Table of Contents
Foreword ix
Acknowledgments xi
Introduction 1
For Those Who Are Open to Help: Treatments That Work
Why They Refuse Help
Digging Out
How to Use This Book
Chapter 1 What Is Compulsive Hoarding? 13
Defining Compulsive Hoarding
Why Save That?
Why People Keep Hoarding
How Do You Know if Your Loved One Has the Problem?
Could It Be Something Else?
Chapter 2 Harm Reduction 27
What Is Harm Reduction?
Applying Harm Reduction to Compulsive Hoarding
Why Harm Reduction Can Help
Chapter 3 Setting the Stage for Harm Reduction 35
Let Go
Understand
Forgive
Grab Hold
Chapter 4 Helping Them Accept Help 51
Engaging Your Loved One in the Harm Reduction Approach
Introducing Your Loved One to the Harm Reduction Approach
Chapter 5 Assessing Harm Potential 71
Conducting the Home Assessment
Acquisition Pathways
Identifying Harm Reduction Targets
Chapter 6 Creating a Harm Reduction Plan 95
Features of a Harm Reduction Plan
Putting the Harm Reduction Team Together
Creating the Harm Reduction Plan
Formalizing the Harm Reduction Contract
Chapter 7 Keeping the Harm Reduction Targets Clear 113
Step Carefully: Seven Steps to Successful Home Visits
Why Do You Have This Here?
L.E.A.R.N.: Listen, Empathize, Affirm, Redirect, and Negotiate
Skills for the Long Term
Chapter 8 Managing the Bumps in the Road 135
Six Common Reasons for Contract Failures
Working Through Contract Failures
Avoiding Contract Burnout
Using Appropriate Pressure
Making the Best of a Public Situation
Chapter 9 All in the Family and Other Complications 153
When People Who Hoard Live Together
When People Who Hoard Live in Assisted-CareFacilities
When the Person Who Hoards Is an Older Adult
How Frailty Influences Harm Reduction
Chapter 10 When the Landlord Knocks, and Other Terrors 165
There Are No "Bad Guys," Only Potential Team Members
Adult and Child Protective Services
Health and Safety Codes
Guardianship or Conservatorship
Eviction Notices
Clear-Out Interventions
Resources 179
Recommended Reading
Professionals Who Can Help
Support Groups
Other Resources
Tips for Managing Paper, Mail, and E-mail
Where to Donate or Recycle
Reference 187