Part I: Hoarding and Harm Reduction: Hoarding Behavior and Hoarding Disorder
Harm Reduction
Part II: The Approach: Harm Reduction Process for Severe Hoarding
Engaging the Client Who Hoards in the Harm Reduction Approach
Assessing Harm Potential
Building and Facilitating a Harm Reduction Team
Creating a Harm Reduction Plan
Managing the Harm Reduction Plan
Part III: Other Considerations: Special Populations
Legal Considerations.

Dedication; Foreword; Preface; Acknowledgements; Contents; Chapter 1: Introduction; 1.1 Definition of Severe Hoarding; 1.2 Definition of Harm Reduction; 1.3 Rationale for Harm Reduction to Manage Severe Hoarding; 1.3.1 Refusal to Accept Treatment; 1.3.2 Significant Health and Safety Risks to the Client Who Hoards; 1.3.3 Significant Health and Safety Risks to the Public; 1.3.4 Significant Costs of Managing Severe Hoarding; 1.4 Intended Audience for This Book; 1.5 How to Use the Book; Part I: Hoarding and Harm Reduction; Chapter 2: Hoarding Behavior and Hoarding Disorder; 2.1 Hoarding Behavior

2.1.1 Hoarding Behavior and Dementia2.1.2 Hoarding Behavior and Diogenes Syndrome, Self-neglect, and Squalor; 2.1.3 Hoarding Behavior and Other Medical Conditions and Genetic Disorders; 2.1.4 Hoarding and Obsessive-Compulsive Disorder; 2.1.5 Hoarding and Obsessive-Compulsive Personality Disorder; 2.1.6 Hoarding Behavior and Other Psychological Disorders; 2.2 Hoarding Disorder; 2.2.1 Persistent Difficulty Discarding or Parting with Possessions; 2.2.2 Save Items to Avoid Distress of Discarding; 2.2.3 Accumulation of Possessions Results in Significantly Cluttered Living Spaces

2.2.4 Significant Distress and Impairment2.3 Features of Hoarding Disorder; 2.3.1 Prevalence of Hoarding Disorder; 2.3.2 Gender Differences in Hoarding Disorder; 2.3.3 Onset and Course of Hoarding Disorder; 2.3.4 Etiology of Hoarding Disorder; 2.3.5 Hoarding Versus Collecting; 2.4 Faces of Hoarding Disorder; 2.4.1 Hobbyist; 2.4.2 Sentimentalist; 2.4.3 Librarian; 2.4.4 Curator; 2.4.5 Frugal Saver; 2.4.6 Girl or Boy Scout; 2.4.7 Handyman; 2.4.8 Global Resource; 2.4.9 Personal Historian; 2.5 Cognitive-Behavioral Model of Hoarding Disorder; 2.5.1 Information-Processing Deficits

2.5.2 Emotional Attachment to Possessions2.5.3 Distress and Avoidance; 2.6 Why They Refuse Help; 2.6.1 Poor Insight; 2.6.1.1 Anosognosia; 2.6.1.2 Overvalued Ideation; 2.6.1.3 Defensiveness; 2.6.1.4 Fear of Discovery; 2.6.1.5 Deeply Held Personal Values; 2.6.1.6 Hopelessness, Surrender, and Depression; 2.6.2 A Final Word About Insight; Chapter 3: Harm Reduction; 3.1 Definition of Harm Reduction; 3.2 Harm Reduction Versus Treatment; 3.3 Principles of Harm Reduction Applied to Severe Hoarding; 3.3.1 First, Do No Harm; 3.3.2 It Is Not Necessary to Stop All Hoarding Behavior

3.3.3 No Two Hoarding Situations Are Identical3.3.4 Client Who Hoards Is an Essential Member of the Harm Reduction Team; 3.3.5 Change Is Slow; 3.3.6 Agreement Failures Do Not Mean the Harm Reduction Approach Is Failing; 3.3.7 Client Who Hoards May Have Other, More Pressing Problems than Hoarding; Part II: The Approach; Chapter 4: Harm Reduction Process for Severe Hoarding; 4.1 Phases of the Harm Reduction Process; 4.1.1 Initial Phase; 4.1.2 Ongoing Phase; 4.2 Features of the Harm Reduction Process; 4.2.1 Initiating the Harm Reduction Process