Can I Treat Hoarding Disorder?

Can I Treat Hoarding Disorder?

Can I Treat Hoarding Disorder

Can I Treat Hoarding Disorder?

The majority of individuals have belongings that they think helpful or significant. Getting rid of your favorite sweater, concert tickets from your first musical performance, or even your beloved coffee cup would certainly be a tough decision.

 

 

A person suffering from hoarding problem, on the other hand, is more prone to attach significance to every thing, regardless of its monetary worth. Each piece of mail may be considered essential, and an empty bottle may be considered valuable at some point in the future. A substantial collection of belongings that are particularly difficult to part with might result as a result of this situation.

 

 

 

 

Hoarding disorder is a condition that affects many people. It affects around 2.6 percent of the population, which is approximately the same as the prevalence of bipolar disorder, which is 2.8 percent.

The problem, like other mental health disorders, is curable. While living with hoarding disorder might be difficult, it is not impossible.

4 Tips for Getting Rid of Clutter

What is hoarding disorder and how does it manifest itself?

Compulsion hoarding, often known as hoarding disorder, is a complicated illness in which a person has continuous trouble parting with their things.

When hoarding disorder is severe, it may create a living condition that is very difficult to manage. In rare circumstances, a person may have difficulty reaching or utilizing their stove, front door, or toilet due to physical limitations.

Diagnostic criteria for hoarding disorder are included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and contain the following elements:

 

 

 

 

They have a continuous trouble parting with their goods, and they save items in order to escape the terrible sensations that come with disposing of their belongings.
an excessive collection of goods that clutter one’s living space an abnormal level of discomfort or impairment in one’s everyday functioning
In the most current version of the Diagnostic and Statistical Manual of Mental Disorders, the fifth edition, hoarding disorder was given its own set of diagnostic criteria. A subtype of obsessive-compulsive disorder, it was formerly thought to be present (OCD).

 

 

 

After some time, it became obvious that the vast majority of persons who suffer from hoarding disease do not exhibit the classic signs of OCD, since they are not plagued by intrusive and unsettling thoughts.

As a result, although hoarding disorder is still considered a disease that is linked to OCD, it is now classified as a separate diagnosis under the umbrella term “compulsive spectrum disorders.”

What is the treatment for hoarding disorder?

Due to the fact that persons suffering from compulsive hoarding often experience happy sensations when they obtain a new possession, treating the illness may be challenging. They are not always bothered by the presence of clutter. Instead, people express the majority of their grief at the prospect of having to part with their possessions.

In addition, those who suffer from hoarding condition are more likely to suffer from another mental disease, which may need treatment. The most prevalent is serious depression, which may impact up to 50% of those who suffer from hoarding disease, according to a reputable source.

Attention deficit hyperactivity disorder (ADHD) is especially frequent among those who have a compulsive hoarding problem, particularly the inattentive symptoms associated with the disease.

 

 

 

Hoarding may begin in youth, but it is common for it to increase as people become older. It has a tendency to become clinically important in persons in their mid-life.

Clinically, cognitive behavioral therapy (CBT) is the most effective treatment for hoarding problem. In CBT, a trained professional assists the patient in identifying and changing dysfunctional beliefs. This treatment may also include exposure to objects that are being sorted and discarded.

 

 

 

 

Some individuals, especially those suffering from significant depression, discover that medicine helps them to feel better.

Cognitive behavioral therapy (CBT) is a kind of treatment in which the patient thinks about his or her thoughts and feelings.
In the treatment of hoarding disorder, cognitive behavioral therapy (CBT) is the most well-studied technique.

 

 

 

 

Gail Steketee, a professor of social work at Boston University, and Randy Frost, a professor of psychology at Smith College in Massachusetts, collaborated on the development of a 26-session cognitive behavioral therapy program particularly intended for hoarding problem.

In the therapist handbook “Treatment for Hoarding Disorder,” the program is stated as follows:

 

 

Cognitive therapy strategies to challenge attitudes about hoarding are used in conjunction with a reduction in the number of new goods that come in.
getting used to the process of getting rid of belongings
individuals get skills training to assist them in organizing their stuff and remaining focused on their duties


Individuals who are disengaged might benefit from motivational interviewing.
Motivational interviewing is a technique that may be used to increase one’s self-confidence.
Motivational interviewing is a client-centered treatment that is intended to assist the person in discovering their own internal desire to create a positive change in their lives. Many persons who suffer from hoarding disorder are adamant about not changing their ways since the clutter and accumulation of goods do not necessarily cause them substantial anguish.

