How do you treat compulsive hoarders?

DSM-V

DSM-V will have a major impact on people suffering from hoarding disorder (compulsive hoarding) because it will separate ‘hoarding” from being a symptom of OCD and define it as an independent disorder with its own parameters.

Hoarding will thus attract even more research into possible treatments. Up until the release of DSM-V, hoarding will still be defined as a symptom of OCD. The current generally available treatment strategies will thus continue to conform to OCD requirements.

There are no established protocols to treat hoarding disorder (compulsive hoarding) which leaves many healthcare professionals at a loss.

The first stop - the GP

Often GP's do not understand the depth of this debilitating, isolating and progressive illness.  It also presents a peculiar difficulty to GPs because however extreme the situation the patient truly does not believe they have a problem.  Any suggestion that there is something wrong and that they need to see a psychiatrist ends the patient-doctor relationship.

It can be difficult to get a referral to any specialist at all, as there only a very few psychiatrists, psychologists and therapists experienced in treating compulsive hoarding in the UK.

Co-morbidity

When the hoarder is suffering from another identifiable psychological conditions (co-morbidity), that can be treated with medications and other therapies, the professionals are more comfortable helping.  Indeed, hoarding can be a symptom of several neurological / psychiatric conditions in which case treatment should be according to the primary diagnosis.

The problems

If you are fortunate enough to get a referral, the standard treatments are ineffective leaving prolonged frustration for the patient, the therapist, the GP and the family. Drug therapies are often not successful, partly because clinical compulsive hoarders forget to take their tablets at the right time, if at all, and lose their medications in the disorder.

Hoarders are chronically disorganised and frequently do not turn up for appointments.   Even if well motivated, they forget the appointment, turn up late, lose their keys or the car won't start. 

Treatment takes time, a LONG time. 

There are several different treatment options for clinical compulsive hoarding.

  • Medication
  • Cognitive Behaviour Therapy (CBT)
  • Intervention
  • Support groups
  • Self-help

Read on ...

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