What is Hoarding Disorder?
Hoarding Disorder is a condition where a person collects and fails to discard possessions. The collection of possessions can sometimes lead to hazardous living conditions due to hallways being blocked, poor maintenance of food storage and functions of the home may end up in disrepair such as bathrooms and kitchens, garages and yards, bedrooms and living areas. Hoarding disorder was once considered to be a problem that was rare but new figures show it is now about 2-5% of the community, that is one in twenty of our community have some degree of hoarding behaviours. Hoarding Disorder is now classified as a mental health problem in the new diagnostic manual called the DSM V which will aid researchers and those in practice find new ways to treat this common problem.
Currently there are excellent programs such as the Buried Treasures workshop series and individual counselling. Counselling can be delivered in a counselling room or more often onsite where the hoarding is occurring. Cognitive Behaviour Therapy (CBT) is one of the most common approaches, but Interpersonal Psychotherapy (IPT) is likely to also be effective depending on the type of person and the presenting health concerns or age of the person seeking treatment. Workplace Hoarding is another type of problem and often such behaviours may occur at both work and at home. Hoarding may start in youth, middle age or in seniors years and there is not one cause for the condition but usually an array of life events and stressors, financial limitations, other mental or physical health conditions and lack of social supports. Treatment ideally is tailored to all of these factors. No one approach will work for everyone. Peer support groups are also helpful for those who lack social supports.
What is Multi-Systemic Therapy for Hoarding Disorder
Multi-Systemic Therapy (MST) is an ecological treatment approach used successfully to treating complex conditions like juvenile offending or families where parents are abusing substances. MST is quite complicated as it requires intervention at several levels as seen in our diagram below. All levels of treatment may be worked on simultaneously and there is not one that is more important than the other.
At the broadest level the problem of hoarding is made worse by the stigma or negative stereotypes attached to the behaviours. Those with the disorder may fear being treated badly by others if they disclose about their living conditions. Organisations like BeyondBlue have changed our society’s view of depression and helped Australians to learn to seek help. Likewise we need organisations to promote that hoarding is a common problem and seeking help early will prevent the hardship if left too long.
Apart from media and social stereotypes help can occur at the organisational or service level. Services such as housing, health and emergency services work together in Brisbane to help those who have come to the attention of government services. Government services are available in Brisbane to support families with hoarding and that need help. Centrecare has an hoarding support service that can help with professional cleaning and coordinating help.
The people closest to those that hoard are usually family, friends and workplaces. Family and friends are usually the ideal supports to include in the process of treatment an helping the person. Therapies like IPT will involve social supports to help the person to change so that hoarding doesn’t overtake the person’s life. Sometimes family and friends will be the reason the person seeks treatment and family and friends will be the key helpers when it comes time to improve living conditions in the home of the person with hoarding.
Individual counselling may include any type of counselling that helps to improve how the person with the hoarding condition feels. Decreasing distress should be the key focus of the counselling. When an individual feels confident and able to take control of their lives, it is a natural progression to want to improve their living conditions. Apart from counselling for emotional distress, there may be significant physical health problems that will need to be addressed. Those living in squalor may not be sleeping well or eating healthy food, they may be exposed to mould or hazardous substances such as dead animals, rodents or pests. The physical health problems will need to be addressed by a GP who is aware of the level of hoarding and the effect on the person’s health.
What Do I Do Next?
If you or someone you care about is experiencing hoarding disorder or if you fear they may be at risk of developing this condition, please book into a Free Emotional Health Check Up at our clinic and let us know so we can help!
Author: Vivian Jarrett, B Psych (Hons), MAPS, MAICD.
Vivian Jarrett is the Clinic Director at Vision Psychology in Mt Gravatt and now M1 Psychology at Loganholme. She is passionate about providing high quality psychology services to Australians from all walks of life.
To make an appointment with Vivian, please visit her online booking calendar.