Friday, May 25, 2012

MassHousing - A housing professional's perspective

This website is based in Massachusetts, but it's content is relevant to people across the world dealing with hoarding and hoarders.
**Disclaimer: This website is primarily formatted for professionals in the housing and code inspection professions, and I am suggesting these as ideas, not cut and dry calls to action.

MassHousing - Hoarding Resouces

How to Talk to Someone with Hoarding: Do’s and Don’ts

Massachusetts Housing Finance Agency TEL: 617.854.1000 FAX: 617.854.1091
One Beacon Street, Boston, MA 02108 TDD: 617.854.1025 www.masshousing.com
By Cristina M. Sorrentino, PhD, LCSW | Boston University School of Social Work


DON’T

• Use judgmental language. Like anyone else, individuals with hoarding will not be receptive to negative comments about the state of their home or their character (e.g., “What a mess!” “What kind of person lives like this?”). Imagine your own response if someone came into your home and spoke in this manner, especially if you already felt ashamed.

• Use words that devalue or negatively judge possessions. People who hoard are often aware that others do not view their possessions and homes as they do. They often react strongly to words that reference their possessions negatively, like “trash,” “garbage,” and “junk.”

• Let your non-verbal expression say what you’re thinking. Individuals with compulsive hoarding are likely to notice non-verbal messages that convey judgment, like frowns or grimaces.

• Make suggestions about the person’s belongings. Even well-intentioned suggestions about discarding items are usually not well-received by those with hoarding.

• Try to persuade or argue with the person. Efforts to persuade individuals to make a change in their home or behavior often have the opposite effect—the person actually talks themselves into keeping the items.

• Touch the person’s belongings without explicit permission. Those who hoard often have strong feelings and beliefs about their possessions and often find it upsetting when another person touches their things. Anyone visiting the home of someone with hoarding should only touch the person’s belongings if they have the person’s explicit permission.




DO

• Imagine yourself in the hoarding client’s shoes. How would you want others to talk to you to help you manage your anger, frustration, resentment, and embarrassment?

• Match the person’s language. Listen for the individual’s manner of referring to his/her possessions (e.g., “my things”, “my collections”) and use the same language (i.e., “your things”, “your collections”).

• Use encouraging language. In communicating with people who hoard about the consequences of hoarding, use language that reduces defensiveness and increases motivation to solve the problem (e.g., “I see that you have a pathway from your front door to your living room. That’s great that you’ve kept things out of the way so that you don’t slip or fall. I can see that you can walk through here pretty well by turning sideways. The thing is that somebody else that might need to come into your home, like a fire fighter or an emergency responder, would have a pretty difficult time getting through here. They have equipment they’re usually carrying and fire fighters have protective clothes that are bulky. It’s important to have a pathway that is wide enough so that they could get through to help you or anyone else who needed it. In fact, the safety law states
that [insert wording about egresses], so this is one important change that has to be made in your home.”)

• Highlight strengths. All people have strengths, positive aspects of themselves, their behavior, or even their homes. A visitor’s ability to notice these strengths helps forge a good relationship and paves the way for resolving the hoarding problem (e.g., “I see that you can easily access your bathroom sink and shower,” “What a beautiful painting!”, “I can see how much you care about your cat.”)

• Focus the intervention initially on safety and organization of possessions and later work on discarding. Discussion of the fate of the person’s possessions will be necessary at some point, but it is preferable for this discussion to follow work on safety and organization.

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Readiness to Change Questionnaire
(fill in the blank with the behavior)

                                                            Strongly      Disagree    Unsure    Agree   Strongly
                                                            Disagree                                                     Agree 

1. My home is ok as it is                                                                               

2. I am trying to collect less                                                                       
than I used to

3. I enjoy saving things but sometimes                                                      
I collect too much

4. I should cut down on my                                                                        
collecting items

5. It’s a waste of time thinking about                                                         
my collecting items

6. I have just recently changed my                                                             
collecting habits

7. Anyone can talk about wanting to                                                          
Do something about collecting, but
I am actually doing something about
It

8. I am at the stage where I should                                                               
think about collecting less

9. My collecting is a problem                                                                       

10. It’s alright for me to keep collecting                                                         
as I do now

11. I am actually changing my collecting                                                      
habits right now

12. My life would be the same, even                                                              
if I collected less




How to score the Stage of Change questionnaire

  • The pre-contemplation items are numbers 1, 5, 10 and 12
  • The contemplation items are numbers 3, 4, 8, and 9
  • The action 2, 6, 7, 11
  • The highest score represents the Stage of Change Designation


Scoring legend:
# of points                   Response                                                                                
    -2                             Strongly disagree
    -1                             Disagree
      0                            Unsure
    +1                            Agree
    +2                            Strongly Agree


Scale Scores:

Pre-contemplation _______

Contemplation      _______

Action                   _______

**The Highest Score represents the person’s level of change**


Appropriate response from helper depending on the person’s stage of change

Stage                                         Response from Helper

Pre-contemplation                     Leave brochure, information sheets, phone numbers, ask “How would you better off if you “collected” less

Contemplation                           Write down pro’s and cons of behavior, ask “How would you be better off if you “collected” less

Action                                        Develop an action plan with the consumer immediately, follow up with the person





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