Abstract
A recent addition to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), hoarding disorder (HD) is characterized by difficulty discarding possessions and associated distress, cluttered living space, and substantial functional impairment. This chapter focuses on Jocelyn, a 60-year-old single female with HD and comorbid major depressive disorder, posttraumatic stress disorder, attention deficit disorder, and history of polysubstance abuse, living in an urban, Section 8 housing. This case example illustrates the manifestations and course of HD as well as the specialized cognitive behavioral treatment (CBT) strategies for HD in a community mental health clinic. The core components of specialized CBT for hoarding (developed by Steketee and Frost, 2007a,b; 2013a,b;) include assessment, psychoeducation and case formulation, motivational enhancement, goal setting, skills training (organizing, problem solving, decision making), behavioral exposure practice for discarding and non-acquisition, cognitive strategies to challenge thoughts and beliefs, and relapse prevention. The CBT techniques portrayed are aimed to address specific aspects of Jocelyn’s personal hoarding model which include personal and family vulnerabilities, information-processing problems, beliefs about possessions, emotional responses (positive and negative), and learned behaviors. The role of case management and other human service personnel are also discussed.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Abramowitz, J. S., Franklin, M. E., Schwartz, S. A., & Furr, J. M. (2003). Symptom presentation and outcome of cognitive behavior therapy for obsessive compulsive disorder. Journal of Consulting and Clinical Psychology, 71, 1049–1057.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing.
Bratiotis, B., Sorrentino Schmalisch, C., & Stekete, G. (2011). The hoarding handbook: A guide for human service professionals. New York: Oxford.
Bulli, F., Melli, G., Sara, M., Carraresi, C., Stopani, E., Pertusa, A., et al. (2013). Hoarding behaviour in an Italian non-clinical sample. Behavioural and Cognitive Psychotherapy, 41, 1–15.
Cromer, K. R., Schmidt, N. B., & Murphy, D. L. (2007). Do traumatic events influence the clinical expression of compulsive hoarding? Behaviour Research and Therapy, 45(11), 2581–2592.
Frost, R. O., & Hartl, T. L. (1996). A cognitive-behavioral model of compulsive hoarding. Behavior Research and Therapy, 34(4), 341–350.
Frost, R. O., Krause, M. S., & Steketee, G. (1996). Hoarding and obsessive-compulsive symptoms. Behavior Modification, 20(1), 116–132.
Frost, R. O., Steketee, G., & Williams, L. (2000). Hoarding: A community health problem. Health & Social Care in the Community, 8(4), 229–234.
Frost, R. O., Steketee, G., & Grisham, J. (2004). Measurement of compulsive hoarding: Saving inventory-revised. Behaviour Research and Therapy, 42(10), 1163–1182.
Frost, R. O., Steketee, G., Tolin, D. F., & Renaud, S. (2008). Development and validation of the clutter image rating. Journal of Psychopathology and Behavioral Assessment, 30(3), 193–203.
Frost, R. O., Tolin, D. F., & Maltby, N. (2010). Insight-related challenges in the treatment of hoarding. Cognitive and Behavioral Practice, 17, 404–413.
Frost, R., Steketee, G., & Tolin, D. (2011). Comorbidity in hoarding disorder. Depression and Anxiety, 28(10), 1–9.
Frost, R. O., Ruby, D., & Shuer, L. (2012). The buried in treasures workshop: Wait list control trial of facilitated self-help for hoarding disorder. Behaviour Research and Therapy, 50, 661–667.
Frost, R. O., Hristova, V., Tolin, D., & Steketee, G. (2013). Activities of daily living scale in hoarding disorder. Journal of Obsessive-Compulsive and Related Disorders, 2, 85–90.
Grisham, J. R., & Frost, R. O., Steketee, G., Kim, H. J., & Hood, S. (2006). Age of onset of compulsive hoarding. Journal of Anxiety Disorders, 20(5), 675–686.
Gilliam, C. M., Norberg, M. M., Villavicencio, A., Morrison, S., Hannan, S. E., & Tolin, D. F. (2011). Group cognitive-behavioral therapy for hoarding disorder: An open trial. Behaviour Research and Therapy, 49 (11), 802–807.
Harris, J. (July, 2010). Household hoarding and residential fires. Paper presented at International Congress of Applied Psychology, Melbourne, Australia.
Hirschtritt, M. E., & Mathews, C. A. (2013). Genetics and family models of hoarding disorder. In R. O. Frost & G. Steketee (Eds.), Oxford handbook of hoarding and acquiring. New York: Oxford.
Iervolino, A. C., Perroud, N., Fullana, M. A., et al. (2009). Prevalence and heritability of compulsive hoarding: A twin study. American Journal of Psychiatry, 166, 1156–1161.
