CREST Community Program: Treatment for Hoarding in Older Adults

Eligibility for Services

CREST is funded by the County of San Diego Behavioral Health Services and administered by UC San Diego Health’s psychiatry services. The program is free of charge for older adults living in San Diego County who meet criteria based on income and other qualifications. We encourage you to learn more about our program and eligibility requirements by calling 619-543-6904​.

​Hoarding in the elderly community is a relatively common issue that can have a serious impact on individuals, family members and the community. Changes in life conditions, including living alone and less frequent social interaction, in addition to mental health issues such as preexisting personality disorders, depression or dementia all place seniors at a greater risk.

The Cognitive Rehabilitation and Exposure/Sorting Treatment (CREST) community program offers a personalized and compassionate approach for helping older adults with hoarding behaviors and mental health needs.

Treating Hoarding Disorder​

Treatment includes 26 weekly sessions. Our approach is innovative, patient-centered and consists of two important components:

  • ​Cognitive training: Aims to change ways of thinking and organizing information through learning new skills and strategies. A mental health professional will meet with you one-on-one to help you enhance your cognitive abilities, including flexible thinking, memory and problem solving skills. 
  • Exposure therapy: Helps you gain control of the fear and distress associated with discarding items. Through weekly sessions, you will make decisions about discarding and acquiring items, improving your ability to make choices about possessions​.​

Comprehensive Care for Hoarding Behaviors

We work with each individual to develop a comprehensive treatment and recovery plan, tailored to each person’s unique needs. Our team includes psychologists, social workers, care managers, peer support specialists and mental health professionals in training. Our services include:

  • In-depth evaluation (ongoing): Patients undergo a thorough assessment that includes interviews and questionnaires. Your progress will be monitored throughout treatment and after completing the program.
  • Care management: Includes weekly meetings or check-ins (as needed) with a care manager to help improve wellbeing, independent functioning and quality of life. Care managers assist individuals in identifying their goals and coordinating support services.
  • Peer support: Graduates of the CREST program help patients learn and practice new skills, develop effective coping techniques and foster advocacy skills.
  • Family group support: We offer information on hoarding and its treatment, tips on how to talk to family members about their hoarding behaviors, health and safety issues related to hoarding, boundary setting and self-care. Family members are linked to counseling or mental health services as needed.
  • After-care and recovery: We provide ongoing care management, after-care groups, additional individual psychotherapy sessions (as needed), and access to peer support.
  • Community linkages: Financial assistance, housing, food, legal and physical health services are among the resources we help you obtain. We also collaborate with our community partners to help reduce the risk of homelessness for our patients.

Appointments & Referrals



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