CBT for Hoarding Disorder A Group Therapy Program Workbook

Part of a two-component product with a companion therapist's guide, CBT for Hoarding Disorder: Client Workbook guides patients struggling with hoarding disorder who are enrolled in a comprehensive CBT group program through the therapeutic process of addressing and overcoming their difficulties.

• Designed for participants in group cognitive-behavioral therapy for hoarding disorder - an evidence-based program created by experts in the field
• Helps readers to work on the many factors that contribute to ongoing difficulties with clutter, in order to learn how to make quicker, more efficient decisions that are less stressful and draining.
• Addresses many of the barriers to successful decluttering, such as time management, organizational skills, and problem-solving
• Shows that while living with hoarding disorder can be frustrating, both for the sufferer and for family and friends, there is a way forward and nobody has to live with clutter.

David F. Tolin is Founder and Director of the Anxiety Disorders Center at The Institute of Living, USA, and an Adjunct Professor of Psychiatry at Yale University School of Medicine. He was the 2014 President of the Clinical Psychology division of the American Psychological Association, and is a recipient of the Award for Lifetime Contribution to Psychology from the Connecticut Psychological Association. An internationally recognized expert in the study and treatment of hoarding disorder, Dr. Tolin is the author of over 150 scientific journal articles and several books. He was a featured expert on the A&E series Hoarders, hosted the VH-1 series The OCD Project, and has been a recurrent guest on programs such as The Dr. Oz Show and The Oprah Winfrey Show.

Bethany M. Wootton is a clinical psychologist and Senior Lecturer in Clinical Psychology at the University of New England, Australia. She has an interest in the treatment of anxiety and related disorders. Her research focuses on the development and evaluation of remote treatments in order to improve access to evidence-based treatments for these conditions.

Blaise L. Worden is a clinical psychologist at the Anxiety Disorders Center at the Institute of Living, USA, where she runs and directs cognitive-behavioral treatment groups for hoarding disorder. She has co-authored book chapters on the phenomenology of both hoarding and obsessive-compulsive disorder, and provides educational talks to community organizations about HD treatment.

Christina M. Gilliam is a clinical psychologist and Director of Educational Programs at the Anxiety Disorders Center at the Institute of Living, USA. She is an expert in providing and training others in cognitive behavioral therapy for anxiety disorders, obsessive compulsive and related disorders, and she has published journal articles and book chapters in these areas.