Landau, D., Iervolino, A. C., Pertusa, A., Santo, S., Singh, S., & Mataix-Cols, D. (2011). Stressful life events and material deprivation in hoarding disorder. Journal of Anxiety Disorders, 25(2), 192–202
Mataix-Cols, D., Rauch, S. L., Manzo, P. A., Jenike, M. A., & Baer, L. (1999). Use of factor-analyzed symptom dimensions to predict outcome with serotonin reuptake inhibitors and placebo in the treatment of obsessive-compulsive disorder. American Journal of Psychiatry, 156(9), 1409–1416.
Mataix-Cols, D., Frost, R. O., Pertusa, A., Clark, L. A., Saxena, S., Leckman, J. F., et al. (2010). Hoarding disorder: A new diagnosis for DSM-V? Depression and Anxiety, 27(6), 556–572.
Mueller, A., Mitchell, J. E., Crosby, R. D., Heide, G., & Martina, Z. (2009). The prevalence of compulsive hoarding and its association with compulsive buying in a German population-based sample. Behaviour Research and Therapy, 47(8), 705–709.
Muroff, J. (2011). Thinking outside the box: Novel delivery methods for treating hoarding. International Journal of Cognitive Therapy, 4, 280–296.
Muroff, J. (2014). Alternative modalities for hoarding treatment. In R. O. Frost & G. Steketee (Eds.), The Oxford handbook of hoarding and acquiring. New York: Oxford University Press.
Muroff, J., Steketee, G., Rasmussen, J., Gibson, A., Bratiotis, C., & Sorrentino, C. (2009). Group cognitive and behavioral treatment for compulsive hoarding: A preliminary trial. Depression and Anxiety, 26(7), 634–640.
Muroff, J., Steketee, G. H., & Frost, R. O. (2010). Delivery of internet treatment for compulsive hoarding (D.I.T.C.H.). Behaviour Research and Therapy, 48(1), 79–85.
Muroff, J., Steketee, G., Bratiotis, C., & Ross, A. (2012). Group cognitive and behavioral therapy and bibliotherapy for hoarding: A pilot trial. Depression and Anxiety, 29(7), 597–604.
Pertusa, A., Frost, R. O., & Mataix-Cols, D. (2010). When hoarding is a symptom of OCD: A case series and implications for DSM-V. Behaviour Research and Therapy, 48, 1012–1020.
Samuels, J., Bienvenu, O. J., III, Riddle, M. A., Cullen, B., Grados, M.A., Liang, K., et al. (2002). Hoarding in obsessive compulsive disorder: Results from a case-control study. Behaviour Research and Therapy, 40, 517–528.
Samuels, J. F., Bienvenu, O. J., Grados, M. A., Cullen, B., Riddle, M. A., Liang, K. Y., et al. (2008). Prevalence and correlates of hoarding behavior in a community-based sample. Behaviour Research and Therapy, 46, 836–844.
San Francisco Task Force on Compulsive Hoarding. (2009). Beyond overwhelmed: The impact of compulsive hoarding and cluttering in San Francisco and recommendations to reduce negative impacts and improve care. San Francisco: Mental Health Association of San Francisco.
Steketee, G., & Frost, R. O. (2007). Compulsive hoarding and acquiring: Client Workbook. New York: Oxford University Press.
Steketee, G., & Frost, R. (2013a) Treatment for Hoarding Disorder: Therapist guide (2nd ed.). New York: Oxford University Press.
Steketee, G., & Frost, R. (2013b) Treatment for Hoarding Disorder: Workbook (2nd ed.). New York: Oxford University Press.
Steketee, G., Frost, R., & Kyrios, M. (2003). Cognitive aspects of compulsive hoarding. Cognitive Therapy and Research, 27(4), 463–479.
Steketee, G., Frost, R. O., Tolin, D. F., Rasmussen, J., & Brown, T. A. (2010). Waitlist-controlled trial of cognitive behavior therapy for hoarding disorder. Depression and Anxiety, 27, 476–484.
Tolin, D. F., Frost, R. O., & Steketee, G. (2007). An open trial of cognitive-behavioral therapy for compulsive hoarding. Behavioral Research and Therapy, 45(7), 1461–1470.
Tolin, D. F., Frost, R. O., Steketee, G., & Fitch, K. E. (2008). Family burden of compulsive hoarding: Results of an Internet survey. Behaviour Research and Therapy, 46(3), 334–344.
Tolin, D. F., Frost, R. O., & Steketee, G. (2010a). A brief interview for assessing compulsive hoarding: The hoarding rating scale-interview. Psychiatry Research, 178(1), 147–152.
Tolin, D. F., Meunier, S. A., Frost, R. O., & Steketee, G. (2010b). Course of compulsive hoarding and its relationship to life events. Depression and Anxiety, 27(9), 829–838.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Muroff, J., Underwood, P. (2016). Treatment of an Adult with Hoarding Disorder. In: Storch, E., Lewin, A. (eds) Clinical Handbook of Obsessive-Compulsive and Related Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-17139-5_17
Download citation
DOI: https://doi.org/10.1007/978-3-319-17139-5_17
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-17138-8
Online ISBN: 978-3-319-17139-5
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)