Clinician's Guide to Severe Hoarding

A Harm Reduction Approach

  • Michael A. Tompkins

Table of contents

  1. Front Matter
    Pages i-xxiii
  2. Michael A. Tompkins
    Pages 1-11
  3. Hoarding and Harm Reduction

    1. Front Matter
      Pages 13-13
    2. Michael A. Tompkins
      Pages 15-48
    3. Michael A. Tompkins
      Pages 49-56
  4. The Approach

    1. Front Matter
      Pages 57-57
    2. Michael A. Tompkins
      Pages 59-88
    3. Michael A. Tompkins
      Pages 143-197
    4. Michael A. Tompkins
      Pages 199-231
    5. Michael A. Tompkins
      Pages 233-276
    6. Michael A. Tompkins
      Pages 277-339
  5. Other Considerations

    1. Front Matter
      Pages 341-341
    2. Michael A. Tompkins
      Pages 343-355
    3. Michael A. Tompkins
      Pages 357-383
    4. Michael A. Tompkins
      Pages 385-389
  6. Back Matter
    Pages 391-413

About this book


The cat lady. The couple who won't let anyone in their apartment. The old man with all that junk in his yard. Their severe hoarding puts them, and often others, at risk for injury, disease, and even death. Most deny needing help, and for this reason, professionals are desperate to find more effective ways to offer and provide assistance to them.

In response to this growing public health problem, Clinician's Guide to Severe Hoarding refines our understanding and presents in depth an innovative alternative to traditional interventions. Arguing that although treatment for hoarding can be effective for those who are open to help, people with severe hoarding are not. The Clinician’s Guide to Severe Hoarding describes an alternative strategy to help those who adamantly refuse help and yet face significant health and safety risks due to the hoarding problem – harm reduction. This client-centered approach takes readers through harm reduction plan development, team building, goal setting, client collaboration, and progress assessment. The Clinician’s Guide also explains that a successful harm reduction plan may encourage clients to seek further help, and offers insights into working with special populations such as people who hoard animals and children who exhibit hoarding behavior. The Clinician's Guide describes in detail a range of strategies for assisting people with severe hoarding: 

  • Strategies for engaging with clients who hoard.
  • Guidelines for assessing harm potential.
  • Guidelines for creating a harm reduction plan, building a harm reduction team, and conducting and evaluating home visits.
  • Skills for client self-help: decision making, time management, and more.
  • Guidelines for navigating the ethical and legal issues that arise in assisting people who hoard.
  • Readings, links, and other resources.

With its practical common-sense approach to a complex problem, Clinician's Guide to Severe Hoarding is a unique volume not only for mental health practitioners, but also other professionals who assist people who hoard, such as home health aides, social workers, and professional organizers.


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Authors and affiliations

  • Michael A. Tompkins
    • 1
  1. 1.San Francisco Bay Area Center for Cognitive Therapy and University of CaliforniaOaklandUSA

Bibliographic information

  • DOI
  • Copyright Information Springer Science+Business Media New York 2015
  • Publisher Name Springer, New York, NY
  • eBook Packages Behavioral Science
  • Print ISBN 978-1-4939-1431-9
  • Online ISBN 978-1-4939-1432-6
  • Buy this book on publisher's site