Description
My treatment team uses a cognitive behavioural approach to group therapy for compulsive hoarding. Hoarding disorder involves extreme difficulty discarding (or donating, recycling, etc.) objects in addition to excessive acquisition of objects, resulting in a home that is so full of possessions that one or more rooms cannot be used for their intended purpose. The group meets weekly with two student therapists, and each client also has two individual sessions at home (with one student therapist and a supervisor).
Types of Cases
Most of our clients tend to be midlife or older, with high levels of education but low income. Most clients struggle with depression and social isolation in addition to their problems with hoarding.
Caseload
We strive for about six group members, and each student takes primary responsibility for half of the clients (e.g., handling between-session phone calls, home visits).
Supervision Approach
I directly observe all sessions. During group, I am in the observation hallway, and students occasionally take a break from the group for a quick consultation. I attend individual home-based assessment and therapy sessions along with the student. The student therapists and I meet weekly for supervision where we work to build specific CBT skills as well as nonspecific skills to build therapeutic alliance and group cohesion.