Many are familiar with hoarding based on popular television and reality shows. For others, however, the familiarity goes beyond the TV screen and touches their life and the lives of their family and friends. Compulsive hoarding is neither entertainment nor a mere hobby of collecting; it is a mental health disorder that can negatively impact a person’s life and health. Because the disorder affects anywhere from 4–14% of the U.S. population, hoarding intervention and treatment are important for long-term recovery.
Understanding hoarding is a vital first step before helping someone. Hoarding intervention strategies and hoarding intervention tips are based on knowledge of the condition and the experience of those who have overcome or helped others overcome this debilitating mental health disorder.
Table of Contents
Plan Your Approach
In 2009, Eviction Intervention Services implemented an intervention program in Manhattan for individuals with hoarding behaviors who were facing eviction. Taking a multidisciplinary approach to prevent the eviction of tenants with hoarding behavior, the first step is to assess the individual and create a personalized plan that includes the individual’s treatment preferences. Not all communities have access to such a program. In many cases, concerned family members and friends may be the only ones available to provide help for the removal of items and cleanup of homes.
A hoarding care plan should have clear, realistic goals with a reasonable timeframe. The first goal of an intervention should involve having the person visit with an experienced therapist. Family members usually meet the therapist first to discuss the situation and learn what an intervention would involve. A practice session with those most affected by the hoarding behavior is strongly recommended before the actual intervention takes place. This can encourage a united front from those involved and prevent the minimization of the problem.
Once arrangements have been made for a visit with the therapist, the intervention can take place. During this time, each family member or friend can take turns talking to the hoarder about the effect of their behavior on their lives. It is vital to avoid confrontation while still remaining firm in the decision for treatment. It should be clear to the hoarder that they need help and have the support to receive it. Following the intervention, the hoarder will need reassurance and counsel from an experienced therapist.
The Decluttering Process
The process of decluttering will take much time and effort. Efforts during a hoarding cleanup are most often resisted and pushed away, even when they have been agreed upon. This is why it is important that therapy continues after the initial intervention to help with any personal issues along the way. Often, the decluttering process begins after the treatment process is in progress and the person is ready to take this step. Typical steps of the hoarding cleanup process usually involve the following:
1. Discuss the Pros and Cons of Hoarding & Reasons for Keeping Items
The reasons for hoarding behavior may be different for every person. If possible, consider when the hoarding began and what were possible triggers. A skilled therapist can help determine what caused the hoarding and how to further motivate the person to make changes.
People who hoard items generally feel overwhelmed when contemplating their possessions and will have difficulty deciding what to keep and what to get rid of. Many items that hoarders keep have little to no value, such as dated receipts or papers. A pros and cons list can be used, defining what negative effects hoarding has on the person, their life and those around them. It is unreasonable to expect the hoarder to get rid of everything. By clearly defining an individual’s core values and goals, it will be easier to decide on appropriate items to keep and the need to discard items that are not in harmony with their goals.
2. Sort & Organize Items
The tendency to become overwhelmed with organizing is part of the reason some people’s lives become so cluttered. Providing assistance to sort and organize is essential for the person struggling with hoarding. A general list can be made of items that should be discarded and items that can be kept. If possible, break the work into small tasks with definable goals. For example, working on a small pile once a day or one room at a time.
3. Make Decisions
Making decisions is a very difficult task for many people who struggle with hoarding, causing significant anxiety and worry. Discussing in detail with a therapist any concerns or anxiety can help alleviate the anxiety associated with discarding items. Typically, a therapist will work with an individual to develop the ability to make decisions without the added emotional stress. Starting small and working their way up, a person with hoarding behaviors can eventually move beyond their indecision and progress to making everyday decisions on their own.
One technique that can be used is motivational interviewing. With a little help from a trained professional, family members can employ this technique when talking to their loved one who struggles with hoarding. Instead of telling a person what to do, motivational interviewing encourages a person to come up with solutions on their own time to effect positive change.
4. Get a Storage Unit
Having a storage unit to keep and manage valuables helps to free up space in the home. Not intended to become another area for hoarding, having a storage unit allows a person to keep organized valuables that they can’t part with yet. It is a very scary and daunting process for the person facing an intervention, but knowing that they do have a place containing their possessions can be therapeutic. Many storage units can be monitored online to ensure no secret hoarding is taking place. Eventually, as the person moves through their treatment process they will be able to part with more and more items. Storage units should not be used long term, but instead serve as a step toward decluttering the home.
All intentions may come from a good place, but that doesn’t make them right for the person struggling with hoarding. There are some key points to remember to help the intervention process run as smoothly as possible. Being realistic and knowing that there will be struggles along the way can help family members keep their confidence with the intervention and treatment process. With hoarding, knowing what to avoid is just as important as knowing what to do.
1. Do Not Force Clean-Outs
Many well intentioned friends and family members have conducted a forced clean-out. Without the permission or knowledge of the hoarder, they have entered the home and thrown away nearly all of the clutter. When the hoarder returns they are not only in shock, but sometimes face severe anxiety and depression.