 

 

A motivational interviewing technique that assists the client in identifying what they desire for themselves rather than what the therapist believes they should do Consequently, persons suffering from hoarding disease do not feel as if they are being forced to give up something they like doing. As a result, individuals are compelled to begin living the life that they have chosen for themselves.

Suppose a customer is driven to clean their clutter in order to be able to walk freely around their house or to have guests once again in their home.

Rehabilitation of the cognitive functions

Cognitive rehabilitation and exposure/sorting therapy (CREST) is a treatment for those who have suffered a traumatic brain injury that is based on treatments for people with traumatic brain injury. Ayers, PhD, ABPP, a professor of psychiatry at the University of California, San Diego, was the one who came up with the idea.

 

 

Individuals might benefit from this treatment because it helps them analyze, plan, and solve difficulties. A person suffering from hoarding condition may be urged to look through each of their possessions and select what they need to retain and what they can part with, depending on their situation. Over time, a person suffering from hoarding disorder learns to cope with the grief that comes with letting go of their possessions.

 

 

Older persons with hoarding problem took part in a 26-session CREST therapy program in one 2018 research, according to Trusted Source. A 40% decrease in hoarding symptoms was seen in the participants, and these gains were maintained six months after the study ended.

 

 

Medication

There are currently no FDA-approved or marketed drugs for the treatment of hoarding disorder. However, some people may benefit from using selective serotonin reuptake inhibitors (SSRIs), which are drugs that may treat comorbid illnesses such as anxiety, depression, and sleeplessness.

More study is required in order to discover appropriate drugs and treatments for the treatment of hoarding syndrome.

Find out where you may get assistance.

For those who suffer from hoarding disorder, seeking therapy from a reputable mental health practitioner, ideally one who has had prior experience with compulsive hoarding, may be advantageous. Asking for assistance should not be seen as a source of shame..

Some questions to think about asking a new therapist are listed below. They include:

Has any formal training in the treatment of hoarding disorder been completed by you?

 

 

When treating hoarding problem, what methods do you employ?

Your opinions on the use of medicine for hoarding disorder are welcome!
To what extent does treating hoarding disorder figure into your practice?
When it comes to obtaining mental health assistance, Psych Central has put up a guide to help you get started.

 

 

Steps to be taken after that

It might be difficult to live with hoarding disorder. You may not be distressed by the fact that you are accumulating more and more goods; yet, the situation may have a negative influence on your health and well-being..

There is hope if you suffer from hoarding problem; you are not alone, and help is available. In order to get help, you may wish to speak with a mental health expert. Individuals who suffer from compulsive hoarding might find help through support groups as well. Please see the following links for further information:

Treatment for hoarding

People who hoard may benefit from and be harmed by reality television programs. Discover why, and learn what works best for clients and the people that care for them.

“Intervention” is a popular term. Television programs have started to dramatize the clutter associated with hoarding: newspapers heaped from floor to ceiling, clothing and linens stacked on furniture, and goods strewn around a home with just a limited way to pass through. Extreme incidents of hoarding—where stray animals are crammed into a tiny flat or where so many objects have collected that the floors have collapsed—illustrate the seriousness of the problem.

Hoarding problem affects between 3% and 5% of the population in the United States (Tompkins, 2011), but it impacts many more, damaging marriages and home lives while alienating family and friends.

 

 

 

“Hoarding has come out of the closet as a result of media attention. “People are more inclined to discuss hoarding today,” Terrence adds. Daryl Shulman, JD, LMSW, ACSW, CAAC, CPC, is the founder and director of The Shulman Center for Compulsive Theft and Spending, as well as an addictions counselor who specializes in hoarding, compulsive spending, and theft.

 

 

 

“TV shows like A&E’s Hoarders have brought attention to a very secretive, shameful disorder, encouraging people and their families to seek help,” says Gretchen H. Placzek, MBA, LCSW, MSW, a psychotherapist at East Bay Family Wellness in California who specializes in treating anxiety and works with individuals and families in cases involving hoarding. According to her, the program Hoarders displays follow-up with strong therapeutic aid and advice, and she believes that media attention has prompted specialists to learn more about the illness and build expertise in order to better assist hoarders and their families.

However, television portrayals of hoarding have led to misunderstandings about the illness and its treatment.

 

 

 

“The downside is that the programs might be seen as exploitative, and they don’t necessarily convey the terrible pain and suffering that comes with a hoarding disease,” Placzek notes.

Another disadvantage, according to Shulman, is that when hoarders see severe, alarming examples on TV, they may say to themselves, “I’m not that terrible,” prompting them to avoid or oppose treatment.

