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  • Q&A with Australian Health Practitioners

    Who can help me with my hoarding?

    Hi there
    A member of my family is finally ready to seek help for their chronic hoarding. I would like to help them find someone suitable to talk to. Can anyone recommend what kinds of practitioners have specialist experience in this? Thanks
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    I am a Melbourne Relationship Counsellor and Family Lawyer who is skilful in helping people get out of the pain of relationship distress and create … View Profile

    There are many different modalities of therapist and there is no clear cut answer to your question. It is ultimately a personal decision and you may even need to try a few. The best way is for your family member to see how comfortable they feel talking to the professional. Do you they feel more comfortable talking to a male or female? Is age relevant? When you make the appointment ask the therapist if they have experience dealing with this area and what are the ways in which they operate. Your family memeber will get a sense of how confident they feel with the area by asking a few questions.For example you might find a professional who does CBT or Radical Exposure Tapping. I think Radical Exposure Tapping may work well with chronic hoarding. Most experienced therapists treat the problems underlying the symptoms. I would look for someone who is comfortable delving into the deeper issues behind this problem and with whom your family member can develop a sense of trust and rapour. These are essential elements to the therapeutic relationship. Good luck!

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    Jennifer Grant

    Psychologist

    New practice opened Feb 2018. Seewebsite www.coffspsychneuro.com.au I'm passionate about working with people from all walks of life to help them create a more vital, … View Profile

    Hoarding Disorder is complex and difficult to remedy. I run a group for Hoarding on the NSW Central Coast, and am undertaking some research in this area. At present, the only evidence-based treatment is a CBT-based model developed in the US by David Tolin, Randy Frost and Gail Steketee. Their self-help book “Buried in Treasure – Help for compulsive acquiring, saving and hoarding” is a good starting point. Their best treatment outcomes suggest clinically significant improvement for only about 40% of participants.
    I am trialling a different approach using the principles of Acceptance and Commitment Therapy (ACT). This trial is only in its early stages but a few insights from my experience (and these are supported by the peer-reviewed literature):

    • A team-based approach works best – case workers, family members, practical helpers, therapist and (ideally) a support group of others with hoarding difficulties;
    • The client MUST own the process (eg, no item should be moved or disposed of without the client’s permission);
    • Duration of therapy needs to be longer than for many other mental health difficulties and progress is slower (Australia’s Medicare subsidised 10-session annual psychologist visits is woefully inadequate for this disorder);
    • Relapse is common;
    • Co-morbidity is the norm (depression, anxiety and ADHD are common);
    • A different approach is needed when there is cognitive impairment (eg as in dementia).
    There are also hoarding therapy groups running in Sydney and Newcastle (these use the CBT approach). If any of these locations are relevant for your family member, I’m happy to provide details. Contact me.
    Best wishes in supporting your family member. Their willingness to seek help is an encouraging first step.
    Kind regards
    Jennifer

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    My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile

    I think that the clinical health professionals have all offered good ideas.

    My private experience with hoarding concerns my now-deceased mother-in-law, who was a hoarder.

    I suspect but do not know that she had undiagnosed (and therefore untreated) Obsessive Compulsive Disorder, which probably contributed to her hoarding behaviour.

    Possibly a clinical professional with experience of helping clients with Obsessive Compulsive Disorder might be able to assist your family member.

    All the best.

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    Ash Rehn

    Counsellor, Psychotherapist, Sex Therapist, Social Worker

    Mental Health Medicare Provider of focussed psychological strategies, Counsellor & Therapist specialising in ‘sex addiction’, pornography issues, gay counselling, online therapy. For more information: www.ForwardTherapy.com View Profile

    The title of the post was ‘Who can help me with my hoarding?’ but the post is by a family member seeking practitioner recommendations. You mention that your family member is ready to seek help. Are they really? If so, why are you seeking the recommendations for them?

    Most of us want the best for members of our family and it can be frustrating when they indicate to us that that they are ready to seek help and then don't appear to accept the help we offer. Things can go from bad to worse when we find ourselves disempowered after all the effort we put in. I'd suggest encouraging your family member to make their own enquiries and supporting them, where appropriate, to do this. If you centre yourself in their treatment plan, you could easily burn out as some therapists do when they try to make things change for their clients.

    Treating hoarding as a behaviour can result in a lot of wasted effort when there is no understanding of why the person is hoarding. Practitioners layer diagnosis on diagnosis but often don't listen to what the individual is telling them. I once worked with a family who had an extreme hoarding problem that no one - the family, the support workers, the council, doctors, psychologists etc - were able to change. When we explored this family's circumstances we discovered the eldest member (who owned the house) had lost everything during war and been interned in a refugee camp for several years at a young age. This person's sense of insufficiency was quite compelling: when you lose everything and have to live on rations that may or may not be delivered, every little thing becomes vested in value. In other words, it was not hoarding that this person needed help with, but the trauma, or the cause. The hoarding was simply an expression of this trauma.

