1. The Complexity of a Hoarder Wyvonnia W. Walker, MA, GRPA

2. The Complexity of a Hoarder ▪ What is a Hoarder as defined by the DSM V. ▪ Am I a Hoarder? ▪ What I should know about Hoarding. ▪ How can we help? ▪ Resources

3. The Complexity of a Hoarder

4. Collector or Hoarder? Take our quiz and find out if your possessions are in control? Take this quick quiz and find out if you are at risk for compulsive hoarding—the tendency to over-collect, along with an inability to organize and/or get rid of items. Print this page, circle the answers you most agree with, and score your quiz below. 1. I have difficulty using spaces in my home for their intended purpose (for example, eating at my kitchen table, sitting on my sofa to watch TV, or sleeping in my bed). a. Never b. Sometimes c. Often/Always 2. Getting rid of my possessions—whether I'm throwing them out, donating them, or selling them—causes me distress and anxiety. a. Never b. Sometimes c. Often/Always 3. I never pass up a freebie, even if I don't need it or have space for it. a. Never b. Sometimes c. Often/Always

5. The Complexity of a Hoarder Collector or Hoarder? Continue 4. I have duplicates of many things (for example, Italian cookbooks, scarves of the same color, similar toiletry items). a. Never b. Sometimes c. Often/Always 5. I buy things I want, even if I can't afford it or don't have space to put it. a. Never b. Sometimes c. Often/Always 6. My possessions are so disorganized that I often have a hard time finding what I am looking for. a. Never b. Sometimes c. Often/Always 7. I avoid inviting people to my home because of the clutter. a. Never b. Sometimes c. Often/Always

6. The Complexity of a Hoarder Collector or Hoarder? Continue 8. I feel like I have no control over the clutter in my home; my possessions own me. a. Never b. Sometimes c. Often/Always 9. My possessions are a source of family conflict. a. Never b. Sometimes c. Often/Always 10. I notice that other people in my family (for example, a sister, mother, or uncle) have a lot of clutter as well. a. Never b. Sometimes c. Often/Always

7. Score Your Quiz on Hoarding Behaviors Give yourself 1 point for every A answer, two points for every B, and three points for every C. 10 to 15 points means you are at low risk for hoarding. Congratulations; your home is clutter-free. The rest of us envy you. 16 to 21 points puts you at medium risk for compulsive hoarding. Don't let your possessions get the best of you! Organization may not be your strong suit, so try to acquire less and recycle or donate items that you don't need or no longer use. 22 points or more means you are at high risk for compulsive hoarding. Your possessions are very important to you, and though at times you feel like the clutter is out of control, it's very difficult for you to throw things away. For more assistance on how to get your collecting habit under control, visit The International OCD Foundation Hoarding Center. Source: This quiz was adapted from information from the International OCD Foundation—Hoarding Center. Publication Review By: the Editorial Staff at Healthcommunities.com Published: 01 Nov 2010 Last Modified: 22 Aug 2012 The Complexity of a Hoarder

8. Development and Course ▪ Hoarding appears to begin early in life and spans well into the late stages. Hoarding symptoms may first emerge around ages 11-15 years, start interfering with the individual’s everyday functioning by the mid -20s, and cause clinically significant impairment by the mid- 30s. Participants in clinical research studies are usually in their 50s. Thus, the severity of hoarding increases with each decade of life. Once symptoms begin, the course of hoarding is often chronic, with few individuals reporting a waxing and waning course. ▪ Pathological hoarding in children appears to be easily distinguished from developmentally adaptive saving and collecting behaviors. Because children and adolescents typically do not control their living environment and discarding behaviors, the possible intervention of third parties (e.g., parents keeping the spaces usable and thus reducing interference) should be considered when making the diagnosis.

9. The Complexity of a Hoarder Culture-Related Diagnostic Issues While most of the research had been done in Western, industrialized countries and urban communities, the available data from non-Western and developing countries suggest that hoarding is a universal phenomenon with consistent clinical features. The key features of hoarding disorder (i.e., difficulties discarding, excessive amount of clutter) are generally comparable in males and females, but females tend to display more excessive acquisition, particularly excessive buying, than do males. Gender-Related Diagnostic Issues

10. The Complexity of a Hoarder What can you do to help? These are NOT solutions 1.Coercing a person into throwing away all of their possessions. 2.Forcing a person to move. 3.Going into a person home and throwing everything away. 4.Bullying/ intimidation 5. Refusing support

11. The Complexity of a Hoarder Communication ▪ You must open as many clear lines of communication as possible. ▪ Both you and the person that you are trying to assist must listen to each other and have no barriers in communication. ▪ You have to reframe from the following barriers of communication: ▪ Pre-judging ▪ Criticizing ▪ Power Struggles ▪ Minimizing ▪ Arguing

12. The Complexity of a Hoarder Actively listening ▪ Giving your physical and mental attention ▪ Eye contact ▪ Paraphrasing ▪ Watching your tone ▪ Watching your body language (minimizing your fears) ▪ Be in the moment ▪ Taking notes and or pictures (with permission)

13. The Complexity of a Hoarder 1. Develop rapport 3. Multiple visits /Gain trust 2. Family education and involvement

14. The Complexity of a Hoarder 4. Remember that you can only assist 7. Seek additional help and supports 5. Allow the person to feel in control 6. Create a safe and secure place for the person

15. The Complexity of a Hoarder 8. Start small

16. The Complexity of a Hoarder Normative collecting does not produce significant clutter, distress, or impairment typical of hoarding disorder

17. The Complexity of a Hoarder Common features of hoarding disorder include indecisiveness, perfectionism, avoidance, procrastination, difficulty planning and organizing tasks

18. The Complexity of a Hoarder Items or object Hoarding

19. The Complexity of a Hoarder What can you do to help? Develop rapport Multiple visits /Gain trust Family education and involvement Create a safe and secure place for the person Seek additional help and supports Allow the person to feel in control Remember that you can only assist Start small