Hoarding disorder: exploring forced clearances and helpers’ experiences of providing support

Parker, Hannah 2025. Hoarding disorder: exploring forced clearances and helpers’ experiences of providing support. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Hoarding Disorder (HD) is a mental health difficulty which can have a significant impact on the individual, their living environment and those around them, and may generate support from a range of helpers to manage the accumulation of belongings. This thesis captures aspects of HD both from those experiencing it and people working with it. Paper 1 aimed to explore the experiences of professionals and non-professionals supporting people with HD, in the form of a thematic synthesis. A systematic search of the literature generated 12 studies for inclusion, with all text within the “Results” or “Findings” section extracted and coded ‘line by line’. This led to the identification of four themes: 1) Relationships are Complex; 2) Possessions are Just the Tip of the Iceberg; 3) Juggling Dilemmas on a Tightrope; and 4) Working with Hoarding is Like a Puzzle to Solve. 12 subthemes were also identified. These themes captured the various challenges and complexities involved in working with HD. The study has implications for how best to approach working with HD, with suggestions for adapting practice, as well as the importance of supporting those working with HD in terms of offering effective supervision and training to prevent burnout. Paper 2 describes the experiences of forced clearance of possessions from the perspective of those with HD. Nine participants who met diagnostic criteria for HD completed a semi-structured interview consisting of measures to assess hoarding severity and distress as a result of the clearance, as well as questions capturing the experience of clearance, and impact upon self and hoarding behaviour. Participants were also asked for recommendations for working with people with HD. Three themes and six subthemes were identified: 1) Power Imbalance (subthemes: Criminalisation of Mental Health Difficulties; Clearance as the Lesser of Two Evils); 2) The Trauma of Clearance (subthemes: Losing Belongings is Like Losing Myself; ‘Trauma on top of Trauma’; and 3) Picking up the Pieces (subthemes: Clearance Weighs Heavily on the Mind; Replacing the Shield). Participants also gave recommendations in relation to the importance of early intervention in HD, needing to build trust, and seeing the person behind the belongings. The study describes forced clearance as an experience which is traumatic many years later, and one which drives people to further accumulate belongings therefore perpetuating problems with HD. There are theoretical implications for recognising Post-Traumatic Stress Disorder in the HD population, as well as suggestions for support during and in the aftermath of clearance.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	1 April 2025
Last Modified:	04 Apr 2025 09:35
URI:	https://orca.cardiff.ac.uk/id/eprint/177319

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