“Gold standard,” evidence-based treatments for hoarding disorder are still being researched and developed, but several promising elements have emerged as successful practice. Often clinicians find the most benefit from using a combination of the types of treatment described below with their clients.
Cognitive Behavioral Therapy (CBT) is a type of therapy that helps individuals to examine the way they think and behave, and to change the thought processes or behaviors that may be problematic. The specific CBT elements involved in HD treatment include restricting acquiring, practicing sorting and discarding, and cognitive restructuring to challenge thoughts and beliefs about attachment to items.
Motivational Interviewing (MI) is a technique that seeks to increase the individual’s motivation to make positive change(s) in their behavior. MI increases motivation by helping the individual connect their values and goals with their behaviors, and brainstorming ways to change behaviors that are not in line with their values and goals.
Skills Training for HD focuses on helping people learn (1) how to organize their belongings within their homes, (2) how to use problem solving methods to address common problems that arise in working on their clutter, and (3) how to make decisions about keeping needed items and removing unwanted objects that contribute to clutter.
Medication for HD works to change an individual’s brain chemistry and activity. They can enable the individual be more able to engage in the treatment process, whether by improving their mood or by reducing their severe anxiety.