Social workers need to confront prejudices in order to work effectively with people with hoarding issues, expert says

Hoarding is on the rise and a UK hoarding expert is urging practitioners to re-frame the way they work with people who have hoarding issues.

Description_of_image_used_in_why_we_have_missed_opportunity_to_tackle_self-neglect_cluttered_room_West_Yorkshire_Fire_and_Rescue_Service
Photo: West Yorkshire Fire and Rescue Service

Social workers need to confront and overcome their own prejudices in order to work effectively with people with hoarding issues, a leading trainer on the issue has said.

Speaking at a conference on self-neglect and hoarding last Friday, Heather Matuozzo, director of hoarding support organisation Clouds End, acknowledged that it was a challenging area of practice for social workers But she said practitioners should approach individuals exhibiting hoarding behaviour with enthusiasm and optimism in order to make a difference.

“There’s still this very pervasive stigma around hoarding, thanks in part to reality television and representation in mainstream media, which means hoarding is seen as something quite revolting that lazy people do,” she said.

Hoarding can be described as the collecting of, and inability to, discard large quantities of goods, objects or information. Hoarding may involve neglecting aspects of the home and/or self, resulting in poor sanitary conditions and social isolation which eventually impact on the person’s physical or emotional wellbeing.

Hoarding is characterised by:

• An intense emotional attachment to objects that are not regarded as having the same value or worth to others.
• The person feeling a sense of loss were they to dispose of the object.
• The person perhaps seeing other value in the object such as environmental recycling use, or intrinsic value, for example, seeing the object as a thing of abstract beauty such as pebbles, stones, driftwood or artwork.

This information is taken from Community Care Inform Adults’ guide to working with adults who hoard, which is available to anyone with an Inform Adults licence. For free learning on hoarding, register now for this month’s Community Care Live, where trainer Deborah Barnett will be delivering a session on trauma-informed practice with adults who self-neglect or hoard.

She cited a local news story where a mother with hoarding issues was described by her landlord as “not even human”.

During her presentation at the conference, Matuozzo showed the audience an image of a hoarded house, before asking delegates – many of whom were social workers – how it made them feel and what they would like to do about it.

One replied that it made them feel “quite disgusted” and that they wanted to clean it up.

Matuozzo said this was a natural response.

“There’s no denying that entering a hoarder house can be quite confronting; the smells and the nausea they induce can be difficult to deal with,” Matuozzo said.

But she added that practitioners should pretend they haven’t seen the state of the person’s home before starting work with them, in order to minimise the impact of any preconceived notions or bias.

“The general public, I think, have developed their own opinions and ideas about hoarding and practitioners are not exempt because they’re also human. But it’s really so important to focus on the people you can help and not get bogged down by the more difficult cases.”

Asking questions gently and patiently to try and understand the root of the individual’s hoarding issues was critical to making progress, Matuozzo said.

“Curiosity didn’t kill the cat; practitioners must ask as many questions as possible. Often, as a wee test during the initial interview, I’ll ask somebody where they keep their socks or something menial and if they’re unable to tell me then it’s clear to me they’re experiencing issues.”

Matuozzo founded Clouds End in 2009 to address what she saw as the absence of support for people who hoard, having previously worked to help people declutter their homes. The organisation provides training to local authorities and other agencies and  runs three hoarding support groups in the Midlands, which Matuozzo said have had extremely positive outcomes.

“If I ruled the world I would have a support group in every single town or village, they’re inexpensive, they’re so effective – group work is brilliant,” she added.

Matuozzo said other effective therapies for people with hoarding issues included cognitive behavioural, counselling, motivational interviewing, mindfulness and hypnotherapy, though their impact depended on the person.

“There is no ‘one size fits all’, however; you need to really tap into the individual and use trial and error to formulate a combination treatment plan that works for them,” she added.

“Above all though, the main hard rule is the process must be fun.”

The conference was organised by Social Care Conferences UK, which is holding an adult safeguarding summit, focused on how to deliver a strengths-based approach, on 15 November in London. Find out more about this event here.

5 Responses to Social workers need to confront prejudices in order to work effectively with people with hoarding issues, expert says

  1. Jill October 3, 2019 at 11:59 am #

    How does pretending not to have seen the state of the person’s home fir with the requirement to act with “honesty and integrity” ?

  2. Eco Social-Worker October 4, 2019 at 3:28 pm #

    I’m not sure this really helps. If social workers are involved with a hoarding issue it’s usually because the situation has reached a crisis and intervention is urgently needed. We aren’t there to be the person’s new friend.

    What seems to be effective is integrated mental health and social care teams, who can deal simultaneously with the psychological and practical problems, but who also know their legal duties and limitations.

  3. Ken October 4, 2019 at 4:17 pm #

    I have come across people with hoarding issues twice in my long career in social work. In both cases one man and one woman they were in their 60s. In one case they had a major drink problem. Their daughter was very concerned for their safety. The house was propped up with scaffolding inside. We provided a home care worker who established a good relationship with the and over a period o 6 months persuaded them to be rehoused.
    The second person had no family. Again with a home care worker much to the annoyance of neighbours, hosing and environmental health we went slowly first to remove rubbish from from garden and then gradually the food waste in the house. Finally to reduce the amount of ten years of “free “ papers.

  4. Annie October 4, 2019 at 4:19 pm #

    I was wondering how social workers are expected to ignore the state of the home when the very reason they are there is due to the home conditions and the potential impact on the children?

  5. pjak October 9, 2019 at 2:45 pm #

    This resonates. Very difficult work which pushes right up against legal moral and ethical boundaries. I find having to manage expectations of other professionals more of a challenge than service users.

Leave a Reply