Hello and welcome to Sam’s research corner! My goal of this blog series is to take a look at recently published scientific literature that is relevant to what we do here at Clouds End- supporting those who hoard through supportive intervention. I hope that I can bring awareness to the great work being done in this area and help make it easy to understand for academics and not academics alike!

 

Towards the end of last year Daisy Twigger and her colleagues published research on psychosocial interventions for hoarding disorder (1).

What are Psychosocial Interventions?

Psychosocial interventions take one of several forms, but at the centre, they all look to understand the relationship between a person’s physical, social and psychological situations and how they interact.

Understanding psychosocial interventions is crucial because many people who hoard receive interventions like these from social workers, housing officers, firefighters and other professionals, making it a common experience!

For example, a housing officer might work with a client to develop a routine of decluttering while helping them to access other services that may help them.

What can we learn from this research?

The research highlights how varied psychosocial interventions can be. For approaches, the focus is on immediate needs—like improving health and safety or ensuring access to essential services (2,3). For others, the goal is long-term change, such as helping clients develop organizational skills to manage clutter in their homes (4,5).

We know that at Clouds End that these kinds of interventions can vary wildly from case to case, and from provider to provider, with different services placing different emphasis on the clutter or the safety or the psychological factors involved.

How effective are these approaches?

But how effective are these approaches, really? That’s where things get tricky- because effectiveness can mean different things, depending on your perspective.

For example, outcomes might only track the number of fire risks, or clutter within the home, while other may look at how upset a person is by their hoarding behaviour. But when teams only look at one of these outcomes they miss the full picture!

At Clouds End we know that while clutter and a client’s safety are of vital importance, they are not the whole story- the way that a person feels about their hoarding is also very important, it is the difference between feeling motivated for change and feeling overwhelmed by one’s context.

What’s next?

It is surprising that despite so many people receiving psychosocial interventions for hoarding globally, this review only found five studies- and all of them based in North America! This means we don’t have lots of data to make informed decisions on, and we don’t know how these approaches will work in other contexts, like here in the UK.

Studies like this show that we need more data to become available when it comes to supporting those with hoarding. When agencies share their knowledge, expertise, successes, and even failures, we all learn more- collaboration helps us develop better ways to support those facing challenges with hoarding.

Through sharing case studies, experiences, and even challenges, professionals can contribute to a growing body of knowledge that improves interventions worldwide.

By working together, we can create a future where everyone who hoards, and those who support them, feel supported, understood and empowered to make positive progress.

References

1. Twigger, D., Gregory, J. D., Bowers, E., & Millar, J. F. (2024). Psychosocial interventions for hoarding disorder: a systematic review. The Cognitive Behaviour Therapist, 17, e41.
2. Kwok, N., Bratiotis, C., Luu, M., Lauster, N., Kysow, K., & Woody, S. R. (2018). Examining the role of fire prevention on hoarding response teams: Vancouver fire and rescue services as a case study. Fire technology, 54, 57-73.
3. Kysow, K., Bratiotis, C., Lauster, N., & Woody, S. R. (2020). How can cities tackle hoarding? Examining an intervention program bringing together fire and health authorities in Vancouver. Health & social care in the community, 28(4), 1160-1169.
4. Metropolitan Boston Housing Partnership, J. (2015). Rethinking hoarding intervention MBHPs analysis of the hoarding intervention and tenancy preservation project.
5. Pittman, J. O., Davidson, E. J., Dozier, M. E., Blanco, B. H., Baer, K. A., Twamley, E. W., … & Ayers, C. R. (2021). Implementation and evaluation of a community-based treatment for late-life hoarding. International psychogeriatrics, 33(9), 977-986.