Interview: Hoarding Therapist (by Caleb) ​

Reason ​

We decided to interview a therapist because hoarding is a psychological disorder. We figured that a therapist could use our app to help treat people who have hoarding disorder. Additionally, we were able to find a therapist with a decade of experience dealing with HD, so her insights as to how to most effectively treat HD were invaluable.

Interesting Findings ​

Carole really wanted us to know the HD is similar to alcoholism in that it requires constant effort to be treated. They have trouble with executive functioning, so figuring out whether to keep or discard an item is a struggle. Additionally, most people realize they have HD in their 50's/60's, only after they've burned all their connections to family and friends, making catching it early difficult. People with HD are also generally Earth-conscious, which makes throwing things away even more difficult, even though most of their belongings are not particularly valuable/worth saving (mostly paper - books, magazines, newspapers, etc.).

Notes ​

What is your experience with people with hoarding disorder? ​

• Carole has been working with hoarders since 2013. Her first experience w/ hoarders was trying to help a friend organize their home. Turns out the friend's husband was a hoarder, and his office was full of things.

What are the biggest factors for a HD diagnosis? ​

• Typically, if someone is a hoarder they will know that they have a problem
  • Alr cut off by family/friends. Lonely
  • Want to host a gathering but physically can't
  • They feel a lot of shame/embarrassment typically
• Comes with OCD, depression, anxiety, etc.

What does the average person with HD look like? ​

• Paper says there was no significant differences
• Age?

  • 50 years. Typically 60's-70's

• Respiratory illness
• 'Quirky'
• Owns ≥1 storage unit

What are some of the early signs of hoarding disorder? ​

• Collecting things, but not in an organized fashion
  • Having baseball cards but some are ripped, bent, etc.

What are the causes for HD? (if any) ​

• 'Zero' executive functioning
  • Cannot decide whether to get rid or keep items, so they postpone the decision
  • In the paper, ambivalent responses to throwing away 'personal items' were much more common in people with HD than a control group

Are there different stages of HD? ​

• Do people fluctuate between stages? Constant decline?
• Which stage is the most common?
• Would you recommend an app?

At what point do people with hoarding disorder realize they have a problem? ​

• Family, friends gone.
• They want to invite friends over but can't

Do the hoarded items usually have monetary value/could monetary gain be an incentive to declutter? ​

• No. Most commonly hoarded items are paper - books, magazines, newspapers, etc
• Most hoarders want to trade their things for other things
• Other hoarded items are from family (living/dead)

Saving Cognitions Inventory vs Hoarding Rating Scale Interview? ​

• Could these be implemented into an app?
  • Potentially? She did not know much about SCI, but HRSI is very accurate. We just have to trust the user to self-diagnose

What is the most common treatment plan you recommend? ​

• Cognitive Behavioral Therapy
• Going to their home to help them declutter
  • Have to respectful of boundaries
  • Throw nothing away - they must get rid of things themselves
• Continuous Treatment - there is no cure