Institute on Compulsive Hoarding & Cluttering

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Think Outside the Boxes
18th Conference on Collecting Behaviors*
*AKA the disorder formerly known as Hoarding

March 22-23, 2018

The Institute for Compulsive Hoarding and Cluttering is a local, national, and international thought leader which maintains the centrality of peer perspective in seeking to understand Collecting Behaviors.

Since 1998, MHASF has held annual conferences bringing together an impressive range of peers and professionals:  government agencies, clinicians, case managers, landlords, researchers, and all affected by this issue. This is the longest running and most comprehensive such conference in the world.

We offer a comprehensive range of supports that foster community for those personally and professionally dealing with collecting challenges.

  • Information & Referral
  • Peer Response Team
  • Weekly Drop-in Peer-led Support Group
  • Community trainings and presentations
  • Therapist and peer-led 16-week CBT Treatment Group
  • Family and Friends Support Group
  • San Francisco Task Force on Hoarding

We are also proud to have hosted and participated in the Patient Centered Outcomes Research Institute (PCORI), a 3 year collaboration between MHASF and UCSF to compare the outcomes of 15 therapist-led and 15 peer-led cognitive behavioral therapy based groups.   Over 300 individuals completed the free 16-week groups.  The study has already produced findings to support the effectiveness of both therapist and peer-led CBT as an evidence-based practice.

For more information on ICHC programs, contact Stephen Leader, Peer Support Coordinator

415-421-2926 x316 or

Learn more about ICHC and support for collecting behaviors:

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Collecting Behaviors 101

Collecting is a universal human behavior. All of us collect possessions that we use and value. Some people acquire a large number of possessions and/or have persistent difficulty parting with them when they are no longer useful or when they exceed available space.  The accumulation can result in significant distress and/or impairment in the functions of daily living. The situation can be a serious risk to health, safety, and relationships.

An estimated 3-5% or 9-16 million Americans are believed to have problematic collecting behaviors.  This is more people than are diagnosed with Alzheimer’s disease. In San Francisco alone, that is 25,000–45,000 individuals. The behavior occurs across all socio-economic categories. Although tendencies often appear in early adolescence, most individuals seeking treatment are over 55.

Recovery is possible. The most important barrier to seeking support is societal and self stigma. Peer community is a powerful tool to overcoming the shame and isolation.   We urge individuals with collecting challenges to seek out local and on-line supports.   We urge concerned family members and professionals to practice non-judgmental harm reduction that maintains caring relationships while focusing on immediate health and safety risks.

While it can be tremendously difficult and frustrating to deal with collecting challenges, it’s good to remember that “It’s not about the stuff.” There are many and complex factors that have led to this situation. Every person with collecting challenges has their own unique personality, circumstances, and story.   Some frequently seen themes are:  trauma, change in life circumstances, change in physical and mental health, unhelpful beliefs and fears, family history, and co-occurring challenges such as difficulties concentrating, categorizing, and decision making.    If these underlying issues are not addressed, de-cluttering efforts including large scale cleanouts of the type seen on television will not be successful or long lasting.  Recovery is possible, but there is no quick fix to the situation.

In 2009, the San Francisco Task Force on Compulsive Hoarding brought together a broad range of stakeholders to produce the report  “Beyond Overwhelmed:  The Impact of Compulsive Hoarding and Cluttering in San Francisco and Recommendations to Reduce Negative Impacts and Improve Care.”  An excellent primer has been used as a model for many municipal Task Forces can be found HERE.

Peer Response Team

Peer Responders all have lived experience with collecting and accumulating. We use our experience to provide non-judgmental, harm reduction-based, one-on-one peer support often including multiple home visits. We also give community presentations that message anti-stigma and discrimination, empowerment, and the possibility of recovery. We currently facilitate a growing range of support and treatment groups on-site at MHASF.

Who We Are

  • 1 Coordinator
  • 3 part-time (10-15 hours/ week) Peer Responders with lived experience of collecting challenges

What We Do

  • We listen to your situation without judgment.
  • We follow your lead, process, and goals.
  • We respect your confidentiality.
  • We can suggest tips, strategies, and resources.
  • We can make 1-3 home visits to establish relationship.
  • Occasionally, we can accompany you to hearings, inspections, and storage spaces.
  • We can help you connect to support groups and a larger peer community.
  • We encourage your action and self-empowerment.
  • We model recovery and hope.

