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Obsessive-Compulsive Spectrum Disorders
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Treatment Recommendations for Hoarding Disorder

Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute, edited by C. E. Zupanick, Psy.D.

People with hoarding disorder face some unique challenges. Their insight into the scope, magnitude, and nature of the hoarding problem is often quite limited. People with hoarding disorder frequently face financial strain, compromised or unsafe living conditions, and greater family discord.

piles of papersDrs. Gail Steketee and Randy Frost are widely recognized hoarding disorder experts and certainly pioneers in their field. They have developed a specialized treatment approach for hoarding disorder:

  • Cognitive therapy for hoarding disorder requires cognitive restructuring to challenge entrenched beliefs about emotional attachment to items and to the items themselves.
  • A specialized type of therapy called motivational interviewing strengthens the motivation for treatment. This is often necessary because people with hoarding disorder are ambivalent or unclear about the need for treatment.
  • Behavioral exposure and response prevention therapy for hoarding disorder specifically targets the avoidance of anxiety-producing experiences related to their disorder. This protective strategy is quite common with hoarding disorder and greatly limits treatment progress if it is not addressed.
  • Skills training is needed to improve organizational and decision-making skills.
  • Family therapy is beneficial to address strained family relationships that commonly result from living with a loved one's hoarding behaviors.
  • Referrals to financial management, housing, and other community resources are also helpful.