 

 

 

According to Gail Steketee, LCSW, MSW, PhD, a professor and dean at Boston University who has been researching hoarding since the mid-1990s and has coauthored numerous publications with Randy O. Frost, PhD, a psychologist and professor at Smith College, including their most recent book, Stuff: Compulsive Hoarding and the Meaning of Things, the hard work required to change hoarding behavior is minimized by focusing on sensational cases.

 

 

 

“Sadly, these programs often portray an unrealistic intervention that minimizes the role of mental health treatment and sets up unrealistic expectations for hoarders and their families,” says Christiana Bratiotis, PhD, LCSW, a postdoctoral fellow and director of Boston University’s Compulsive Hoarding Research Project.

According to Bratiotis, hoarding is a chronic illness that increases over time, frequently over decades. TV programs provide the idea that effective treatment may be achieved in a matter of days, without the need for longer-term cognitive behavioral therapy (CBT).

“Professional organizers and clean-up companies are useful and necessary partners in the work,” Bratiotis explains, “but they don’t begin to be the totality of the intervention, and portraying that as the solution is to minimize the painful and difficult work required to overcome a hoarding problem.”

 

 

 

Recognizing the Problem

Acknowledging the underlying issues that cause hoarding behavior is the first step in hoarding therapy. Hoarding has a variety of causes, and therapy may be difficult since individuals who hoard are frequently unaware that their behavior is a problem, or they feel socially alienated and humiliated because of the state of their house. They may refuse therapy if they believe it will merely require cleaning away the clutter.

“Cleaning away the material doesn’t address the underlying psychological difficulties,” argues Shulman. “It’s not a clutter issue; it’s a perception/thinking one,” says the author.
According to Steketee, hoarding is caused by a combination of factors. The following are examples of contributing factors or stressors:

• being reared in a chaotic household or in a family with a tangled web of relationships, or moving often;

• problems with decision-making and problem-solving due to cognitive processing impairments;

• ADD (attention deficit hyperactivity disorder);

• depression and/or anxiety;

• an overabundance of waste guilt; and

• Hoarding behavior occurs in families, thus genetics and family history are important.

“Hoarding may occur in patients with dementia, schizophrenia, and obsessive-compulsive disorder [OCD], but the symptoms and reasons are not apparent,” adds Steketee.

 

 

 

 

There is a widespread misconception that hoarding is predominantly driven by OCD or anxiety. However, although anxiety or compulsion may play a role in hoarding, psychologists now feel it is not a kind of OCD, and anxiety is not the major motivator, as Steketee says.

Hoarders, for example, may suffer from worry or stress as a result of obsessive thoughts, such as grieving over the death of a loved one or the loss of essential possessions, or perfectionist thinking. Hoarding either prevents or lessens the degree of the anxiety they are feeling. According to Shulman, accumulating items might help a hoarder relax.

 

 

 

“Focusing on ‘things’ diverts attention away from the cognitive processes that cause worry,” Shulman explains.

“Hoarding may provide a sense of protection and security, as well as strengthen identity,” Steketee says.

Hoarding’s specific origins are unknown, and study into the physiology and psychology of hoarding is continuing. According to Steketee, geneticists are seeking to find genetic loci linked to hoarding behavior. During the most severe hoarding symptoms, cerebral blood flow in a patient with OCD and severe hoarding displayed a specific pattern, which altered as the patient’s hoarding habits improved, according to an imaging research (Ohtsuchi, Matsuo, Akimoto, & Watanabe, 2010). Compulsive hoarding may be a distinct condition with its own diagnostic criteria, according to a study of epidemiological, neurological, and therapeutic data (Pertusa et al., 2010).

 

 

 

 

Hoarding is not currently recognized as a distinct disease in the DSM-IV, however it is described as a symptom or criterion of OCD. However, a revision for the fifth edition, due out in 2013, suggests that hoarding disorder be classified as a distinct condition under the category “OC spectrum disorders.” According to Steketee, it is also likely to be eliminated from the OCD criteria.

 

 

 

Taking Care of the Problem

Regardless of the continuing dispute about the reasons and diagnostic criteria for hoarding, there is little doubt that treatment is required. Hoarding is known to cause social isolation from family members, and integrating family members in the treatment process tends to help with hoarding behavior recovery.

Education is the first and most crucial aspect of family therapy. “Hoarding, like any addiction, is a family illness; everyone is impacted, and every family member has to be taught about it,” Shulman adds. Families must recognize that hoarding is a condition with a lengthy therapy process.