What We Don't Do

  • Judge or criticize you.
  • Touch, move, or remove your possessions.
  • Report about you to anyone (unless you request it).
  • Set goals for you or force you.
  • Work weekends or after 5pm.

This is about you and your unique relationship to your possessions. We have our own lived experience of collecting behaviors that at one time overwhelmed us. We truly believe in the possibility of recovery. We believe you can establish a more balanced, healthier, happier relationship with things. But it is your stuff, your life, your work, your process.

Work with a Peer Responder

Contact Stephen @ 415-421-2926 ext. 316 or

Support Groups

For information on the Drop-in Peer-led group below, contact Stephen Leader at 415-421-2926 x316 or

Weekly Drop-in Peer-led Support Group

For over 15 years, this group has been the steady mainstay of our program and often the first point of contact and information for newcomers. It is also a good place to re-connect with support and community.  This is a safe place to find non-judgmental support, information, and resources.

No registration necessary; just drop in and be welcome.

NOTE: the Drop In group is no longer located in Suite 928. Please join us in Suite 785 on the seventh floor of the Flood Building.

Download the January - June 2018 Schedule here.


WednesdayJan. 103:00PM - 4:30PMMHASF, 870 Market Street, Suite 785
MondayJan. 155:30PM - 7:00PMMHASF, 870 Market Street, Suite 785
WednesdayJan. 243:00PM - 4:30PMMHASF, 870 Market Street, Suite 785


MondayFeb. 55:30PM - 7:00PMMHASF, 870 Market Street, Suite 785
WednesdayFeb. 143:00PM - 4:30PMMHASF, 870 Market Street, Suite 785
MondayFeb. 195:30PM - 7:00PMMHASF, 870 Market Street, Suite 785
WednesdayFeb. 283:00PM - 4:30PMMHASF, 870 Market Street, Suite 785

MARCH 2018

MondayMarch 55:30PM - 7:00PMMHASF, 870 Market Street, Suite 785
WednesdayMarch 143:00PM - 4:30PMMHASF, 870 Market Street, Suite 785
MondayMarch 195:30PM - 7:00PMMHASF, 870 Market Street, Suite 785
WednesdayMarch 283:00PM - 4:30PMMHASF, 870 Market Street, Suite 785

Buried in Treasures 16-week Treatment Group

This group is based on the Cognitive Behavioral Therapy text Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding  (Tolin, Frost, and Steketee).  It requires steady attendance and weekly homework. There are both therapist and peer-led groups.

For more information or to reserve your spot in the group, please contact David Bain at 415-421-2926 x326 or

Upon completion of the 16 week Buried in Treasures group, you will be eligible to join the peer-led Unburied from Treasures maintenance group that meets twice a month on 2nd and 4th Thursdays from 6:00pm-7:30pm.

Famiy & Friends Support Group

This group is specifically for family members, partners, and friends who are supporting and/or living with someone with collecting challenges. This is not a group for individuals dealing with their own personal collecting challenges.  It is facilitated by clinician Susie DuBois, Marriage and Family Therapist.  Topics include:  Self-care and Boundaries; Declutter Coaching Skills, Effective Communication Strategies, and Problem-solving.

For more information or to reserve your spot in the group, please contact David Bain at 415-421-2926 x326 or

Clearing House (LGBT 55+)

This peer-led drop-in group is especially for LGBT 55+ seniors. It is held in conjunction with Openhouse at their new space at 65 Laguna. This group meets 1st and 3rd Wednesdays from 12:30-2:00pm.

For more information, contact Varian Pierce at 415-939-7248 or

or Ariel Mellinger at 415-503-4180 or

Training Institute

Learn more about the Training Institute offerings related to collecting behaviors, including the following:

  • Cognitive Behavioral Therapy
  • Harm Reduction
  • Motivational Interviewing
  • “Tackling the Paper Giant”
  • Intensive De-cluttering Techniques

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