Compulsive Hoarding

ServiceNet now offers group treatment to assist individuals with issues around compulsive hoarding. We help group members examine their thinking about their possessions, alter their habits of acquisition, and gain skills at organizing and discarding, thus making living spaces safer and more functional, and daily life less stressful and more enjoyable. Members receive encouragement to stay motivated, as completion of tasks between sessions is necessary. This treatment program is based on a cognitive-behavioral approach developed by Dr. Randy Frost of Smith College and Dr. Gail Steketee of Boston University. For more information, contact Christine Mero at cmero@servicenetinc.org or 413.585.1332.

What is hoarding?

Compulsive hoarding is a debilitating disorder characterized by the acquisition of a large volume of possessions that clutter living areas to such a degree that living spaces cannot be used for their intended purpose. In addition, the disorder causes impairment in normal life functioning and often affects others in their environment. (Randy O. Frost, Ph.D.)

What causes compulsive hoarding?

Although we cannot yet determine the ultimate cause of compulsive hoarding, we do know enough about the problem to develop some theories about it. Based on what we know about this problem, we have proposed a Cognitive Behavioral Model of Compulsive Hoarding. This model suggests that hoarding is based on 5 interrelated deficits or problems:

Information processing deficits
Problems with emotional attachments to possessions
Strong beliefs about the nature of possessions
Motivational problems
Behavioral avoidance

What is the difference between clutter and hoarding?

Cluttered conditions in a senior’s home may result from a variety of causes including physical frailty, dementia, or hoarding behavior. Clutter becomes problematical when areas of the home cannot be used for their intended purpose (i.e., bed cannot be slept in, stove cannot be used for cooking) or possessions pose a safety hazard or endanger the senior’s tenancy.

Hoarding is a behavior characterized by:

Collecting items that either do not serve a purpose or are redundant
Collecting but not discarding
Extreme emotional attachment to the items collected and an inability to part with them without significant anxiety and stress

Indicators of Hoarding

Many people collect special items and put them in distinct places. People who save excessively or hoard are different. They collect and keep things to the point where it encroaches on living space and safety. People who excessively collect or hoard experience two or more of the following:

Saving or collecting continues beyond what is needed or usable, even though the house and additional storage space is full
Value, uniqueness, and sentiment is found in much “stuff” that others do not find valuable, such as old papers, spoiling food, and animal waste
Strong emotional attachments are formed with many items for comfort or safety
Efforts to stop collecting or to discard things are unsuccessful, leading to a sense of anxiety, emptiness, vulnerability, and more collecting
The fear of losing things prevents discarding or putting them away, out of sight
“Stuff” interferes with safe and functional use of the home to sleep, cook, bathe, and socialize.
Others suggest that the “stuff” should be reduced and are bothered by it more than the collector
The “stuff” is often overwhelming and immobilizing

In addition, people who hoard:

Worry about having their possessions at hand when needed, so they often carry many items in their purses, pockets, and cars
Acknowledge that saving useless things make no sense. Many try unsuccessfully to change; some attribute their hoarding behavior to frugality and view it as a positive trait.
Buy extra supplies of necessities so they won’t ever run out
Are likely to have close relatives who hoard
Tend to be overly indecisive and perfectionistic
Fear they will be unprepared or will make a mistake

What can we accumulate too much of?

Some examples of items people tend to hoard

include but are not limited to:

Clothes
Food
Animals
Trash
Tag sale items
Equipment of any kind
Newspapers, books, magazines, papers

Who can have a hoarding problem?

Hoarding effects people of all ages, beginning as early as age 13. They may be male or female, married or unmarried (but generally living alone). People with a range of IQs or cognitive abilities, even the extremely intelligent, can have a problem.

What difficulties can cause hoarding?

Information processing and decision making problems
Fear of difficulties with memory
Emotional attachments to possessions
Feelings of responsibility of items (i.e., animals)
Seeing value in things that others might not
Fear of lost opportunities or loss of control

Why is discarding difficult for some of us?

Discarding can feel like loosing a part of oneself or like the death of a loved one.
Saving or acquiring may result in positive emotions such as feeling cared for or safe.
Saving or acquiring may allow positive feelings that mask depression, anxiety or other mental illness.

How can I help someone with a hoarding problem?

Understand that it will take a community approach to help.
Ask the individual, a family member, or a friend if the situation is causing difficulty
Listen non-judgmentally
Suggest the person ask for assistance or ask for an assessment on their behalf

How do you help someone who resists getting help?

Frequently, people with problematic hoarding behavior refuse help. It is tempting for concerned neighbors, friends and family to suggest that redundant articles are given away and useless ones thrown away. However, researchers have found that it is often more effective to focus on sorting possessions before suggesting removal of items. The de-cluttering process can be extremely slow and labor-intensive and is best accomplished if the person with the hoarding problem is able to maintain a sense of control. A few motivational techniques proven to be useful include:

Discussions about the daily functions that can’t be carried out because of the clutter
Breaking down larger tasks into manageable small areas
Choosing target areas so progress is apparent.

Since de-cluttering is likely to be extremely stressful, it is important to provide emotional support and encourage open communication about the emotional difficulties experienced during de-cluttering. It may be useful to enlist the assistance of a professional, such as a social worker or psychologist, who has had experience in dealing with people who have hoarding problems.

How does ServiceNet help?

ServiceNet and Highland Valley Elder Services are available to assist with

In-home assessments for elders 60 and over
Individual treatment services
Group treatment services
Community education presentations on hoarding

Goals of Treatment

Keep elders safely in their homes
Create functional living space
Decrease acquisition of new items
Increase ability to discard
Improve decision-making and organizing skills, challenge beliefs
Prevent future hoarding

Treatment Approach

Therapist or coach may not touch items without permission
All decisions are made by the client
The client will learn new skills, be exposed to difficult emotions, and learn new thinking about possessions
Use of visitor effect

What areas do you serve?

We serve 24 towns in western Massachusetts:

How do I find out more?

For questions or to make a referral, contact:

Age 60 and over: Linda Candage at Highland Valley Elder Services at 413.586.2000 or Ellen Shaw-Smith at ServiceNet at 413.584.6855, ext. 1540.

Under age 60: ServiceNet at 413.584.6855. Call Ellen Shaw-Smith at ext. 1540 for information on individual treatment or Chris Mero at ext. 1332 for group treatment services.

In addition, you may contact the Department of Public Health or the MSPCA.