An introduction to working with people with Hoarding difficulties using CBT

Hoarding Disorder is now recognised as a distinct and separate mental health difficulty. It has had a high profile in media coverage, & great interest from a wide range of people. Defining Hoarding may be an important first step but caution remains over how self-identification as a ‘Hoarder’ carries costs as well as potentially granting access to mental health services. Hoarding has traditionally been seen as difficult to treat, and can present huge challenges to services, not solely mental health. The costs to the person who hoards (& may be living in extremely compromised accommodation), can be physical, psychological, social & financial. The risks can also be high for children who have parents who hoard, or for older adults who live with someone who hoards. Research evidence on individual CBT is developing & indicates the importance of involving family members. High drop out from therapy suggests we need to re-think our approach & actively engage with people, in order to improve quality of life & well-being, and reduce risks.

This workshop will provide an overview of current thinking about defining & describing hoarding. It will offer a cognitive behavioural formulation of acquiring, keeping & disposing of items. It will attempt to foster hope that psychological intervention is both worthwhile & can lead to change for people who hoard. A review of the evidence base for treatment & strategies for maximising engagement & successful treatment will be covered. It will demonstrate how working with other agencies, such as social care & environmental health, or carers can maximise the impact of CBT



Holmes,S. et al (2016) Understanding Hoarding When Our Relationship with Possessions Goes Wrong BPS:Leicester

National Housing Federation (2016) Hoarding: Key considerations and examples of best practice Contributor

Holmes, S. (Ed) (2015) A Psychological Perspective on Hoarding DCP Good Practice Guidelines BPS:Leicester

Holmes et al (2014) Developing a self-help group for people with hoarding disorder and their carers Mental Health Today Nov/Dec






Sophie Holmes

Sophie Holmes is a Lead Consultant Clinical Psychologist & Professional Lead for Psychology & Psychological Therapies in Sussex Partnership NHS Trust. She has worked for many years with people with severe & complex mental health difficulties, including community mental health services and in Assertive Outreach Services for people with psychosis.

Sophie completed her Clinical Psychology training in Oxford, after qualifying she has worked in Oxford, North Somerset, Surrey until her move to Sussex in 2014.  She is experienced in working with people with extremely severe & disabling problems associated with hoarding. She has particular expertise in reaching out & engaging people in psychological work who traditionally have not wanted contact with services. She is an accredited Cognitive Behaviour Therapist (BABCP) and experienced in working with individuals, carers and outside agencies. She has run staff training workshops in CBT for Psychosis, Family Intervention, & Hoarding to a wide range of people, and services. She has set up the first self-help group for both people with hoarding difficulties and their carers in partnership with a third sector organisation in Surrey.

Additional Information

Cancellation & changes policy

If you cancel more than 14 days prior to your booked event, we will refund your fee minus a charge of 15% to cover our administration costs. We regret that cancellations 14 days or less before the booked event cannot be refunded or changed/transferred.

If you wish to change/transfer your booking after confirmation we will do our best to accommodate you if you notify us 14 days prior to your booked event, and if there is space to do so. However there will be an administration charge of £15 per change/transfer.


Workshops often contain clinical material. This is always anonymised as far as possible but delegates are none the less reminded to respect confidentiality.

All that is discussed in your therapy sessions will be treated as confidential, with the following exceptions.
We are required to seek supervision by our professional body (The British Psychological Society or equivalent) as a means of ensuring good practice. We will usually inform your referrer of your progress, but the details that we disclose will be discussed with you. We do have a statutory obligation to break confidentiality under rare circumstances, namely, if we believe that a client is of danger to themselves or to others (under the Mental Health Act, 2001) or if we believe that a child is at actual risk of physical or sexual abuse (The Children Act, Section 47, 1989).

If we felt that it would be helpful to request additional medical, social or legal information, we could only do this with your consent. Similarly, should another medical, social or legal professional request information from us, we would not release this without your consent.


OCTC makes every effort to ensure that this programme is delivered as advertised. However, should a presenter have to cancel, we will endeavour to find another suitable presenter. We will inform attendees as soon as is reasonably practical and, if requested, will offer a refund. In the rare event that we are unable to substitute a presenter, we may cancel a workshop and refund payments already made by attendees. OCTC will not refund travel and accommodation costs that attendees may incur.
All the workshops in this programme are carried out by highly experienced therapists and trainers. The individual presenter is responsible for the content of the workshop and any views expressed do not necessarily represent those of OCTC.
Although highly informative, none of the open workshops or workshop series confer a formal qualification or assurance of competence in CBT (or a specialist area of CBT) since we are unable to assess attendee competency within the training event. However, credit and award-bearing courses that lead to formal qualifications are offered by OCTC in conjunction with the University of Oxford. More about these courses is available on our website

Levels of competence

Before booking a place on a workshop, please ensure that it is pitched at the appropriate level of competence for you. The guide to levels is as follows:


Basic workshops are for people from a variety of backgrounds, who have at least one year’s clinical experience. Cognitive behavioural knowledge is not necessary for attendance at these workshops, though in practice, a number of attendees will have some skills in the area, and are refreshing/updating their knowledge.


Intermediate workshops are directed towards people who already have knowledge of CBT, and experience in using cognitive formulations and treatment methods – for instance, they are able to identify and test automatic thoughts, and design behavioural experiments. Most participants will be using CBT as part of their clinical practice, and may still be acquiring new CBT skills.


Advanced courses are directed towards those professionals who use CBT routinely as part of their clinical practice. They have probably undertaken a significant number of training courses and/or workshops, and use a broad range of cognitive behavioural strategies to work with a range of presentations at varying levels of complexity.

Making reservations

Bookings can only be considered confirmed after we have received your online registration or application form and payment (or invoicing details, including an official purchase order document). Please note that registration to workshops closes 7 days prior to the event date.

If you are booking a workshop place for someone else, you must complete your own details in the billing field, but ENTER THE WORKSHOP PARTICIPANTS NAME/ADDRESS in the shipping field. If you wish to order items using a paper order form instead of online, you can view or download an order form in Adobe Acrobat (PDF) format. Once downloaded, print it out, fill it in, and send off with your payment [cheque made payable to OXFORD HEALTH NHS FOUNDATION TRUST] to the address on the form.


The cost of the workshops includes hot drinks on arrival, mid-morning and mid-afternoon, but not usually lunch unless stated. However, for workshops that do include lunch, if you have any special dietary requirements please let us know at the time of application.

Special needs

We welcome applications from diverse backgrounds. If you have any particular needs, please contact us
prior to booking.