Treatment for Hoarding Behaviors: A Review of the Evidence

This article reviews the empirical literature on treating clients with hoarding behaviors, including psychosocial treatments, mainly cognitive behavioral, and pharmacotherapy. Standard treatments used for obsessive compulsive disorder (OCD) such as medication and/or behavior therapy have been associated with poor treatment response for those with hoarding. Recent prospective pharmacotherapy research suggests that serotonergic medication may be helpful to OCD patients with or without hoarding. A multi-component cognitive behavioral treatment (CBT) designed specifically for hoarding has shown promising results especially in trials of individual therapy with periodic home visits. Social work researchers have played a prominent role in the development and testing of this CBT intervention and development of instruments to assess hoarding treatment outcomes. This CBT intervention has demonstrated modest success when delivered individually in an open trial and a waitlist-controlled trial, and in quasi-experimental studies of group treatment modalities, including in-person and web-based groups as well as bibliotherapy-based support groups. Overall, evidence supports the use of specialized CBT methods to improve hoarding symptoms. Future testing may include controlled trials with more diverse samples.