1. Compulsive Hoarding Roland Simmons

2. Objectives Briefly define hoarding Impact – On the person – On the environment Activity Feedback Conclusion

3. What is hoarding? Failure to discard large quantities of possessions which appear to be useless or have little value Living spaces which are no longer able to be used for purpose Significant distress or impairment in functioning (Frost and Hartl 1996) Excessive acquisition (Frost et al 1998)

4. What is hoarding continued Characteristic of OCD – Other conditions demonstrate hoarding issues (Saxena et al 2011) Hoarding is a debilitating condition and is often difficult to treat (Gibson, Rasmussen and Steketee 2010) Little is known of the underlying issues related to hoarding, why people hoard or at which stage of life hoarding becomes an issue (Ayers et al 2010) Often referred to as ‘Cluttered’ or ‘Messy’ home Can be costly to Services (Tolin et al 2008:201)

5. Impact of hoarding on a person Washing Dressing Eating Mental Health Relationships Social Isolation Death

6. Impact on Environment Cleaning Risk of falls Hospitalisation Eviction – Homelessness Assessments Repairs Fire risk Costly to clear

7. Kitchen

8. Kitchen 2

9. Activity Now it is over to you!

10. Role of Occupational Therapy Relevant skills to work with people that hoard Building on knowledge and evidence base Promote OT Moving into a non-traditional setting Three successful placements

11. Expected Outcomes Complete overview of service Referrals Address social and environment fears Reduce enforcement from Environmental Health Services Reduce social isolation Raise the profile of hoarding More time less costs Effective interventions

12. Conclusion Hoarding is a debilitating condition Affects persons quality of life Can affect services being offered Be prepared for long interventions

13. References Ayres, C. R., Saxena, S., Golshan, S and Wetherell, J.L. (2010) ‘Age at onset and clinical features of late life compulsive hoarding’. International Journal of Geriatric Psychiatry 25: 142-149 Curwen, B., Palmer, S., and Ruddell, P. (2000) ‘Brief Cognitive Behaviour Therapy:’ Sage Publications: London Frost, R. O., and Hartl, T.L. (1996) ‘A Cognitive-Behavioral model of compulsive hoarding’. Behavioural Research. 34 (4) 341-350 Frost, R. O., Kima, H., Morris, C., Bloss, C., Murray-Close, M and Steketee, G. (1998) ‘Hoarding, compulsive buying and reasons for saving’ Behaviour Research and Therapy 36. 657 - 664 Gibson, A.K., Rasmussen. J., and Steketee. G. (2010) ‘Ethical Considerations in the Treatment of Compulsive Hoarding’ Cognitive and Behavioral Practice 17 426-438 Gilliam, C.M., and Tolin, D.F. (2010) ‘Compulsive hoarding’. Bulletin of the Menninger Clinic. 74, (2)

14. References Continued Miller, W. R., and Rollnick, S. (2002) ‘Motivational Interviewing; Preparing people for change.,’ The Guildford Press: New York Saxena, S., Ayres, C. R., Maidment, K. M., Vapnik, T., Wetherell, J. L., and Bystritsky, A. (2011) ‘Quality of life and functional impairment in compulsive hoarding’. Journal of Psychiatric Research. (45) 475-480 Steketee, G., and Frost, R. O. (2007),Compulsive Hoarding and Acquiring: A Therapist Guide.’ Oxford University Press: New York Steketee, G., and Frost, R. O. (2003) ‘Compulsive hoarding: Current status of the research’. Clinical Psychology review 23 905-927 Tolin, D.F., Frost. R.O., Steketee, G., Gray. K.D. and Fitch. K.E. (2008) ‘The economic and social burden of compulsive hoarding’. Psychiatry Research 160 200-211

15. Contact details Roland Simmons – 02476 437059 roland.simmons@orbit.org.uk Or follow project Webpage: http://www.orbit.org.uk/main.cfm?Type=HOARDhttp://www.orbit.org.uk/main.cfm?Type=HOARD Blog to follow!