Two Case Examples of Cognitive Behavioral Treatment for Hoarding Disorder

The application of cognitive behavioral therapy (CBT) for hoarding disorder (HD) is described. We describe the components of CBT for HD and provide examples of how this treatment was implemented with two individuals at our clinic, one in group treatment and the other in individual therapy. These case examples are used to highlight a process of troubleshooting common barriers to treatment, enhancing motivation, creating structure, and assessing treatment progress. We compare the group and individual treatment for HD and discuss the pros and cons of each approach. Furthermore, we emphasize the importance of in-session practice, accountability and clear expectations, and realistic goal-setting across individual and group treatment. Finally, based on the cases included here, we highlight the need for additional research to extend CBT for HD (e.g., additional modules to help family members support a loved one in treatment for HD).