Cognitive behavioral therapy for child and adolescent hoarding disorder

Hoarding disorder (HD) has a prevalence rate of around 2.5% in adults, but the prevalence rate in children and adolescents is uncertain. HD is characterized by difficulties in discarding or parting with possessions regardless of their actual value, urges to collect and acquire new items along with excessive clutter in living areas. In general, there is a lack of assessment scales and diagnostic tools for use with children and adolescents although one psychometrically sound parent-rating scale, the child savings inventory, is available. Treatment studies for this age groups are also lacking, but a limited number of case studies suggest the effectiveness of cognitive behavioral therapy (CBT) including exposure to discarding and refrainment from collecting new items, using contingency management for exposure and oppositional behavior, cognitive training as well as instructing parents to assist with exposures in the home. To conclude, child and adolescent HD is understudied, and there is a need for proper assessment tools as well as CBT-based treatment manuals that are tried and tested and include the components listed.