Rendering promise: Enhancing motivation for change in hoarding disorder using virtual reality

Treatment ambivalence is commonly associated with hoarding disorder (HD), representing a public health challenge. One possible innovative approach to reducing problematic treatment ambivalence leverages virtual reality (VR) technology as a motivational strategy. For this pilot study, 23 adults with HD were immersed in a VR environment depicting rooms in their own homes without existing clutter. At pre-VR immersion, participants completed diagnostic interviews; self-reported on HD symptoms and correlates, as well as valid measures of motivation for change; and described a cluttered series of rooms on a floor of their home that was then rendered in a VR environment minus the clutter. After immersing participants for 10 min in the VR environment and asking them to explore the rendering, they completed the measures of motivation again, plus items about acceptability of the VR protocol. The VR immersion was rated as acceptable by participants in many ways and with no indication that it was unacceptable. Pre-to post-immersion results indicate an increase in some indices of motivation, as well as in confidence to change. This pilot study provides preliminary support for the VR immersion as a motivation strategy and warrants further investigation.