Compulsive hoarding is a complex problem involving problematic patterns of acquisition, organization, and retention of items of questionable value. Compulsive hoarders often acquire excessive quantities of items, live in cluttered and disorganized circumstances, and fail to dispose of items in a reasonable and timely manner. The predominant treatment for compulsive hoarding is cognitive behavior therapy. (CBT) that employs exposure (e.g., practice in discarding hoarded items), response prevention (e.g., forgoing opportunities to add items to the cache of hoarded items), and cognitive restructuring (e.g., correcting distorted beliefs relating to hoarding). Pharmacologic treatment has also been applied to hoarding. While there is little research on treatment outcome, it is believed that hoarding is strongly predictive of a poor treatment outcome. It is widely held that these individuals are often difficult to engage in treatment, lack motivation to change and are resistant to therapeutic interventions. Thus, among the so-called "obsessive-compulsive (OC) spectrum disorders," hoarding is viewed as an OC variant that is particularly hard to treat.