    Accredited Mental Health Social Workers can assist with both psychological and practical matters. Medicare offers a rebate when a referral is made by a GP. You can do a search for mental health social workers in your area by using the search tool on the AASW website: http://www.aasw.asn.au/find-a-social-worker/search/

    I wish you well with assisting your family member.

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    Dr Nellie Lucas

    Clinical Psychologist, Psychologist

    Our Clinical Psychologists provide care for the whole family with each Clinical Psychologist specialising in helping adults, adolescents or children. Our Clinics are centrally located … View Profile

    That is wonderful that your family member is ready to seek help to address what is troubling them. Clinical research has demonstrated that hoarding tends be associated with Obsessive Compulsive Disorder, Depression and other types of anxiety disorders. There is some evidence to suggest that it should be recognised as a condition in its own right. Hoarding is quite common (2-5% of the community) though it is under-recognised by health professionals and people tend to not seek help until it becomes very problematic. It can be helpful to know that many other people experience the condition and sometimes group therapy can help de-stigmatise and lessen shame or worry associated with talking about hoarding. Health professionals such as Clinical Psychologists, Psychiatrists and other professionals who specialise in anxiety will be in a good position to help your family member.  I would suggest talking with your family GP about a referral which can also give them a good opportunity to have a medical check-up in the first instance which can rule out any physical health concerns that may be contributing to the anxiety and/or depression associated with hoarding.

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    Bruni (Brunhilde) Brewin

    Counsellor, Hypnotherapist

    Bruni Brewin is President Emeritus of The Australian Hypnotherapists’ Association (AHA), the oldest and largest National Registration Body for hypnotherapists in Australia founded in 1949, … View Profile

    To hoard usually means that we keep buying new things when we don't need them and we don't throw out the old.  But this needs clarifying as to exactly what is happening and how long has it been happening and what was going on in that family member's life when it first started or even before that.

    Whatever label we want to put on this, i.e.  hoarding or compulsive obsessive disorder - that simply tells us that what is happening is a symptom developed to meet a need.  It doesn't tell us why it is happening, (which is the original cause).  Many of us hoard to a certain extent, maybe for sentimental reasons - even though it does not get used, yet we are reluctant to let it go.  But when it becomes chronic, it goes beyond that.

    As a clinical hypnotherapist/counsellor, as has already been mentioned above, in hypnosis I would ask the client to go back to the very first time they were aware of the problem.  Even then, that can only be the 'straw that broke the camels back', and things can have happened prior to that, but it opens a window to view what was going on at that time.  The question; 'Was there a time before that when you felt this...' can take you to a further window.

    So I would recommend that you look for a professional who has done the training to be able to not only deal with regression work, but know how to release the cause(s) which may be tied in with anxiety, stressfull or traumatic happening(s) from an earlier time in the client's life. 

    Recent advances in neuropsychology and brain imaging have opened new doors to  understanding of PTSD and other anxiety-related disorders.  The researchers say they now know that the symptoms associated with these conditions closely interweave with memory circuits of the brain. Although PTSD or anxiety is triggered by a traumatic event(s), it is really a problem of the memory they tell us.  The problem isn’t the trauma or anxiety related happening; it’s what happened can’t be forgotten, and so the memories of how we felt at the time of the original happening(s) keeps coming back the same as if it were happening right now, giving us the same feelings over and over, causing us to repeatedly find a way to deal with these.

    However, all of this is hypothetical, until we can check with the client what it is for them that causes this to happen.

     

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    Susan Loane

    Counsellor, Psychotherapist

    I have been a clinical psychotherapist and counsellor for over twenty years. I have worked successfully with clients of all ages and socio economic backgrounds. … View Profile

    Hoarding disorder can affect anyone, it doesnt discriminate,like all mental health disorders.  It isnt clear, though, how common hoarding is.  That's because in part, most people never seek out treatment. The risk factors include a person's age, it ususally starts around early puberty and gradually worsens.  Young children may start saving items, such a broken toys, school books, and other broken items, most children would throw away.  Hoarding is more common in younger adults.  Most people who suffer from hoarding, have a temperament that is consistent with indicision. There is also a strong correlation between sharing this disorder with a close relative.  Some people develop horading disorder after experiencing a stressful life event that they have had great difficulty dealing with, such as the death of a loved one, divorce, eviction or loss through other major loss and tragedy such as household fire. People who suffer from hoarding become socially withdrawn and isolated.  This results in social isolation and loneliness.  Support for this disorder should provide patience, non judgemental ongoing contact with the person.  Trust building is imperative, and has to be gained through consistency, and acceptance of their vulnerability, by creating and establishing that the very state of their vulnerability is alright, the relationship between the support person and the hoarder, can develop into further establishin a strong relationship and creating normalisation through ongoing acceptance, trust, disclosure, and working closely with the person.  Anxiety and trauma counselling, can then be gradually introduced, and slowly introducing socialisation with support groups.

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