Our Prerogatives

Hoarding behavior represents a condition which causes the individual substantial long-term impairment including debilitating anxiety and distress, increased risk of physical injury, physical health problems, and/or psychological problems, such as depression. For example, those with hoarding behaviors may be five times more likely to access mental health services than the general population. Further, having clinically impairing clutter places those with hoarding behavior at increased risk for family dysfunction, isolation, and even premature death. Because the environmental manifestations of hoarding behavior (i.e., clutter) reduces the function of living areas, creates safety and fire hazards, increases insect and rodent infestations it carries significant risks to both family and community alike. 

The economic cost to society can also be quite significant. For example, the clean-up costs of a single hoarded house can be as much as $40,000. A single fire, in a multiunit building, caused by clutter in one hoarded apartment can result in as many as 16 people living in different units to be displaced and result in well over $300,000 in damage. While there is considerable cost in terms of the increased use of public services and social resources, the real economic price associated with hoarding is actually the loss of these productive members of society. largely due to higher rates of illness, injury, disability, eviction, homelessness or premature death. These are just a few of the unfortunate consequences of hoarding behavior when left untreated. 

There are multiple ramifications of ignoring hoarded situations. Currently, more than 6% of older adults have clinically impairing clutter in their life. Furthermore, one out of every thousand elders live in squalor. In conjunction with a lack of funding for the costly clean-ups of clinically impairing clutter in homes of those who are not elders with hoarding behavior, there is also an over-usage of scarce elder resources to fund clean-ups for hoarded homes in the community. 

For most, lack of funding and social support for clutter removal presents a major obstacle for those seeking and needing change. However, other factors such as a lack of insight, stigma, self-stigma, and even fear can prevent many people from self-reporting until the problem has become so pervasive that it comes to the public eye via a second party report. Unfortunately, this usually does not happen until the fifth or sixth decade of life when changing long standing beliefs and behaviors is more difficult, in part due to normal age-related changes in the healthy brain. 

Research on the current treatment methods available indicate that the best treatments are only moderately effective at symptom reduction, especially in the elder population, when hoarding behavior is most commonly uncovered and subsequently diagnosed. However, adding additional interventions that improve insight, increase motivation and address underlying cognitive factors that manifest as clutter improves the efficacy of mainstream therapeutic interventions. Ideally, earlier more timely clutter interventions are possible if we screen for hoarding behavior starting in early adulthood.

The first step to helping those with clinically impairing clutter requires creating a greater level of community awareness and an initiative that is action driven!

Increase Self-Reporting 

Provide screening via out reach that reduces stigma, encourages self-assessment and provides public access to self-report screening measures. Provide an assessment of service needs for those living with clinically impairing clutter that require continuous clutter interventions to resolve, manage and prevent clinically impairing clutter from evolving beyond the private sector into a public health problem.

Institute Screening Policies 

Research has consistently revealed that hoarding behaviors typically begin in early adolescence and persist throughout life when not treated, yet there are no age appropriate screening methods for children or policies in place for at risk populations (e.g., teens, young adults, older adults and elders with attention, memory and executive function issue). 

Invest in Peer Support 

The Massachusetts Statewide Steering Commission on Hoarding (2017) study also revealed a lack of public knowledge concerning support groups and the efficacy of peer support groups. A recent study, led by San Francisco’s Mental Health Association, demonstrated that peer led CBT groups can be just as effective as professionally led CBT groups in addressing hoarding behavior. Our own search found only three Clutterer's Anonymous groups and no pre-established individualized peer support programs for those with clinically impairing clutter or hoarding behavior local to Boston area. However, peer social support can be found without leaving the house by utilizing your phone or a computer. Take the first step and reach out to us for a free 30-minute phone consultation today. 

Initiate New Interventions 

Innovative interventions based on new research may provide effective alternative or additional treatment strategies to CBT, including the Next Step to Reorganization (NSR). A core difference between the Next Step to Reorganization, and clinical treatments offered today, is that NSR directly addresses the most debilitating symptoms of hoarding behavior including the disorganization of lives and the safety and health hazards within the home. It assists in restoring the function of living areas and maintaining functionality through continuous clutter interventions. The Next Step method is a non-stigmatizing, step by step, process that starts with motivational interviewing to find out what motivates and inspires you. The hands-on approach includes a combination of both cognitive behavioral therapy and exposure response prevention therapy used in mainstream treatment for hoarding today. However, our trained peers recognize hoarding behavior as a way of self-regulation in the face of underlying information processing difficulties, and NOT simply as a stand-alone symptom of a mental illness. We strive to increase the individual’s awareness and productivity through helping the individual compensate for cognitive processing inefficiencies, while reducing shame and stigma and creating a platform for positive change that is self-perpetuating and self-reinforcing. Accordingly, the Next Step to Reorganization includes, as a ket element, motivational coaching and direct assistance, within the individual’s home It helps to break very large, overwhelming tasks into small steps and prioritize and assist in remedying safety or health violations. Perhaps most importantly it assists the individual to maintain motivation, develop endurance and enhance the executive skills necessary to see organizational tasks all the way to completion, one step at a time.