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Patients with hoarding disorder (HD) experience difficulties discarding that result in excess clutter in the home. HD causes distress and impairment for patients and family members and represents a significant public health burden, highlighting a need for treatment research. In this chapter, we provide an overview of cognitive behavioral therapy (CBT) for hoarding, a promising avenue to treat core HD features in a collaborative and time-limited manner. We begin by discussing etiological factors for HD, including familial features, information-processing deficits, and core beliefs about the self and possessions. Next, we describe HD assessment, including standardized measures and case conceptualization considerations. After discussing the research evidence for individual and group CBT for HD, we provide an overview of treatment components, including psychoeducation, motivational enhancement, skills training, behavioral exposures, cognitive techniques, and relapse prevention. Barriers to treatment are also considered. We end with a case vignette illustrating the successful application of CBT for HD in an individual outpatient setting.
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