3 Things to Look for in a Hoarding Disorder Therapist

The decision to enter therapy for any disorder is a significant one. Yet, many looking for a hoarding disorder therapist have already struggled with shame and embarrassment and possibly even worked with other therapists who stated they could help yet didn’t. If you’re looking now, what are the essential things to look for in a future therapeutic partnership?

Ask about a hoarding disorder therapist’s training

Therapists receive training to address both anxiety and depression during grad school. Some programs include specializations for working with trauma, children, and families. Very few grad schools or early work experiences offer therapists the opportunity to receive training in hoarding disorder.

So, It’s appropriate to ask a potential hoarding disorder therapist about their training specific to working with individuals who hoard. Most of us would ask a surgeon about their training and experience before allowing them to schedule a procedure for us. Ask your therapist about what type of initial training they received for hoarding (there are currently only two widely accepted treatments–cognitive-behavioral therapy [CBT] and compassion-focused therapy [CFT]; ERP is not an effective treatment for HD, and it’s okay to challenge a provider who says that they utilize ERP to address hoarding that isn’t directly related to OCD…but that’s a post for another time). Also, ask about the amount of ongoing training they participate in, specifically continuing education (CEs) related to hoarding disorder (HD).

Ask about how successful other clients have been

First, let’s acknowledge that some individuals come to therapy eager to make significant progress, regardless of the circumstances. That said, most individuals with hoarding behaviors are ambivalent about changing because their values support hoarding, including financial stewardship, environmental friendliness, and frugality. These values, combined with the prevalence of other disorders, make this kind of work complex.

Effective hoarding disorder therapy is not a brief therapy. Strict manualized CBT for HD requires a minimum of 12-16 sessions. Yet, clinically significant change for most clients takes a lot longer. The longer the client has struggled with their hoarding behaviors and the greater the level of clutter in the home, the longer effective treatment will take. (I typically tell clients to expect to work together for 18 to 24 months, sometimes longer.)

Ask about how they measure their clients’ success

Although this is the final point in our discussion, this answer will reveal a great deal about a hoarding therapist’s competency. We do not measure success in treating hoarding disorder simply by a reduction in the level of clutter. We examine changes in beliefs, the ability to manage impulsive buying behaviors, learning and applying new tools for emotional self-regulation, as well as reducing the level of clutter in the home. Effective treatment and progress in recovering from HD involves shifting beliefs about acquiring new items and the ability to tolerate distress related to parting with the many essential items in the home.

The therapist you choose to work with must understand that success is not exclusively measured by how much “stuff” you get part with. Your success in overcoming hoarding includes reducing new acquiring, decreasing the number of possessions in your home, and the ability to engage with emotions that often lead to these behaviors.

It’s okay to ask questions!

I encourage clients to ask questions before choosing a therapist. While many of us share similar educational backgrounds, we each have unique personalities and experiences that make us distinct. It’s perfectly fine to ask a potential therapist questions about how they work with clients, their training, and how they measure success before engaging in the therapeutic relationship. (To schedule a discovery call and join my client waitlist, send me a message here.)