CBT for Hoarding Disorder: A Group Therapy Program Therapist's Guide

Hoarding Disorder (HD) was first afforded diagnostic status in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5; American Psychiatric Association, 2013). The DSM-5 diagnostic criteria for HD include: 1. Difficulty discarding or parting with possessions due to strong urges to save items and/or distress associated with discarding. 2. Clutter that precludes activities for which living spaces were designed. 3. Significant distress or impairment in functioning caused by the hoarding. Prior to the publication of the DSM‐5, hoarding behaviors were informally considered to be a syndrome or subtype of obsessive‐compulsive disorder (OCD). However, as evidence mounted about the differences between hoarding and OCD (Pertusa et al., 2010), it became increasingly clear that hoarding represented a unique syndrome that had not been adequately categorized. Epidemiological research has suggested that the prevalence rate of HD is between 2 and 5% (Frost, Steketee, & Williams, 2000; Iervolino et al., 2009; Mueller, Mitchell, Crosby, Glaesmer, & de Zwaan, 2009; Samuels et al., 2008), making HD a very common Condition.