innovative approach aims to help patients develop organizational and decision-making skills, desensitize them to the distress associated with discarding items, and enhance the effects of cognitive behavioral therapy—the current standard treatment.

Understanding Hoarding Disorder

Hoarding disorder is a mental condition characterized by persistent difficulty in parting with possessions.

This condition often leads to the accumulation of clutter, which can severely impact relationships, work, and personal safety.

Despite its significant impact, hoarding disorder has only been formally recognized as a diagnosis since 2013.

People with hoarding disorder are often older individuals who may face stigma and shame, preventing them from seeking help.

In some cases, the condition remains hidden until it is discovered through cluttered backgrounds on video calls or, tragically, when emergency responders encounter dangerous living conditions.

Challenges of Traditional Treatment

Traditional treatment methods for hoarding disorder, such as cognitive behavioral therapy, may involve home visits by clinicians to help patients practice decluttering.

However, some homes are too cluttered and dangerous for clinicians to enter.

The study’s lead author, Dr. Carolyn Rodriguez, explains that virtual reality therapy can serve as a safe and effective alternative to traditional in-home interventions.

The Virtual Reality Solution

In the pilot study, nine participants over the age of 55, all diagnosed with hoarding disorder, played a central role. These individuals took photos and videos of the most cluttered room in their homes, along with 30 possessions.

A VR company, in collaboration with Stanford University engineering students, transformed these images into custom 3D virtual environments.

Participants used VR headsets and handheld controllers to navigate these virtual spaces and interact with their possessions.

Participants underwent 16 weeks of online facilitated group therapy, which provided peer support and cognitive behavioral skills related to hoarding.

Additionally, during weeks seven to 14, they received individual VR therapy sessions guided by clinicians.

These sessions helped participants explore their emotional attachments to objects and practice discarding items virtually, mimicking real-life scenarios. Subsequently, participants were assigned the task of discarding the actual item at home.

Promising Results

The study yielded encouraging results:

  • Seven out of nine participants reported improvements in self-reported hoarding symptoms, with an average decrease of 25%.
  • Eight out of nine participants had reduced clutter in their homes, based on visual assessments by clinicians, with an average decrease of 15%.

While it remains unclear whether VR therapy adds significant value to group therapy alone, this pilot trial demonstrated that VR therapy for hoarding disorder is feasible and well-tolerated, even among older patients.

Future Directions

The researchers acknowledge that VR therapy could serve as a stepping stone, providing a less intense way to practice decluttering before tackling real-life situations.

They anticipate that advancements in technology may enhance the VR experience and potentially introduce augmented reality, where virtual objects are integrated into a patient’s actual living environment.

Conclusion

Virtual reality therapy offers a promising avenue for individuals with hoarding disorder to overcome their reluctance to declutter and improve their living conditions.

By providing a safe and controlled environment for practicing decision-making and desensitization, VR therapy complements existing treatments for hoarding disorder and offers hope to those struggling with this challenging condition.

Raising awareness of available treatments and reducing the stigma surrounding hoarding disorder are essential steps in helping individuals seek the support they need.

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The research findings can be found in the Journal of Psychiatric Research.

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