Treatment Interventions for Adults with Hoarding Disorder General Guidelines for Creating an Effective Poster Posters need to be read by attendees from a distance of 3 feet or more, so lettering on illustrations should be large and legible. The title should be in very large type, 84 pt. or larger. Do NOT use all capitals for titles and headings. It makes them hard to read. Text on panels should be between 18 and 24 pt. to be legible. Use double or 1.5 spacing between lines of text. Keep each panel relatively short and to the point. More than 25 lines won't get read, but 15 to 18 usually will. Framing the text by putting a box around it will also help readers to focus. Choose a simple font such as Times, Helvetica or Prestige Elite and stick with it. Avoid overuse of outlining and shadowing, it can be distracting. To make something stand out, use a larger font size, bold or underline instead. Whenever possible, use graphs, charts, tables, figures, pictures or lists instead of text to get your points across. Make sure your presentation flows in a logical sequence. It should have an introduction, body and conclusion, just like any other presentation. Posters don’t need to be "arty". Simplicity, ease of reading, etc., are more important than artistic flair. In a room full of posters, consider the visual impact your presentation needs to make in order to attract readers. Use colors behind panels to increase contrast and impact, but avoid fluorescent colors which will make things hard to read when someone gets closer. Consider bringing extra copies of your data and conclusions. Tracy Roach GRC MSW Program Abstract Criteria New to the DSM-5 Comorbidities Hoarding disorder is a new diagnosis in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. Hoarding disorder is seen in approximately 5.8% of people in the United States. Individuals with hoarding disorder often face unique health and safety risks due to their accumulation of clutter. People with hoarding disorder have high comorbidity rates with other mental and physical health disorders and have co-occurring medical issues. This paper discusses comorbidities and addresses treatment intervention strategies and causes of hoarding disorder in adults. Findings show that the therapeutic relationship is a critical part of treatment for this disorder. Findings also suggest that motivational interviewing, cognitive behavioral therapy, and exposure therapy are effective treatment options. The use of an interdisciplinary team approach utilizing a therapist, doctor, and professional organizer has been shown effective in treating adults with hoarding disorder. Difficulty discarding items, even if they are of no real value A need to save or accumulate items, and marked distressed when trying to get rid of these items Living areas become cluttered and cannot be used for their original purpose The hoarding causes functional impairment in at least one area of functioning, such as social, occupational, or keeping a safe environment American Psychiatric Association (2013) is the reference for this criteria Estimates say that 75-92% (Kress et al., 2016; Hall, Tolin, Frost, & Steketee, 2013) of people with hoarding disorder have another mental health disorder Depression and attention-deficit hyperactivity disorder have high comorbidity rates with hoarding disorder (Hall et al., 2013) There is a weak correlation between hoarding disorder and obsessive compulsive disorder, however hoarding behaviors may be a symptom of obsessive compulsive disorder (Hall et al., 2013) People with hoarding disorder also exhibit a high comorbidity with medical issues Kress et al. (2016) report higher instances of the following in people with hoarding disorder: fibromyalgia, obesity, chronic fatigue syndrome, diabetes, sleep apnea, bleeding or heart problems, and arthritis Ayers and Dozier (2015) add that high blood pressure, seizures, and stroke are medical comorbidities Treatment Interventions Risks (Johnson, 2015) Cognitive Behavioral Therapy (CBT) is the most widely-researched, and most accepted, form of treatment for people with hoarding disorder (Levy et al., 2017). More specifically, the CBT method of Exposure and Response Prevention has been shown to decrease clutter and decrease hoarding symptoms (Hartl & Frost, 1999) Psychoeducation, which provides clients with information and coping skills surrounding hoarding disorder, has also proven to be helpful (Levy et al., 2017) Motivational Interviewing can be used to define goals when a client is feeling ambivalent (Steketee & Tolin, 2011) Assessments should be given at mental health clinics Causes & Theories Can get sick from expired, or contaminated, food Too much clutter can become a fire hazard and escape from a fire may be difficult Clutter could also prevent emergency personnel from entering the house for rescue purposes Insect infestations Toxic odors Falls in the home Losing medications Risk of eviction/homelessness Possible visits from child protective or animal welfare services Job loss Kress et al. (2016) is the reference for all of these risks 49% of people with hoarding disorder have relatives who exhibit hoarding behaviors (Lynch et al., 2015) Situational factors such as divorce, a move, the death of a spouse or parent, retirement, or a young adult moving out of the home can be causes. Dozier, Porter, & Ayers (2016) also add job loss or changing jobs Loss and grief are common themes associated with hoarding Social Learning Theory says that children who observe hoarding may take on those behaviors themselves (McLeod, 2016) The client-therapist relationship is critical when working with people with hoarding disorder. A person-centered approach should be taken (Ayers et al., 2012) Kress et al. (2016) suggest a multi-disciplinary approach