 

 

 

Placzek notes that “psychoeducation is nearly often the initial step in engaging with the relatives of hoarders.” To show compassion and understand hoarding as a mental health condition, family members must be informed about it. She emphasizes that they must realize that each gathered object has significance and value for the hoarder.

Another vital step is to provide support and recognition for the anger and sadness that many family members are experiencing. Placzek says the therapist has to make sure the family realizes that the hoarder is unlikely to get well without their support and assistance.

 

 

 

However, not all hoarders live alone and are socially isolated, and family therapy may be very beneficial when the hoarder lives with the family and has to cope with daily interactions. According to Shulman, impatience is frequent throughout the protracted family counseling process. Frequently, “control drama” may arise between the hoarder and other family members, which must be dealt through in order to bridge the communication gap.

 

 

 

Because the hoarder’s spouse is generally codependent when it comes to the hoarding habit, extra couples counseling is sometimes necessary for married hoarders, according to Placzek. Shulman adds that the spouse might be limiting the hoarder’s progress in solo treatment. Family therapy must address these particular family concerns whether the hoarder lives with small children, the elderly, or persons with impairments, according to Bratiotis.
“Special safeguards must be implemented to ensure that these family members remain safe and healthy, and that the hoarding does not pose a threat to these vulnerable and protected persons,” she says.

 

 

 

 

Although anecdotal accounts from practitioners imply that family therapy may be quite effective in resolving hoarding behavior, there is presently no published study on the subject. According to Steketee, unpublished research has focused on the importance of enlisting family members in getting a loved one who hoards into treatment when that individual is hesitant to seek therapy and/or is unaware of the issue.

 

 

 

The advantages of cognitive and behavioral techniques, on the other hand, are supported by research. According to Steketee, over 70% of persons who hoard demonstrate progress after 26 therapy sessions. “Family therapy is unlikely to be effective unless the hoarder also gets CBT to help them acquire new skills, adjust beliefs, and minimize the pain that keeps them from discarding hoarded goods,” she continues.

 

 

 

 

Motivational interviewing, cognitive behavioral therapy, and decision-making skill development are all common methods to individual treatment for hoarders. “Motivational interviewing is critical because many individuals lack a clear understanding of the magnitude of the issue created by their clutter and collecting habits. We also teach techniques for dealing with cognitive issues such as decision-making, organization, and problem-solving. “We use behavioral exposures to discarding and not acquiring to reduce discomfort with these activities,” Steketee explains. “We help people modify mistaken beliefs about possessions using CBT, and we use behavioral exposures to discarding and not acquiring to reduce discomfort with these activities.”

 

 

 

 

According to Placzek, CBT combined with exposure therapy seems to be the most effective treatment for hoarding. Exposure treatment encourages the hoarder to confront his or her fear by organizing, categorizing, and deciding what should be discarded and what should be saved while also keeping track of his or her anxiety level. To modify maladaptive ideas and, as a result, hoarding behavior, the hoarder must go through this process.

 

 

 

 

For individuals receiving CBT for hoarding, family therapy is a helpful supplement. “I utilize CBT to guide the client’s therapy, and I approach families from a family systems viewpoint when I work with them.” Family members are often influenced by hoarding, particularly while living in the house, and are emotionally engaged in the result,” adds Bratiotis. Family members may be able to act as behavioral coaches throughout the CBT process, however she cautions that this may need extensive therapy work with both the family and the hoarder.

 

 

 

 

To address hoarding behavior, academics and psychologists have recently advised employing harm-reduction strategies in family therapy. Harm-reduction treatment focuses on assisting family members in developing a management plan for enhancing a hoarder’s home’s safety and comfort. For example, structural concerns caused by the weight of collected objects, the possibility of fire, mildew and dust, and vermin infestation may all offer serious hazards to a hoarder, particularly an elderly person who lives alone.

 

 

 

 

Harm reduction believes that it is not required to halt all compulsive acquiring or entirely empty the hoarder’s house to end harm, according to the researchers that advocate this strategy. Setting modest, attainable objectives to lessen the risk of injury in the home is part of this therapeutic process (Tompkins). Enlisting the help of the local health authority may help the family communicate the dangers of hoarding to their loved one in certain circumstances. When a hoarder lives with other family members, harm-reduction techniques may be utilized to express the potential damage that hoarding practices might cause.

 

 

 

 

When family therapy is paired with individual CBT and other therapies, such as drugs to address comorbid diseases (e.g., depression) or working with a professional organizer in the house, hoarders are more likely to improve. However, the importance of family cannot be overstated.

 

 

 

“In the end, success is determined by how helpful, empathetic, and patient family members are with the hoarder, as well as the hoarder’s degree of drive and dedication,” Placzek explains.