Bay Area Resources
San Francisco Bay Area Internet Guide for Extreme Hoarding Behavior
Clutterers Syndrome or Pack Rat Syndrome
Supported by Peninsula Community Services, Inc




Savings Inventory (revised) SIR

Clutter Image Rating Scale
The photos of the stages of hoarding
are in the downloadable clinical tools and helpful resources.
Links to the photos.


Multi-disciplinary Hoarding Risk Assessment

Link for Multi-disciplinary Hoarding Risk Assessment PDF form.

Hoarding Assessment Tool -in home by Randy Frost




UC San Diego Health System, News Features, June 26, 2015

Helping People with Hoarding Problems: Q&A with Sanjaya Saxena, MD

By Christina Johnson

"..Sanjaya Saxena, MD, director of the Obsessive-Compulsive Disorders Clinic at UC San Diego Health,
offers insights on HD and how to help loved ones.

Q: How is HD treated?

A: There are two main types of treatment: specialized cognitive-behavioral therapy (CBT) and medication.
During CBT, individuals practice throwing away unnecessary possessions. Gradually, they learn to discard
things with less distress, as their exaggerated perceived need or desire to save possessions diminishes. CBT
also helps extinguish fears of no longer having items that might be useful later. Our hoarding treatment approach 
also teaches skills such as organization, decision-making and relaxation. For many people, certain antidepressant
medications are effective and result in more rapid improvement. We are also now testing novel medications for HD in our program....."

Social Work Today, Vol. 11 No. 3 P. 14,   May/June 2011 Issue

Treating People Who Hoard — What Works for Clients and Families
By Jennifer Van Pelt, MA

Stages of Change/Motivational Interviewing

International Obsessive Compulsive Disorders Hoarding Center 

Structured Interview For Hoarding Disorder

The Clutter Hoarding Scale from the NSGCD
(The National Study Group on Chronic Disorganization)
Excellent for all kinds of providers and self analysis
The scale is on a pdf file.

Compulsive Hoarding and Acquiring :Therapists Guide
for Physicians, Treatments That Work, 2006
Compulsive Hoarding and Acquiring: Work Book
both by G. Steketee and R. Frost 2006

Overcoming Compulsive Hoarding
– Why You Save and How You Can Stop
by F.Neziroglu, J.Bubrick, and JoseYaryura-Tobias;
New Harbinger Publications, 2004.
Note: for a good review of the book go to:
Note: to purchase on line

Boston Univ/Smith College Consortium Newsletter, 2007, 2009 Hoarding Updates.
"One recent analysis from this study has been to learn more about the association
between hoarding and other disorders. You may recall from previous editions of this

newsletter that we were finding that the rate of obsessive-compulsive disorder (OCD) was not
nearly as high among people who hoard as one might anticipate (17%), leading us to question
how strongly hoarding and OCD are related. Conversely, over half (58%) of people with
compulsive hoarding met criteria for Major Depressive Disorder. A recent analysis from
that study shows us that 20% of people with hoarding problems, compared to 4% of people
with OCD and 3% of people selected from the community, meet current (adulthood) criteria for
the inattentive subtype of Attention- Deficit/Hyperactivity Disorder (ADHD)."


Boston Univ/Smith College Consortium Newsletter, Hoarding Updates, 2007
"One recent analysis from this study has been to learn more about the association
between hoarding and other disorders. Although many people consider hoarding to be
a form of OCD, this classification is not certain.      
Our analyses have shown that 17% of people who hoard
also have OCD. This is a high number; however, the fact that most people who hoard show no signs
of OCD whatsoever raises questions about whether hoarding is really a subtype of OCD.
We also found that 57% of people who hoard meet criteria for major depressive disorder,
28% meet criteria for generalized anxiety disorder, and 29% meet criteria for social phobia.
When we examined differences between hoarding participants with and without generalized anxiety
disorder (GAD), we found that people with hoarding + GAD demonstrated more severe
hoarding symptoms, hoarding beliefs, and symptoms of anxiety and depression than did
people with hoarding but no GAD. This research will continue for the next two years.

Hoarding Behavior: Another Perspective
By Suzanne Phillips, Psy.D., ABPPy 
"What if hoarding behavior was actually a response to Trauma? The findings of a recent study  
reported in the Journal of Anxiety Disorders indicate that hoarding may not always be a symptom 
of obsessive compulsive disorder. Rather, it may be a separate disorder that results from the
experience of trauma and stressful life events.... What would this mean?....It means we may be
expanding our understanding of hoarding in a way that makes meaning to some trapped in this
behavior, reduces shame, justifies help and even informs treatment options....Much as know that
the stress reactions of  trauma i.e. the  symptoms of  hyperarousal, the intrusive images and flashbacks,
and the numbing and constriction reflect  a persistent survival response despite the fact that the danger
has passed, hoarding behavior may represent an excessive need to guard against the loss inherent in
traumatic events.                                                                    

Clearinghouse on Abuse and Neglect of the Elderly (CANE)
Selected Annotated Bibliography:

Compulsive Hoarding - A Form of Self-Neglect

Research Abstracts OCD Foundation


Community Tenure of Older, Adults Who Hoard:
Identifying Risks and Enhancing Opportunities May 2007
The University of Kansas, School of Social Welfare, Office of Aging and Long Term Care

Cornell University and
New York City Task Force on Hoarding
Task force gathered information – great site includes:
Assessment Tool ( the NSGCD cluttering and hoarding scale above is more complete)
Best Practices Decluttering tips
Best Practices Hoarding and Dementia
Bldg Code Violations including exits, Bathrooms, Kitchens and General problems
2004 Conference

EDUCATIONAL PROGRAMS for Professionals and Others

Institute on Aging Educational program- The Hoarding Alliance of Marin, March 13, 2008
Recognizing and Responding to Clutter Addiction and Compulsive Hoarding in Older Adults

Behind Closed Doors: Getting a Handle on Hoarding

This five-part course describes the fascinating world of hoarding.
To purchase the Hoarding course together with the Marketing Presentation,
go to the
 Bundled Packages section on the left.
The Hoarding Bundle is $49.

The University of Kansas, School of Social Welfare, Office of Aging and Long Term Care
Community Tenure of Older, Adults Who Hoard:
Identifying Risks and Enhancing Opportunities  May 2007