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Hoarding treatment: Choosing the right therapist

Hoarding treatment: choosing a therapist

For hoarding treatment, choose a therapist that uses cognitive behavioral therapy for hoarding (CBT for hoarding) to address your symptoms.

If you are an individual who struggles with hoarding, you might have been frustrated by negative treatment experiences in the past.  For most individuals who hoard, treatment can be challenging.  However, it is an essential ingredient for regaining control and reclaiming your life.

When selecting a therapist to help you address your hoarding, make sure that your potential therapist practices cognitive behavioral therapy for hoarding (or CBT for hoarding).  Based on research studies, this type of treatment is most likely to be effective in supporting long-term positive changes and leaving you less vulnerable to relapse.  Unfortunately, there are very few South Florida psychologists who have formal experience with hoarding treatment.  Make sure that when you interview your potential psychologist, you ask them about their experience in treating hoarding.  A CBT orientation alone is not sufficient; make sure that they’ve treated other patients who hoard and can explain how cognitive behavioral therapy can be tailored to specifically address hoarding in the context of acquiring, organizing, and discarding objects.  Good CBT therapists will also explain how exposure and response prevention (a CBT component most frequently discussed in the context of obsessive-compulsive disorder) will be integrated into your treatment.  Fortunately, there are resources that make choosing a qualified therapist slightly easier; check out the IOCDF’s database of treatment providers with hoarding experience.  Although this database is largely focused on OCD therapists, it also contains information about providers who treat clinical hoarding.

Sadly, even in today’s society in which there are multiple popular television shows focused on  hoarding, quality scientific knowledge about hoarding is limited to a relatively small group of treatment providers.  Interestingly, one reason why hoarding had a delayed entry into the limelight has been nosological.  Nosology refers to the study of how different disorders relate to each other and are classified.  In the DSM-IV, which is the manual that psychiatrists and psychologists use when making diagnoses, hoarding is currently not recognized as a formal diagnostic category.  Instead, it is described briefly in a side note within a section that pertains to obsessive-compulsive personality disorder.  Given this peripheral placement, it is not uncommon for trained clinicians to open up their DSMs and fail to be able to find hoarding listed at all.  Fortunately, it is likely that the upcoming DSM-V will finally rectify this in May 2013 and will recognize hoarding as a distinct OC-spectrum diagnosis.

Here’s some interesting additional background on this subject:

Questions? Comments? Sound off below.

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  1. Greetings, Doctor. My name is Lissa; & as a person whose behavior falls comfortably under our broad rubric of
    may I please suggest a far kinder
    word? For I believe m-y likelier word may just have a ring to it that could potentially come across as more
    collegial; and as more
    mutual; and as more
    . . .and that, therefore, it might potentially be more – -helpful.
    To my own ears, my preferred word sounds more Carl-Rogerian/ Person-to-Person/ and/or simply NON-finger-pointing. Here it is; and mind you, please don’t laugh before you’ve tried it out in all seriousness. I really should know; as I’m a slob myself.

    • Maybe I missed it but what is your preferred word ?

  2. The costs of hoarding to the relationships in people’s lives are so very real and I think that hoarders totally underestimate this.
    My mom passed away in late 2008. Since then I have come face to face with the fact that my dad (67) has a major problem. He has always had a garage and outbuilding packed with stuff but after mom died he started filling his living areas with tools too. Its gotten to the point that I rarely go to his house or allow my 2 young kids to either. He continues to buy (albeit in smaller quantities since I stopped cleaning it all up and putting it away). He has become aggrevated at his own items now, can’t find what he needs (so he buys another), and comes to my house depressed about his situation sometimes.
    I’ve figured out that my mom was only enabling his habits by throwing out things while he was gone or forcing him to clean up his mess. Wow. I’ve mentioned that he should go and talk to a therapist about all of this but he just dismisses that idea totally. (“Those people are crazy!”)
    Its sad to see a grown man, who I’ve respected all my life, ruin the quality of his own life because his “babtsitter” is no longer there. I’ve told him a few times that he is going to have to stand up and make a choice – do you want people in your life or all of this stuff? Even your grandkids wonder why you live this way. We love you, but NO, you can’t bring your excess items to my house and store them because you’ve run out of room. That’s called a natural consequence. No, I am not ungrateful. I choose to control my items instead of letting them control me and prevent them from living in my house. I love you but you are an ADULT, start acting like one and take responsibility for your actions. Deal with your anxiety if you have some. Find something more constructive to do with your time. Start the next phase of your life and leave these old habits that no longer serve YOU behind.
    So, so sad. 🙁

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