Hoarding and squalor training web slideshow

Acknowledgements
This material and the previous training sessions were made available through
Murray Primary Health Network’s Partners in Recovery.
Particular thanks also go to the following contributors:
Lee and Becca Shuer
Sandra Turnball -Green Team
Elise Watts- Haven, Home, Safe
Bendigo Country Fire Authority (CFA)
Hoarding and Squalor Reference group and Working group
Partners in Recovery (PIR)
Murray Primary Health Network (formerly Medicare Local Loddon Mallee Murray)
Housing Justice.
2

Agenda
1. Introduction
2. Perceptions of hoarding and introduction
3. Definitions
4. Why people hoard/live in squalor?
5. Characteristics
6. Diagnosis
7. Implications of hoarding
8. Service roles and
coordination
9. Approaches
10. Risk
11. Tools
12. Practical strategies
13. Joint case coordination
14. Supporting families, children
and workers
15. Challenges
3

Introduction
4
People living with hoarding behaviour or in a squalid living
environment need to be acknowledged and supported to enable
them to manage their behaviour so they might live safely with
minimal risk to themselves and the community. (1)
New Australian population research estimates more than 600,000
people (2.6%) may suffer from hoarding disorder, putting
themselves and their families at risk of squalor and health risks,
fire hazard, eviction and homelessness. (2)
Hoarding behaviour and squalid living conditions define quite
different circumstances, but under certain conditions may co-
exist.

Definitions: hoarding
6
Hoarding behaviour is the persistent accumulation
of, and lack of ability to relinquish, large numbers
of objects or living animals, resulting in extreme
clutter in or around premises. (1)
This behaviour compromises the intended use of
premises and threatens the health and safety of
people concerned, animals and neighbours. (1)

Definitions: hoarding
7
 People who hoard actively acquire things or animals from
external sources, while others might passively accumulate
over years without relinquishment (for example: with regard to
animals, a person could just allow their animals that are not
de-sexed to keep breeding without acquiring more).
 The word ‘relinquish’ captures the fact that objects or animals
are valued by the person and not easily given away or
surrendered.
 Objects (for example, piles of newspapers) may be neatly piled
up along corridors and not necessarily fill or clutter living
areas, which may remain available for their intended use.
 Some objects and animals may be hoarded outside the home
in other buildings or spaces, in nonliving areas (sheds). (1)

Squalor describes an unsanitary living environment
that has arisen from extreme and/or prolonged
neglect, and poses substantial health and safety
risks to people or animals residing in the affected
premises, as well as others in the community. (1)
Definition: squalor
9

Definitions: animal hoarding
10
The accumulation of large numbers of animals that
overwhelms the person’s ability to provide a
minimum standard of nutrition, sanitation and
veterinary care. (1)

Definitions: co-existing hoarding & squalor
11
When the client has both hoarding and squalor behaviours
together.

Definitions: neglect
12
Neglect involves a failure to remove
household waste and other rubbish as
well as a failure to appropriately
maintain the structure (both internal
and external) of a house, the yards,
gardens and utilities (such as plumbing,
gas and electrics). (10)

Definitions: multi-facet neglect
13
 Multi-Faceted Self Neglect involves behaviours in
which an individual does not (either intentionally or
non-intentionally) appropriately address their basic
personal needs. Issues of personal hygiene,
appropriate clothing, feeding, bathing and medical
needs often go unattended leading to an
exacerbation of medical issues as well as social
exclusion and isolation.
 It is important to note that self-neglect has serious
implications for both the individual and the
community. (10)

Why do people hoard?
14
 Hoarding may be hereditary. Up to 85% of people with
hoarding behaviour can identify another family member
who displays this behaviour.
 Hoarding may begin after brain damage, such as strokes,
surgery, injuries, or infections.
 Intellectual / cognitive reasons such as acquired brain injury
or physical disability.
 Family/life experiences and psychological factors may also
play a role in the development of hoarding and emotional
stress may heighten symptoms. (1)

Why do people hoard?
15
People who hoard have a variety of reasons for doing so:
to avoid wasting things that might have value.
they have a fear of losing important information.
the emotional meaning of objects.
they appreciate the aesthetic appeal of objects, especially
their shape, colour, and texture. (1)

Why do people live in squalor?
16
Possible reasons include:
Lack of living skills i.e. cleaning.
Health issues- physical/mental
Whether someone lives in ‘squalor’ is subjective
and often influenced by the attitude, exposure to
an unclean environment and personal living
conditions of the person making the assessment.

