Hoarding related difficulties: questions to explore in an assessment

Specialist CBT therapy for anxiety, OCD, depression and more in West London

Hoarding related difficulties can involve persistent difficulty discarding possessions and may affect living space, safety, relationships or daily life. A webpage cannot determine a diagnosis, cause, severity or appropriate support for an individual. If there is an immediate risk to your safety or someone else’s safety, use an appropriate emergency or urgent service rather than relying on this page. Hoarding related difficulties can be connected with OCD, anxiety, depression, grief, trauma, neurodivergence or other difficulties. Physical health, medication and life circumstances can all be relevant. An assessment can consider the full picture rather than assuming a single explanation. Safety concerns about living conditions, fire risk, structural hazards or access for emergency services may need input from appropriate local services, housing support or social care rather than therapy alone. A therapist cannot assess a physical space or advise on housing or legal matters. An individual assessment can explore current experiences, relevant health information, safety, personal history, the meaning attached to possessions and practical circumstances. Where appropriate, a clinician may discuss patterns around acquiring, sorting, discarding, avoidance, decision making, shame or relationships. Any exercise or between session reflection should be agreed individually and should not be treated as a self directed prescription or a promise of a particular outcome. The Lyceum Clinic offers an initial conversation for adults considering CBT based support in West London or online. Current availability, location arrangements and whether the service is appropriate for your needs should be checked directly. This does not commit you to a particular treatment route, duration or outcome. What a CBT based assessment may explore An assessment may consider the history of hoarding behaviour, the types of objects involved, the impact on living space, relationships and safety, the person's own understanding of the difficulty and their goals. It may also consider physical health, fire safety, tenancy or housing concerns and whether other support is needed. Where appropriate, a clinician may discuss the thoughts, emotions and behaviours connected with acquiring and discarding. Any between session work should be agreed individually and should not be treated as a self directed decluttering programme. Urgent safety boundaries If hoarding is connected with immediate safety risks, thoughts of self harm, an inability to stay safe or a sudden marked deterioration, seek urgent appropriate help. In immediate danger, call 999 or attend A&E. For related information, see OCD therapy at /therapy/ocd/, OCD and relationships at /guides/ocd relationships impact/ and OCD subtypes at /guides/ocd subtypes/.