One of the most destructive aspects of forced clean-outs is the loss of trust. This means that later on, once the house is again filled with clutter, they will be less likely to listen to or accept help from those who “betrayed” them. Sadly, forced clean-outs don’t fix the problem. It is important to understand that a huge clean-out doesn’t address the reasons a person is hoarding. Those beliefs and hoarding behaviors will continue, but with possible added anger and distrust.
2. Don’t Get Angry
It can be understandably frustrating for family and friends of hoarders to try to remain calm while discussing the hoarding behavior. Remember, getting angry will not accomplish anything. It is important that the person who is hoarding does not feel judged or attacked. Hoarders often feel ashamed and embarrassed by their behavior already. It is important to express genuine concern over their problem and express the desire to help and support their road to recovery.
One means of doing this is by maintaining realistic expectations and speaking in a way that promotes the well-being of the hoarder. For instance, instead of saying “This mess is terrible, I can’t even walk through here. I’m moving these jars,” say this, “I’m worried you may trip and hurt yourself, can we move these jars?” This form of speech is a strategy known as harm reduction. It can help to reduce tension while encouraging change based on safety. This may not decrease clutter, but it can motivate a person to change while reducing danger.
3. Don’t Enable Them
Family members may unknowingly enable a hoarder. It is important for family members wishing to stage an intervention to be firm, yet gentle, with their resolve. If therapy has been agreed upon, family members must be strict and hold the individual to their therapy guidelines as much as possible, even if they fear upsetting the person.
Here are some ways to stop enabling a hoarder:
- Don’t avoid conversations about hoarding just because they are uncomfortable
- Speak truthfully about the negative effects hoarding has on the person and related family members
- Stick to agreed-upon decisions concerning clutter clean-up
- Don’t treat the clutter like it’s a permanent fixture
- Don’t keep adjusting your routine to accommodate hoarding behavior
It may be helpful to evaluate in what ways enabling is taking place. From there, a list can be created, and gradually, enabling can be minimized. Allowing time for the person with hoarding behaviors to make their own adjustments during this process is important.
Consider Involving a Professional
Cleaning up possessions that may have been accumulated over many years of hoarding is a long and tiring process. At times, the hoarding can be so severe that it is hazardous to enter the house. Safety should always come first and any deep cleaning that is carried out should include personal protective gear such as a face mask and gloves.
Some families have opted to enlist the help of hoarding professionals. Professional hoarding cleaners can assist with the laborious task of cleaning up while still keeping and organizing items in the home that are considered valuable, useful or sentimental.
The Importance of Aftercare
Staging an intervention will no doubt be taxing emotionally on all involved, but none so much as the individual who hoards items. Parting with possessions is a painful process for these individuals. If an intervention is carried out, a visit with a therapist is essential for their emotional well being. Trained professionals in hoarding therapy know how to encourage and motivate these individuals to not give up. There are many forms of therapy that assist hoarders to succeed in decluttering their life.
Cognitive behavioral therapy (CBT) is one form of therapy that is helpful for a hoarder. Cognitive behavioral therapy for hoarding encourages the person to examine their beliefs and behaviors and to change those thoughts or behaviors that are damaging. In addition to CBT, a therapist can assist with skills training. Skills training teaches people with hoarding how to organize their possessions and how to problem solve when they meet an obstacle in cleaning up their clutter. Professionals can assist family members with techniques and forms of communication that are helpful when dealing with hoarders.
Without professional help, hoarding can be a lifelong issue. When families and friends of hoarders work together to help their loved one, it is a worthwhile goal. Change and progress may be slow, but this is normal. Some changes may not be noticed on a day-to-to basis, but with continued support, an overall improvement should take place.
If you or a loved one is struggling with hoarding while struggling with alcohol or substance use, reach out to The Recovery Village. One of our representatives can discuss a treatment plan that fits your circumstances.
Iervolino, Alessandra C.; et al. “Prevalence and Heritability of Compulsive Hoarding: A Twin Study.” The American Journal of Psychiatry, October 1, 2009. Accessed June 15, 2019. Rodriguez, Carolyn; Panero, Lisa; Tannen, Audrey. “Personalized Intervention for Hoarders at Risk of Eviction.” Psychiatric Services, February 2010. Accessed June 15, 2019. Neziroglu, Fugen. “Staging an Intervention.” Anxiety and Depression Association of America. Accessed June 15, 2014. International OCD Foundation. “How to Help a Loved One with HD.” 2019. Accessed June 15, 2019.
Iervolino, Alessandra C.; et al. “Prevalence and Heritability of Compulsive Hoarding: A Twin Study.” The American Journal of Psychiatry, October 1, 2009. Accessed June 15, 2019.
Rodriguez, Carolyn; Panero, Lisa; Tannen, Audrey. “Personalized Intervention for Hoarders at Risk of Eviction.” Psychiatric Services, February 2010. Accessed June 15, 2019.
Neziroglu, Fugen. “Staging an Intervention.” Anxiety and Depression Association of America. Accessed June 15, 2014.
International OCD Foundation. “How to Help a Loved One with HD.” 2019. Accessed June 15, 2019.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.