1 Welcome to the Class 1

1. Welcome to the Declutter Class 1

Class Task: Introduce Yourself! 3

2. Class Rules and Guidelines 3

Treatment Contract 5

Class Confidentiality Contract 6

3. What is Hoarding Disorder? 7

Frequently Asked Questions About Hoarding Disorder 7

4. What Will I Learn in This Class? 8

Learn More About What Contributes to You Having Clutter 9

Learn Evidence�]Based Skills to Reduce the Clutter in Your Home 9

Learn How to Apply the Skills on a Consistent Basis 10

5. How Well Does the Declutter Class Work? 10

6. Homework 10

2 Why Do I Have So Much Stuff? 15

1. Homework Review 15

Class Task: Homework Review 16

2. Rewards 16

Individual Rewards 16

Class Task: Brainstorm Rewards 17

Class Rewards 17

3. Meet the Bad Guys 18

Decision�]Making and Problem Solving 18

Intense Emotions 19

Unhelpful Thinking 20

Waxing and Waning Motivation 20

Class Task: Identifying Your Bad Guys 21

4. Setting Goals 24

SMART Goals 24

Class Task: Setting SMART Goals 25

5. Homework 25

3 Making Decisions and Solving Problems: Part 1 30

1. Homework Review 31

Class Task: Homework Review 31

2. Making Decisions and Solving Problems 31

3. Guidelines for Discarding 32

Class Task: Making Your Own Guidelines 34

4. Scheduling the Time to Work on Discarding 35

Class Task: Identifying the Best Time for Discarding and Planning Your Day 40

Improving Organization 40

How Much is Too Much? 40

Class Task: Identifying if I Have Too Much Stuff 41

Where Do Things Belong? 41

Class Task: Make Your Own Categories 43

5. Putting Skills Together to Discard Better 43

Follow the Flowchart for Discarding 43

Class Task: Using the Flowchart to Help with Discarding 44

6. Homework 44

4 Making Decisions and Solving Problems: Part 2 48

1. Homework Review 49

Class Task: Homework Review 49

2. Making Decisions: Acquiring 49

Understanding High�]Risk Situations 50

Class Task: Identifying High�]Risk Situations 51

Understanding Healthy vs. Unhealthy Acquiring 52

Class Task: Identifying Common Unhealthy Reasons for Acquiring 53

Guidelines for Acquiring 53

3. Solving Problems 54

Class Task: Identifying Problems That Maintain My Clutter Problem 55

Learning How to Solve Problems 55

Class Task: Practice Problem Solving 57

4. Discarding Practice 59

5. Bad Guy Re�]evaluation 59

Class Task: Bad Guy Evaluation 59

6. Homework 60

5 Intense Emotions: Part 1 64

1. Homework Review 64

Class Task: Homework Review 64

2. About Intense Emotions 65

Class Task: Class Discussion About Intense Emotions 66

Class Task: Identifying the Intense Emotions That Lead to Clutter 67

3. Tackling Intense Emotions That Lead to Acquiring 68

Class Task: Identifying Negative Beliefs About Emotions 68

4. Homework 70

6 Intense Emotions: Part 2 73

1. Homework Review 73

Class Task: Homework Review 73

2. Tackling Intense Emotions That Get in the Way of Discarding 74

Accepting Our Emotions and Being Our Own Boss 74

Class Task: Being Your Own Boss: Acquiring 76

Class Task: Being Your Own Boss: Discarding 77

Recognizing When Emotions Are Taking Over 78

3. Bad Guy Re�]evaluation 79

Class Task: Bad Guy Re�]evaluation 79

4. Homework 80

7 Unhelpful Thinking: Part 1 83

1. Homework Review 83

Class Task: Homework Review 83

2. How Thoughts Influence Emotions 84

Class Task: Identifying How Thoughts Lead to Emotions 85

3. Identifying Unhelpful Thoughts 85

Common Unhelpful Thoughts in People with Hoarding Disorder 85

Task: Identifying Unhelpful Thoughts That Lead to Difficulty Discarding 87

4. Homework 88

8 Unhelpful Thinking: Part 2 91

1. Homework Review 91

Class Task: Homework Review 91

2. Tackling Unhelpful Thoughts 92

Question the Thoughts 92

Class Task: Practice Questioning Your Thoughts: Acquiring 93

Class Task: Practice Questioning Your Thoughts: Discarding 94

What Would You Say to a Friend? 94

Class Task: How Would I Advise a Friend? 95

3. Bad Guy Re�]evaluation 95

Class Task: Bad Guy Re�]evaluation 95

4. Homework 96

9 Waxing and Waning Motivation 100

1. Homework Review 100

Class Task: Homework Review 100

2. Improving Motivation 101

The Pros and Cons of Continuing Your Efforts 102

Class Task: Identifying Pros and Cons of Continuing Your Effort 102

3. Acting on Your Top Goals and Values 104

Focusing on Goals and Values 104

Class Task: Identifying My Life Goals and Values 104

Class Task: Are My Life Goals Consistent with My Acquiring

and Discarding Behaviors? 105

4. Homework 109

10 Waxing and Waning Motivation: Part 2 112

1. Homework Review 112

Class Task: Homework Review 112

2. Improving Motivation to Discard 113

Visualize Your Decluttered Space 113

Class Task: Using Your Imagination to Visualize Your Decluttered Space 113

3. Being Motivated By Your Values 116

4. Checking In on Long�]Term SMART Goals 118

Class Task: Checking In on Long-Term SMART goals 118

5. Bad Guy Re�]evaluation 118

Class Task: Bad Guy Evaluation 118

6. Homework 119

11 Putting It All Together: Part 1 122

1. Homework Review 122

Class Task: Homework Review 122

2. Troubleshooting Common Barriers 123

Barrier 1: Areas Getting Recluttered 123

Barrier 2: Cannot Access the “Final Home” for Objects 124

3. Putting It All Together 125

Class Task: Putting the Skills Together 125

4. Homework 126

12 Putting It All Together: Part 2 130

1. Homework Review 130

Class Task: Homework Review 130

2. Troubleshooting Common Barriers 131

Barrier 3: Conditions That Interfere with Discarding 131

Barrier 4: Not Having Information About What to Keep or Not Keep 132

3. Putting It All Together 133

4. Homework 134

13 Putting It All Together: Part 3 137

1. Homework Review 137

Class Task: Homework Review 137

2. Troubleshooting Common Barriers 138

Barrier 5: My Family Member Also Has Hoarding Disorder 138

Barrier 6: I Feel Like I Can’t Get Rid of Items If They Are Worth Money 139

3. Putting It All Together 140

4. Homework 141

14 Putting It All Together: Part 4 144

1. Homework Review 144

Class Task: Homework Review 144

2. Troubleshooting Common Barriers 145

Barrier 7: Being Overly Careful When Discarding 145

Additional Barriers (Optional) 146

3. Putting It All Together 147

4. Homework 147

15 Staying Clutter Free in the Future: Part 1 151

1. Homework Review 151

Class Task: Homework Review 151

2. Reviewing Progress 152

What You’ve Learned 152

Choosing How You Think About Progress 153

Class Task: Write Down Your Thoughts About Your Progress 153

3. Practice Discarding 154

Class Task: Discarding Practice 154

4. Homework 154

16 Staying Clutter Free in the Future: Part 2 158

1. Homework Review 158

Class Task: Homework Review 158

2. Maintaining Motivation 159

My Rewards for Working on My Hoarding Problem 160

Class Task: Identify Some Goals and Rewards 160

3. Wrap�]Up and Questions 161

Reward Monitoring Sheet 163

Index 164

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