Understanding Hoarding Clean-Outs: An Interview-Based Survey of Frontline Professionals

The risks of fire, infestations, and health complications are elevated in hoarded homes. To mitigate these risks, many social service providers resort to clean-outs—fast-paced interventions in which large amounts of clutter are removed from a client’s home. Despite their potential to be costly, ineffective, and traumatizing, no research has directly examined this intervention. To address this gap, this study’s method consisted of an interview-based survey of 65 frontline providers, each reporting on one clean-out. Objectives included examining factors precipitating clean-outs, characterizing clean-out practices and client-centered strategies, and describing short-term outcomes. Results indicated that for most clients, the decision to have a clean-out was not voluntary. Rather, clean-outs were mandated by community stakeholders due to multiple risks and often were used as a last-resort. Clean-outs were constrained by short timelines and required multidisciplinary teams. Providers often responded to client distress with client-centered approaches, such as shared decision-making. Providers generally agreed that clean-outs helped to resolve health and safety issues in the short-term but did not address the psychological problems that led to the clutter volume. Implications include establishing standardized guidelines to protect client rights and to support providers in making practice decisions. Future research should prioritize client perspectives and longer-term outcomes.