Hoarding disorder is characterised by a significant accumulation of possessions, accompanied by extreme difficulty in discarding these possessions. This can result in significant impairment to the person’s daily life, such as not being able to bathe or cook at home or not being able to sleep in a bed.

The possessions accumulated can be any type of object. Often, people accumulate large quantities of papers/paperwork/books, clothes, recycling (e.g., empty containers), items that remind them of other people or times in their life, or items they intend to repair or sell. For someone suffering hoarding disorder it is very distressing to discard such items.

Hoarding disorder is estimated to affect 2-5% of the population. People are sometimes reluctant to ask for help as they fear that their possessions will be forcibly removed or that they will face legal proceedings or eviction. People are often ashamed and are isolated from family and friends.

People with hoarding problems often have other psychological difficulties, such as social anxiety and/or depression, and physical health problems, such as fibromyalgia or diabetes.

Hoarding disorder was diagnosed as part of Obsessive Compulsive Disorder (OCD) or Obsessive Compulsive Personality Disorder (OCPD) until 2013 when it was reclassified as a separate problem.

People suffering hoarding disorder have often experienced traumatic events in their past that have contributed to their beliefs about possessions, and/or they have had difficult interactions with authorities or professionals tasked to ‘clear’ their homes, which can make engaging in therapy additionally challenging.

Hoarding problems are usually longstanding and have had a severe impact on people’s lives. Individual and group Cognitive Behaviour Therapy (CBT) has been found to be effective for people with hoarding problems. However, standard CBT for hoarding does not always lead to significant improvements.

An assessment at OHSPIC will include use of standardised questionnaires that assess the severity of the hoarding problem, how the problem impacts on daily life, what thoughts and beliefs are associated with the problem, and an assessment of other difficulties such as anxiety disorders, trauma, and depression.

CBT at OHSPIC includes:

• Working together to build a trusting relationship with shared goals.
• Building a comprehensive shared understanding of the problem, including the impact of trauma and other associated difficulties.
• Identifying and working on beliefs about possessions, including usefulness, intrinsic beauty, and how items relate to memories and personal identity.
• Testing the usefulness of beliefs about possessions.
• Developing strategies for sorting and organising items.
• Helping someone make wise decisions about their possessions, including what might be kept and what might be discarded.
• Looking at patterns of acquiring items and how to reduce acquiring.
• Devising a plan to help maintain progress and work towards longer term goals.