Can Hoarding Be Cured?

Key Takeaways

• Hoarding disorder is managed rather than “cured,” but 70-80% of people undergoing structured CBT show significant improvement after 9 to 12 months.
• Australian researchers at UNSW have developed a promising imagery rescripting technique that helps people feel motivated and positive about discarding.
• A 2025 meta-analysis of psychological interventions confirms CBT remains the gold standard, though outcomes are more modest than for other anxiety-related conditions.
• Combining therapy with practical support services, NDIS coordination, and complementary approaches like therapeutic gardening produces the best long-term results.

If you or someone you love is living with hoarding disorder, this question sits at the front of your mind: can it be cured?

The honest answer is nuanced. Hoarding disorder, like many mental health conditions, is not something that disappears with a single treatment or a moment of willpower. It is a complex condition with neurological, psychological, and sometimes genetic components. The underlying tendencies may persist throughout a person’s life.

But here is what matters more than the word “cure”: with the right support, people with hoarding disorder can and do make significant, lasting progress. They reclaim their homes. They rebuild their relationships. They develop skills that allow them to maintain a safe, functional living environment for years to come.

The research supports this. The treatment landscape is advancing. And in my 15 years of working with individuals and families across Melbourne’s eastern suburbs, I have seen transformations that would have seemed impossible at the outset.

Do 70-80% of People with Hoarding Disorder Actually Improve with CBT?

The headline figure is real, but the full picture is more complex than a single number suggests.

Research from the International OCD Foundation reports that 70-80% of people undergoing structured CBT for hoarding are rated as “much” or “very much” improved after 9 to 12 months of treatment, with improvements largely maintained at one-year follow-up.

However, a 2025 meta-analysis published in the Journal of Psychiatric Research provides important context. Titled “Decluttering Minds,” the analysis found that while psychological interventions (primarily CBT) produce meaningful symptom reductions, only 24-43% of participants achieve clinically significant change, and most continue to meet diagnostic criteria at the end of treatment. This gap between “improved” and “no longer meeting criteria” is important to understand. It sets realistic expectations while still demonstrating that treatment makes a genuine difference in daily functioning and quality of life. CBT adapted specifically for hoarding helps individuals understand the thoughts and beliefs driving their behaviour, develop decision-making skills for sorting and discarding, manage the anxiety that arises when letting go of possessions, and build sustainable habits around acquiring, keeping, and discarding items.

Takeaway: CBT works for hoarding, but “works” means meaningful improvement in safety, functioning, and quality of life, not necessarily a complete elimination of symptoms. Starting treatment through a specialist hoarding service is the most important step, regardless of where the journey ends.

Could Australian Imagery Rescripting Be the Breakthrough in Hoarding Treatment?

Some of the most exciting recent developments in hoarding treatment are coming from Australian researchers, and the early results are genuinely promising.

A team at UNSW Sydney has developed a novel approach called imagery rescripting, an experiential technique that uses sensory-rich mental imagery to help people rescript the feared outcomes of discarding.

In the initial study of 176 participants with high hoarding traits, those who engaged in imagery rescripting were happier, more motivated, and more likely to discard their items compared with those who used cognitive restructuring, imaginal exposure, or mood-improvement techniques. The approach works by addressing something traditional CBT sometimes misses: the vivid, emotionally charged mental images that people with hoarding disorder experience when contemplating discarding. Rather than challenging thoughts logically (as standard CBT does), imagery rescripting helps people rehearse alternative, positive outcomes of letting go through rich sensory imagination. A second, therapist-led study has replicated these findings, with participants showing greater motivation to discard and more positive feelings about the experience. Clinical trials are now underway.

Takeaway: If traditional CBT has not worked for you or someone you support, new approaches are emerging. Ask your therapist about imagery rescripting, or contact our team for referrals to practitioners using the latest evidence-based techniques.

What Do People with Hoarding Disorder Say Actually Helps Them?

Clinical trials measure symptom scores. The people living with the condition can tell us what actually makes the difference.

A 2025 systematic review of patient perspectives asked the question that matters most: what do people with hoarding disorder themselves say helps? The findings highlighted several consistent themes.

Feeling respected and having agency over their own process was essential. Practical support with decluttering (when they were ready for it) made a tangible difference. Social connection and peer support reduced isolation and shame. And treatment that addressed their whole life, not just the clutter, led to sustained improvement. These patient insights align directly with the approach we take at My Inclusion. Treatment is not something done to a person. It is something done with them.

Takeaway: If you are supporting someone with hoarding disorder, the most helpful thing you can do is respect their pace, offer practical help when invited, and connect them with professional support that treats them as a whole person, not just a cluttered home.

Can Medication Treat Hoarding Disorder?

Medication alone is not a solution, but for many people it creates the stable foundation that makes therapy possible.

According to Healthdirect Australia, selective serotonin reuptake inhibitors (SSRIs) are sometimes prescribed as part of a hoarding treatment plan. Medication alone is generally not sufficient to address hoarding, but it can help manage co-occurring anxiety and depression.

For the nearly 75% of people with hoarding disorder who also carry a mood or anxiety diagnosis, managing these co-occurring conditions can make the difference between being able to engage with therapy and feeling too overwhelmed to start. Emerging research is also exploring Acceptance and Commitment Therapy (ACT) as an alternative or complement to CBT for hoarding. ACT focuses on accepting difficult emotions rather than trying to change them, and committing to actions aligned with personal values. Early clinical case studies show promise, particularly for individuals who have not responded well to traditional CBT.

Takeaway: Medication is a supporting player, not the lead. But if anxiety or depression is making it impossible to engage with therapy, talk to your GP or psychiatrist about whether SSRIs could help clear the path. Our support coordination service can help you find the right combination of treatments.

