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Someone should always be designated to be the hoarder’s advocate. This is a particularly challenging job and may fall to the person who knows the hoarder well, has the hoarder’s confidence, and can empathetically represent his or her interests.

Team Colors

EVEN WITH A team of all volunteers, we like to make sure everyone wears the same color shirts to show uniformity. While reinforcing the “team” concept for the cleanup crew and the hoarder, the shirts also represent a big step for the hoarder, who has not been a part of any group in a long time. Hoarders who work hard that first day earn a Clutter Cleaner T-shirt, making them part of our crew. We don’t hand out freebies; they only get the shirt when they give 100 percent effort.

▶ Dates and Scheduling

Most of the hoarders with whom I work try to cancel their cleanup at least once. Even when they are finally committed to the big day, I often find them unprepared. The hoarder may delay the start in order to “tidy up” a bit before the crew enters the house. And it is the job of the designated point person, or team leader, to remind the hoarder that they are there to work on the cleanup together.

Advanced hoarders have often been evicted from a condemned property and are living elsewhere. They often arrive late for the cleanup: Sometimes they are genuinely running behind, but I’ve figured out that some hoarders are testing to see if they really have control of the situation. They need to see that the crew waits for them to begin a cleanup. Starting without the hoarder being present, or getting angry because a hoarder is late, just reinforces the hoarder’s mistrust. Without trust, the cleanup will go straight downhill.

I start each cleanup day with a meeting of everyone on the team who will be involved that day. Even if the team is just the hoarder and a helper, the meeting reinforces the message that this cleanup is serious and confirms that the hoarder isn’t in this alone. We recap the previous day’s accomplishments, lay out the new day’s plan, and answer any questions.

▶ Goals and Expectations

“Our goal here today is for Margaret to clean her house up and get her dogs back.”

Each day may start with a meeting, but more important, it begins with a reminder of the goals and expectations to which everyone has agreed. Starting on a positive and supportive note reminds hoarders that although they may be feeling anxious, they have chosen to take this action to get a result that is meaningful to them: to keep their house, get their kids or pets back, be able to invite friends over, or reconnect with their family.

This is also a good time to review the schedule and logistics for the cleaning crew, which rooms to tackle first, and what will happen if we fall behind the schedule. We also have to remind ourselves of deadlines that have been imposed, such as those enforced by city or county officials or health and welfare services. And don’t hesitate to remind everyone not only of the positive goals but also of the negative consequences—fines, loss of the home, or other unfortunate outcomes.

Timeline goals are what I call “we” goals: The entire team, not just the hoarder, takes responsibility for cleaning the house in the time allotted. If that deadline has to be extended, while it’s often 100 percent the hoarder’s fault, it is better to take responsibility as a team. Hoarders who understand that they are not alone in the process are more likely to succeed.

During the cleanup, the team will want to refer to the life goal frequently, to keep the hoarder on track. Whenever a hoarder starts to waffle, drag his or her feet, or hang on to too many items, it’s time to remind the hoarder of the overall goals, and what must be done to reach them.

▶ Homework

To get a good sense of realistic goals, it’s critical to find out what hoarders are able to do on their own. During the cleanup, we roll out the idea of “homework,” giving the hoarder a small task to complete overnight, maybe sorting through one box, or taking out three bags of trash. If the hoarder is able