Case Formulation
Chapter 4 encourages clinicians to work with clients to develop a clear formulation of how their hoarding and acquiring symptoms developed and why they persist. The conceptual formulation includes discussion of reasons for saving to clarify clients’ thoughts and beliefs about possessions. Clients learn to complete a brief Thought Record and fill out a form to identify locations and times of problematic acquiring. Extensive clinician-client dialog in case vignettes illustrates how to collect information to complete the conceptual model that will guide treatment. Included in the model is information about family and personal vulnerabilities to hoarding, cognitive processing problems, thoughts and beliefs, and positive and negative emotions that drive hoarding and acquiring behaviors. A graphic illustration of a hoarding model is provided, along with instructions for developing a functional analysis of acquiring behavior.