What Does Realistic Recovery from Hoarding Actually Look Like?

Setting realistic expectations is important for both the person with hoarding disorder and their family. Recovery is not a dramatic before-and-after. It is a gradual process.

Research from the International OCD Foundation indicates that meaningful improvement typically requires 9 to 12 months of structured treatment, with ongoing maintenance support recommended to sustain gains.

The first few months focus on building understanding and motivation rather than discarding. The person learns about their condition, identifies their own goals, and begins to understand the thought patterns driving their behaviour. Visible changes to the home may be minimal, and that is normal. Months three to six bring the beginning of practical decluttering work as skills develop and therapeutic rapport builds. Progress may feel slow, particularly to family members who want faster change, but paced, voluntary decluttering produces more sustainable outcomes than rapid clean-outs. Six to twelve months is when most people experience meaningful improvements: living spaces become safer and more functional, decision-making around possessions becomes less distressing, and some social connections may be re-established. Ongoing maintenance is essential because hoarding disorder is typically a long-term condition. A maintenance plan that includes periodic check-ins, continued skill-building, and access to support when needed can help sustain the gains made in active treatment.

Takeaway: Recovery from hoarding is measured in months, not days. But every month of professional support brings real, tangible improvements. The most important thing is to start the conversation and trust the process.

The Role of Practical Support and Complementary Approaches

Therapy addresses the psychological factors driving hoarding, but many individuals also benefit from hands-on support with the physical process of decluttering. At My Inclusion, our hoarding and squalor support service provides practical decluttering support that works alongside therapeutic treatment. Our approach works at the individual’s pace, respects the emotional significance of possessions, focuses on building skills rather than just clearing spaces, includes strategies to prevent re-accumulation, and maintains the person’s sense of control and agency throughout.

We work across Melbourne’s eastern suburbs, from Hawthorn and Balwyn through Doncaster and Blackburn to Mooroolbark and Mount Evelyn.

Recovery from hoarding disorder is strengthened when treatment is not limited to the clutter itself. Therapeutic gardening offers a particularly natural fit, providing structure and routine, healthy attachment to living things that grow and change rather than accumulate, social connection through community gardens, physical activity, and a sense of purpose. For more on how gardening supports mental health recovery, see our guide on the benefits of therapeutic gardening.

Understanding the health and safety risks of hoarding can also motivate engagement with treatment, while recognising when hoarding has become a problem helps families and individuals seek support before the condition reaches its most severe stages.

NDIS Support for Hoarding Treatment

Navigating the treatment landscape for hoarding disorder can feel overwhelming, particularly when NDIS funding is involved. Our support coordination service helps participants connect with the right combination of therapists, practical support services, and community resources.

With 65,300 Australians with psychosocial disability now active NDIS participants, the Scheme provides important funding pathways for hoarding treatment. A good support coordinator can help you understand your options and ensure your NDIS plan is structured to support your recovery goals effectively.

The path from hoarding disorder to a safe, functional home is a journey, not a destination. But it is a journey that hundreds of thousands of Australians are navigating, with outcomes that improve as our understanding of the condition deepens and new treatments emerge.

You do not need to have all the answers before reaching out. You just need to be willing to have a conversation.

Contact My Inclusion today to take that first step. It is free, it is confidential, and there is absolutely no obligation.

FAQ

How long does treatment for hoarding disorder typically take?

Structured CBT for hoarding is typically delivered over 9 to 12 months, with sessions that may include both in-office (or telehealth) appointments and home visits. However, many individuals benefit from ongoing support beyond the initial treatment period. Because hoarding is often a chronic condition, a maintenance plan with periodic check-ins and continued access to support services is recommended for long-term success. The timeline varies based on the severity of the hoarding, the person’s engagement with treatment, and the presence of co-occurring conditions.

Is medication effective for treating hoarding disorder?

Medication alone is generally not sufficient to treat hoarding disorder. SSRIs (selective serotonin reuptake inhibitors) may be prescribed to manage co-occurring depression and anxiety, which affect nearly 75% of people with hoarding disorder. By stabilising mood and reducing anxiety, medication can make it easier for the person to engage with psychological therapy and practical decluttering support. Any medication decisions should be made in consultation with a psychiatrist or GP who understands hoarding disorder.

What is the difference between CBT for hoarding and regular CBT?

Standard CBT addresses general thought patterns and behaviours. CBT adapted for hoarding includes specific components designed for the condition: understanding the beliefs that drive saving (such as “I might need this someday” or “Throwing this away is wasteful”), practising decision-making about possessions in real-world settings, managing the specific anxiety associated with discarding, developing organisational systems, and addressing excessive acquisition. It also typically includes home-based sessions where the therapist works alongside the person in their actual living environment, which standard CBT does not usually involve.

Can hoarding disorder come back after successful treatment?

Yes, relapse is possible, particularly during periods of stress, grief, or significant life change. This is why hoarding disorder is described as “managed” rather than “cured.” The skills learned during treatment, such as decision-making frameworks, anxiety management techniques, and awareness of acquisition patterns, provide ongoing tools for managing the condition. Maintenance support, whether through periodic therapist check-ins, peer support groups, or continued engagement with a practical support service, significantly reduces the risk and severity of relapse.

What should I expect from the first appointment with a hoarding support service?

The first appointment is typically a conversation, not a clean-up. At My Inclusion, initial meetings focus on understanding your situation, your goals, and your concerns. We listen to your story, answer your questions, and discuss what support might look like. There is no pressure to make decisions on the spot, and we will never enter your home without your invitation and consent. Many people tell us they feel relieved after the first conversation, simply because they have shared their situation with someone who understands and does not judge. You can contact us to arrange this initial conversation at a time that works for you.