Question: Having just discovered that my hoarding/saving is an OCD, I’m immersing myself in the literature & want to start treatment with an experienced BT. I’m not depressed, but have spent years in/out of therapy with non-BT’s. Can you advise (without an actual assessment) if BT alone might be effective (with aggressive goals and compliance)? Mary.
Answer 1: The hoarding type of OCD is less well understood and less well researched then some other types. At this point it looks like medication alone is unlikely to be effective but may help a person comply with treatment. Cognitive behavioral therapy is the only thing that really seems likely to make a difference. This will be hard to find as most therapist are not trained and even those who are may not know much about hoarding. You will need a therapist who is willing to make a home visit or supervise someone doing this part of things. hoarders are often not that motivated to change which makes this problem even more difficult to treat. Continued near the bottom of this page.
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Answer 2: You may wish to consider treatment with both medication and behavior therapy. An example of a behavioral approach would be that with the permission of the behavior therapist, a daily goal of a certain amount of paper be set, for example, three or four shopping bags full, and that the you agree that if you have not accomplished this by the end of the day, then a cooperating friend is authorized to pick the papers to discard (I assume newspapers and magazines and junk mail). Your friend could also be authorized to help you sort mail into discard and respond (e.g. Bills) for a certain number of minutes per day. You should be required by your therapist to stop all subscriptions except 2-4, all newspapers except 1, which must be discarded within 5-7 days of receipt of each copy. You should also try various of the effective anti-OCD drugs, and perhaps some augmenting agents if necessary.