A Professional’s Approach to Hoarding Disorder

A Professional’s Approach to Hoarding Disorder

Learning the tango, or any other dance for that matter, begins with a single step. For anyone who has ever watched a professional dancer, that may seem unbelievable. The energetic footwork, the sensual arm-movements, even the communicative facial expressions, all tell a magnificent story. 

But no one is born knowing how to dance a rumba; it takes work, effort, and concentration, until it all becomes second nature. For the un-learned, the steps may seem overwhelming; how do you know where to place your hands; how do you know when to step forward or to the left? A professional dancer can not only answer every one of these questions, but he or she can also show the client how it is done.

The same can be said for decluttering and organizing a home of someone with hoarding disorder; it begins with a single step. Although the result may be different, a flawless tango and an organized home, both benefit greatly from the assistance of a professional. A client with hoarding disorder demonstrates “a persistent difficulty discarding or parting with possessions because of a perceived need to save them”. 

A Professional Organizer can not only address the question of “how do you know when to keep something and when to throw it away”, but he or she can also show the client how it is done. It takes work, effort, and concentration, but just like a well-choreographed dance, it all becomes second nature.

The Professional Organizer and a Client with Hoarding Disorder:
The goal of a Professional Organizer is to “improve the quality of their clients’ home or workplace through organization”; to help create a space that makes the client feel good and that evokes a feeling of peace. Whether or not the client exhibits hoarding behaviour does not change the desired outcome of an organized home; however, it does create a more complex dance.

Beginning steps:

  • As a family member or a mental health professional may reach out to the Professional Organizer initially, the first contact with the client may be at their home.

  • Before entering, it will be prudent to don protective gear such as a mask, gloves, eye protection, and perhaps a hazmat suit.

  • A tour of their space will be next; this is the time to determine the level of hoarding.

    • According to the Ultimate Academy® Grade Level Assessment, the client’s home will be a Level 3.

    • The Professional Organizer will need to determine whether the home is a Heavy or an Extreme Organization.

       

    • Depending on the scope of the clutter, disorganization and cleanliness of the home, the Professional Organizer will also need to determine what additional services will be required. This can include the rental of a refuse bin, specialized cleaning services, and the assistance of a team of Professional Organizers.

  • It is important to spend a significant amount of time with the client in their home prior to any attempt at decluttering; “observation comes before implementation”.

    • Before creating a plan with the client, the Professional Organizer should evaluate what his or her limitations, strengths, and stamina are.

    • Through observation, the Professional Organizer will determine how best to declutter and organize, as well as how to customize the specific skills, tools, and systems to be implemented.

      • For instance, the client may have difficulty sitting still for the length of time it will take to sort through a specific category of items.

      • In this situation, the Professional Organizer may suggest the client remain standing as much as possible to stave off this restlessness.

      • Frequent breaks with a walk around the home’s perimeter may be suggested as well, to combat the client’s inability to focus.

      • Additionally, the client may require the constant assistance of the Professional Organizer as well as a very defined schedule.

    • By spending this time with the client, the Professional Organizer will also be able to get a sense of his or her decision-making style.

      • A client may do well for instance with four sorting categories (keep, donate, trash, and recycle) or he or she may only be able to work with two categories (keep and donate).

    • Particular attention should be given to the client’s state of mind; the Professional Organizer will need to “consider whether a client may get emotionally overwhelmed” once the decluttering begins.

      • “Professional Organizers can provide important help for clients who are getting mental health treatment for hoarding disorder”. As a therapist may not be able to visit the client in his or her home, the Professional Organizer can act as an extension of the therapist’s reach; the Professional Organizer can give the client “critical hands-on help with their excessive items”.

      • “Ideally, the Professional Organizer would contact the therapist and work with them to help the client’s hoarding disorder symptoms”.

    • Every client has “different abilities, limitations, experiences, and circumstances”. This human element is what makes every project unique.

Implementation of organizing skills, tools, and systems:

  • The next step is to implement the skills, tools, and systems specific to the client.

  • Organizing skills can include:

    • Sorting into different piles, such as keep, discard, and unsure.

      • The “unsure” pile allows for a discussion about the pros and cons of keeping the item. Note that not every client will have the emotional capacity to utilize this category.

      • The role of the Professional Organizer is to guide the client through these decisions, and to help him or her understand their reasoning for keeping the item. Negative reasons such as guilt and grief need to be examined, explored, and explained.

    • Categorizing into different types of possessions, such as books, clothing, and shoes.

    • Organizing items using a variety of storage containers.

  • Clients with hoarding disorder often have difficulty making decisions. Clients should be encouraged to touch an item only once; this will help the client to make an immediate and lasting decision.

  • Tools can include:

    • Various storage containers such as bins, baskets, jars, and file folders.

  • Systems will be created with the client in mind, and can include:

    • Learning to touch something once; this includes putting an item away immediately after its use.

    • Reading and sorting mail daily.

      • Create two categories for mail: immediate/upcoming action and trash/recycling.

    • Putting the recycling items in the recycling bin daily.

    • Filing important papers in an accordion folder. Its size will encourage the client to keep the papers down to a minimum.

      • “Paperwork is always better stored vertically than horizontally”; piles are difficult to keep organized.

    • Setting up automatic payments for monthly bills. This allows the client to receive less paper-mail overall.

    • Creating routines; set routines can help alleviate the client’s stress and anxiety that is normally associated with organizing their belongings.

    • Learning time-management skills: clients need to learn how to prioritize daily activities, such as running errands and tidying up.

Motivation:

  • As many clients with hoarding disorder have motivational issues, “professional organizers not only transfer skills and help create organizational systems, they also help motivate their clients to carry out the de-cluttering work”.

  • Motivational strategies can include:

    • Creating a vision of the final result; “by having a goal and reminding the clients of the final vision for the space, it’s easier to stay motivated”.

    • Taking “before & after” photos of the client’s space. If the client hits a roadblock, referring to the “before” photo can offer a much-needed boost.

    • Being a positive-reinforcement partner. Often the role of a Professional Organizer is to cheer the client on, and to offer praise and encouragement for every accomplishment.

    • Helping the client to stay focused; reminding them to take breaks to renew their energy.

    • Creating a customized daily schedule will help the client to stay on track.

    • Taking that first step; Professional Organizers eliminate the fear of starting, simply by helping the client to begin.

  • At the end of each day, anything that is to be donated should be removed from the home. This prevents the client from “re-shopping” from the donate pile.

Decluttering and organizing the home of a client with hoarding disorder is much like learning a complicated dance. It requires a professional to demonstrate the required steps, and the order to do them in. It takes work, effort, and concentration; but once learned, it becomes second nature. Professional Organizers can offer their own choreographed dance of observation, implementation, and motivation. 

Regardless of the extent of the organization required, it all begins with a single step.

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