Explains hoarding, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.

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This Information is provided by NHS Choices.

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It's not easy to treat compulsive hoarding, even when the person is prepared to seek help, but compulsive hoarding can be overcome.

  • The main treatment for compulsive hoarding is cognitive behavioural therapy (CBT). The therapist will help the person understand what makes it difficult to throw things away and the reasons why the clutter has built up. This will be combined with practical tasks and a plan to work on (see below). It is important that the person takes responsibility for clearing the clutter from their home. The therapist will support and encourage this.
  • A type of antidepressant – selective serotonin reuptake inhibitors (SSRIs) – has also been shown to help some, but not all, compulsive hoarders.

Cognitive behavioural therapy (CBT)

CBT is a type of therapy that aims to help you manage your problems by changing how you think and act. It encourages you to talk about how you think about yourself, the world and other people, and how what you do affects your thoughts and feelings. By talking about these things, CBT can help you to change how you think (‘cognitive’) and what you do (‘behaviour’), which can help you feel better about life.

The National Institute for Health and Care Excellence (NICE) recommends that a period of cognitive behavioural therapy is considered for adults who have significant problems with hoarding.

Regular sessions of CBT over a long period of time are usually necessary and should include some home-based sessions, working directly on the clutter. This requires motivation, commitment and patience, as it can take many months to achieve the treatment goal.

The goal is to improve the person's decision-making and organisational skills, help them overcome urges to save, and ultimately clear the clutter, room by room. 

The therapist won't throw anything away, but will help guide and encourage the person to do so. The therapist can also help the person develop decision-making strategies, while identifying and challenging underlying beliefs that contribute to the hoarding problem.

The person gradually becomes better at throwing things away, learning that nothing terrible happens when they do so, and becomes better at organising items they insist on keeping.

They may also be encouraged to keep a daily log of what they have purchased, to monitor incoming clutter.

At the end of treatment, the person may not have cleared all their clutter but will have gained a better understanding of the problem. They will have a plan to help them continue to build on their successes and avoid slipping back into their old ways.

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