Harm Reduction Method

Recently, I was able to help a client whose hoarding had been adding a significant handicap to her life. Because she was living without heat, she contacted me, requesting my organizing services in getting the heat in her house turned back on. She clearly stated, however, that she did not wish for me to help her with her hoarding disorder.

This was the perfect chance to implement the “Harm Reduction” method.

You may already be familiar with Harm Reduction, a strategy employed by many interventionists seeking an alternative approach in aiding drug abusers. Harm Reduction offers an alternative approach to a standard problem. Using the method, interventionists are not attempting to cure the patient, client or victim. Rather, they are trying to minimize the risks instead. An IV drug user, for example, would be given access to a fresh supply of clean needles, as well as a means for disposing of their dirty ones. This is done in lieu of attempting to stop the drug use entirely.

This particular hoarder was not yet ready for change. She had spent years acquiring various articles and artifacts at flea markets and garage sales. The rooms of her house were packed with her “pretties,” floor-to-ceiling and with no spaces in between. Even the air vents were blocked. Because of this, she lived without heat for four years. She told me she couldn’t take another winter without it, so we mutually agreed that our collective goal would be to clear enough space around each vent so that air could flow back into the house.

However, before that, we needed to clear a path for the repairman to reach the heating unit because it was blocked by stacks of paper, old appliances, boxes of yard sale “treasures” and inherited furniture.

I knew the client wasn’t ready to stop her hoarding or acquisition behaviors, nor was she ready to work with a therapist. She did, however, take what she considered to be a huge risk by allowing me into her home and showing me her living conditions. She wasn’t harming a soul except herself. Rather than spending time, energy and money discussing the root causes, conditions and problems associated with this disorder, we worked on curbing the downward spiral instead.

I did not want to risk having her withdraw and isolate herself further, especially for another long, cold winter. I believe it was the best use of my time and her resources to busy ourselves with moving things away from the vents so that we could then clear a path to the heating unit.

By giving her ownership of her individual decisions, as well as the opportunity to deal with her most urgent problem first - getting her home heated - we were able to recognize the risks associated with her hoarding behavior and then focus on minimizing these risks with the implementation of a mutually agreeable strategy.

I hoped that after agreeing to do this, she would see me working with her, not against her, and decide that in the future we could safely and comfortably work together in her home.

She needs to let go of some of her things and I must surrender my preconceived ideas of what an organized home must be.