Hoarding can have considerable effects on individuals, families, and communities and is a risk for significant public health problems and even death.  It is a serious psychiatric problem associated with a poor response to behavior treatment and medications demonstrated to be effective for obsessive-compulsive disorder (OCD). A specialized cognitive behavioral treatment (CBT) for hoarding was developed. Trials testing this individual, manualized treatment have shown positive results; however, this protocol is limited by long treatment periods, problems with feasibility and excessive cost of home visits, and limited access to clinicians that are well-trained in CBT for hoarding. Thus, alternative methods of CBT delivery for hoarding are being developed and tested, including group, web-based, self-help, and coaching approaches. Specialized CBT for hoarding, focusing on innovative alternatives and adaptations of these methods, are reviewed. New advances addressing the home-based component may be considered within the context of stepped care.

Learning Objectives

Upon completion, readers will:

1. Gain a basic understanding of hoarding, its associa
tion with other disorders, and ways to measure and assess hoarding symptoms. 

2. Learn about current treatments for hoarding and areas for future exploration:

3. Recognize how alternative treatment modalities for hoarding can fit into a stepped-care approach to hoarding treatment.