Learning to help those who hoard — without shame or judgment

Source: Boston Globe | By: Cristela Guerra

A woman was shocked to learn she’d accumulated over 3,000 tank tops.

A man filled his house with nearly 15,000 books. To him, they’d become tangible reminders of his intelligence.

A musician collected nearly 20,000 records. The hunt for a new ones brought him a joy like nothing else. So he clung to his vinyl for dear life.

At a three-day Hoarding Intervention Training Institute recently hosted by the Metropolitan Boston Housing Partnership human service professionals from around the state and country looked at cases such as these to understand the underlying factors that contribute to hoarding.

“That is part of the challenge,” said Jesse Edsell-Vetter, program manager for the MBHP’s Center for Hoarding Intervention in Boston, who led the training. “In terms of intervention, [it’s about] helping people tolerate having enough, helping people learn to set limits without it being so anxiety-provoking that it’s interfering with the rest of their life.”

The certification program is being touted as the first of its kind. It’s based on an innovative model developed with the Boston University School of Social Work that’s less about clean up and more about coaching. This model has had an over 90 percent success rate, according to officials with the Metropolitan Boston Housing Partnership.

Since 2006, it’s helped hundreds avoid eviction due to hoarding.

Hoarding, or the acquisition of and failure to discard a large number of possessions, is a multilayered mental illness that affects 5 percent of the US adult population or approximately 15 million people. It can result in unsafe living situations.

On June 17, two Westfield women died in a house fire. Their building didn’t have smoke detectors and officials said a “hoarding situation” made it difficult for firefighters to enter the house, run hoses through the building, and extinguish the fire.

Though the reasons for hoarding disorder vary, there are a few common characteristics, including a difficulty making executive decisions, perfectionism, and low self-esteem.

Someone with a hoarding disorder might have difficulty regulating emotions and a real distrust of others. Even the most well-intentioned loved ones may make the mistake of removing items assuming the person wouldn’t notice. But, Edsell-Vetter said, the person probably did notice and will be less inclined to allow that loved one back in the home or ask for help in addressing the situation.

“People with this problem may not be aware but they also may be really afraid to ask for help because historically we’ve had few resources that were not shaming to do the intervention right,” Edsell-Vetter said. “We get to switch that script a little bit moving forward.”

Building trust and rapport is crucial. Participants in the training were encouraged to adjust their language. Rather than saying “this place is a mess,” they inform clients of the hazards of not having an exit. Rather than judging, they learned to use empathy to give feedback.

The Mental Health Association in Atlantic County, New Jersey has used this hoarding intervention method for several years

It was adopted in the years after Hurricane Sandy devastated the region in 2012. There were local residents with hoarding disorder who were not recovering from the storm.

These residents would not let anyone do repairs, said Jaime Angelini, director of consumer services at the Mental Health Association, who attended the local training here with a colleague. After the storm waters subsided, mold grew on wet piles of their possessions, and clients were unable or unwilling to let waterlogged items go.

At the time, they found few local resources to refer clients to. Now, there’s a hoarding task force and support groups. Carolyn Quinn, manager at the Metal Health Association’s ICE Wellness Center, attributes their success to what they learned from Edsell-Vetter. Quinn remembers when one of their first clients finally invited them into her home. With a look of anxiety on face, the woman said, “Alright ladies. Welcome to the home of a hoarder.”

She told them about her things and how they brought her joy. Her teapot collection, for example, was a reminder of her late son.

“When we talk to other disciplines and other professionals, it’s such a shock [to them] that we’re not there to touch anything, we’re not there to lift anything,” Quinn said. “We’re there to coach the person. We’re focusing on the person, not the stuff.”

Laura Minier, manager of social services in Scituate, plans to bring what she learned back to her community. One local woman’s story motivates her. The client had been diagnosed with cancer. Minier’s team helped the woman clear out enough space to be able to die peacefully at home.

“It’s a very human endeavour to be part of this process,” Minier said. “We are really trying to support people wherever they are in the process of making changes. We try to understand what their goals are and work from there.”

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