CCNB’s HOPE (Home Possessions and Environment) Program offers specialised care management for people experiencing hoarding disorder and/or who are living in severe domestic squalor.
What is a hoarding disorder?
A widely accepted definition of hoarding disorder developed by Steketee et. al. (2000) includes a person having difficulties with:
- Compulsive acquisition of objects with marked and gross associated difficulties with discard, creating avoidance of discard behaviour.
- Living spaces becoming so full of objects (ie. excessively cluttered) that the use of rooms becomes circumscribed or very restricted.
- Significant associated distress or functional impairment. They key point to note is that it does not have to be both. People can struggle with hoarding with extreme functional impairment without apparent significant distress.
How does the HOPE program help?
CCNB has extensive experience in the provision of a range of community care services across the Northern Sydney Region. As a provider of holistic care management, coordination, facilitation and information services in the area, we have highly developed networks and referral pathways that directly benefit our clients, as well as other service providers.
We use a commissioning model that engages a range of specialist service providers to work intensively with our clients to achieve their recovery goals.
The underpinning principle of our mission is to aid recovery by focussing on the person, and not the environment. The care management focus is to support behavioural change.
Rise in hoarding and squalor
CCNB has witnessed a significant rise in the number of people experiencing domestic squalor and those who are presenting to our agency with behaviours associated with hoarding disorder. Often, these individuals have been turned away from existing community care supports, or the available supports are not adequately resourced to be able to meet their very specific needs. A number of these client’s had received multiple interventions (formal and informal) such as forced clear ups with little success to address underlying issues and hence created further stress/trauma which resulted in hoarding behaviours increasing.
People within this target group often experience poor health, live with a mental illness and/or co-morbid conditions.
Hoarding is a psychiatric condition
Hoarding Disorder has been recognised as a psychiatric condition since May 2013 (DSM 5), however CCNB identified that there were limited effective, collaborative and coordinated programs to intensively facilitate people in this target group with their recovery.
The research developed by specialists in the field such as Randy Frost and Professor Snowden have demonstrated that for people presenting with hoarding disorder, psychological intervention is essential in so far as supporting the client to identify, and understand the impact of the triggers that lead them to excessively accumulate or acquire possessions.
Research studies have shown that most people that present with hoarding disorder have experienced trauma in their younger life. For a client who presents with hoarding disorder, the process of change begins with being able to understand why the patterns of behaviour have manifested and become entrenched, and have impacted negatively on their life.
A therapeutic specialist should be supporting the client with practical but powerful skills to be able to start to let go/discard possessions and continual reinforcement of progress is paramount to milestones being achieved.
As a client often sees their possessions as an extension of themselves, as a part of their identity, or as a safety net, the client needs to have a toolkit/bucket of strategies to be able to manage reducing the compulsions to hoard, and then develop decision making capabilities to build resilience to follow through with discarding.
Hoarding carries a high fire risk
Hoarding households represent 8% or 1 in 12 of all fire fatalities since 2000 and 1 in 3 of these fatalities are people aged over 60 years.
Community capacity building
Since 2013, CCNB is building the capacity of the Northern Sydney community to better manage hoarding and squalor issues, by:
- Developing relationships with interested external stakeholders to assist with referral pathways in order to prevent people from falling through the gaps of existing service networks.
- Providing training and skill requirements to improve workforce capacity of direct care providers in order to provide appropriate response to the needs of people with this disorder.
- Working with local fire brigades to identify people at risk of house fire as a result of squalor and hoarding co factors.
CCNB high recommends support groups for people with the disorder, such as Lifeline’s 15 week Buried in Treasures Compulsive Hoarding Treatment Program
Meet Nancy HOPE for complex needs