Resources and More

Contents:

1. Information on Hoarding Disorder
2. Resources for clients, families, friends and other clinicians
3. Services I provide in re: Hoarding Disorder

1. Information on Hoarding Disorder

Greetings! First, a little about how I got here:

I have over a decade of experience providing services to adults in King County who are living in hoarded or high clutter environments.  I have consulted with and been trained by leading Hoarding Disorder experts across the country, and I have presented to groups of providers on the disorder and what we can do to help.  With all this experience, I sincerely believe that it is possible for people who hoard (note: person first language indicates that we use “person who hoards”, not “hoarder) to live in safe organized homes that they enjoy! 

What is unique to working with someone with Hoarding Disorder?

Many mental health diagnoses may affect the family and friends – or sometimes even neighbors – of a person who is diagnosed.  Hoarding Disorder, however, almost always affects the person who hoards’ entire community.  Close family, people living in the same apartment building, property managers, city code enforcement officers, first responders – often all are aware of the intense issues that afflict the individual.

Why doesn’t the person who hoards just get help themselves?

The two major reasons that a person who hoards doesn’t seek help at first seem contradictory.  The first reason is shame.  The huge amount of shame associated with living as a person who hoards is almost incomprehensible.  The second reason is lack of insight.  This “lack of insight” is an element of Hoarding Disorder.  It is difficult to comprehend, but the person who hoards may not perceive their environment as unsafe or unclean.  Other reasons that a person who hoards might not seek treatment include that they don’t believe there is evidence-based treatment for their difficulty (there is!) and that they don’t know where to start.  It can be overwhelming. 

2. Resources for clients, families, friends and other clinicians

What can you do to help?

Table the judgement.  All of it.  We all have issues. Remember who gets to cast the first stone? (hint: none of us.) 

Stop asking the person to get rid of stuff.  Chances are it is aggravating them and driving a wedge between you.  Instead, focus on respect and safety. People who hoard often have intense relationships with their belongings.  If they are to change they will need the support of people they can trust – a support person who cares, like you!  They are unlikely to trust anyone who removes items without their permission or who does not respect their decision-making capacity.  Would you?  Finally, no matter what their level of insight, odds are that they will still want to live in a safe environment.  If they live in an apartment, they will also probably want to pass inspections. 

Focusing on safety is a way to have discussions about what might need to change in the living space. 

Check out these other resources across the nation, world and web: (Coming Soon)

Those are the things you can get started with. You may find you would like to consult with me about possible next steps to help preserve the health, home and/or family of the person who hoards. 

My services and rates are below. I have included an estimate of the typical number of hours that I usually devote to this task per case; please keep in mind that the estimate of hours is only an estimate and actual time devoted to a case may vary significantly. 

Individual psychotherapy via telehealth or my office	6 to 9 sessions total, divided between client’s home, telehealth, and my office location.	$210/ hour
Individual psychotherapy in person at client’s home	(same as above)	$250/ hour
Speaking / Training on Hoarding	Up to 4 hour staff training	$550 flat fee
Consult, with home visit, with individual & family (& landlord, if applicable)	3 hours total meeting to form a safety and harm reduction plan	$250/ hour

 

Note specific to social workers and staff of community living/ senior living housing venues: 

As is the case with many hoarding situations in community living, it is not always easy to establish at the outset of a case who the client is. A lot depends on the level of insight of this individual. For example, if an individual has low insight then they will be unlikely to consent to sign the paperwork and make payments necessary to engage my services for individual psychotherapy treatment.  The person may be willing to engage with me as a “safety consultant,” but who will pay my fees?  I ask that community living staff that wish for residents/ tenants to pay for my cost of services are encouraged to have that conversation prior to engaging me.  A side note: If a senior adult wishes to use Medicare or other insurance to pay for services, I may be able to make a recommendation. I believe it will be difficult to find some to visit in person, however.

No matter what, you may wish to engage me to train your staff on the nature of Hoarding Disorder. This training, done with all staff from maintenance employees to front desk staff, can help minimize the stigma associated with HD at the same time as it increases the awareness of what to expect. I have provided similar trainings at several housing locations across the city over the last few years. Yours could be next!