Why do people hoard animals?
17
Animal hoarders often fall into one of the following three categories, but can
sometimes exhibit characteristics across categories:
The overwhelmed caregiver initially provides adequate care for the animals and
believes that while a problem has slowly developed, it’s not as serious as others
think it is. The overwhelmed caregiver may be socially isolated, but is willing to
accept intervention.
The rescue hoarder develops a compulsion based on a strong desire to rescue
animals from possibly deadly situations, actively acquiring animals, believing no
one else is capable of caring for them. They often work with a network of
enablers, gaining proximity to the animals and finding it difficult to refuse to take
in any new animals.
The exploiter hoarder takes in animals to serve their own needs and is
indifferent to any harm caused to the animals. (1)

Characteristics of hoarding
18
Three behaviours characterise hoarding:
1.acquiring too many possessions.
2.difficulty discarding or getting rid of them when they
are no longer useful or needed.
3.difficulty organising possessions.
When these behaviours lead to enough clutter and
disorganisation to affect someone’s health or safety,
or they lead to significant distress, then hoarding
becomes a ‘disorder’. (1)

Characteristics of hoarding
19
People who hoard may have personality traits that
include avoidance, anxiety, indecisiveness, difficulty
trusting others, perfectionism and poor socialisation
skills. (1)
The person is often resistant to change,
procrastinates or may agonise over decisions,
leaving items that may previously have been of
value to decay or deteriorate to the point where the
items are perceived by others to be worthless. (1)

Characteristics of squalor
20
Individuals who live in squalor may frequently exhibit
poor initiative, drive, and motivation.
May have physical and mental health issues. (1)

Diagnosis
21
The DSM-5 edition (published May 2013)59 classified hoarding as a
distinct disorder with its own diagnostic criteria within the chapter about
obsessive-compulsive and related disorders.
Before the DSM-5, hoarding could be misdiagnosed as a form of
obsessive-compulsive disorder.
Hoarding disorder is new to DSM-5 and is supported by extensive
scientific research. The behaviour usually has harmful effects –
emotional, physical, social, financial and even legal – for a hoarder and
family members. (1)
What does DSM-5 stand for? Diagnostic and Statistical Manual
http://www.dsm5.org/about/Pages/Default.aspx

Implications of hoarding and squalor
22
 Every situation is different, and the impact of a person’s hoarding
behaviour can be anywhere on a continuum of severity from low to
high.
 Hoarding and Squalor not only effects the person who hoards and/or
lives in squalor but also potentially dependants, partners, family, carers
and neighbours and communities. Everyone has different perceptions
on how to best deal with this issue.
 Expensive and emotionally devastating evictions or other court actions
can lead to hospitalisations or homelessness.
 Conflict with family members and friends who are frustrated and
concerned about the state of the home and the hoarding. (1)

Effects of hoarding and squalor
23
Click on link to go to you tube video.
Discussion:
In this clip who were effected by hoarding?
What legal implications were there as a result of hoarding?
Sunrise Interview

What's the law got to do with it?
24
Laws you need to know about that can relate to hoarding and squalor, some examples:
Personal Safety- Occupational Health & Safety (OHS)
Physical Health- Health Records Act 2001, GUARDIANSHIP AND ADMINISTRATION ACT
1986
Mental Health- Mental Health Act 2014, GUARDIANSHIP AND ADMINISTRATION ACT 1986
Privacy- Privacy Act 1988, Information Privacy Act 2000
Child Protection- Child, Youth and Families Act 2005, Child Wellbeing and Safety Act 2005
Animal Protection- Domestic Animals Act 1994, Prevention of Cruelty to Animals Act 1986,
Code of Practice for Private Keeping of Dogs, Code of Practice for Private Keeping of Cats
Sanitation- Public Health Regulation 2000
Housing- Residential Tenancies Act 1997
Building- Occupational Health & Safety (OHS), Environmental Local Law (visibility from
streets etc.), Housing Act 1983
Duty of Care
Human Rights- Charter of human rights and responsibilities Act 2006

Service roles
25
Hoarding disorder, whether or not it is linked to squalor and
self-neglect, is an issue that cuts across many areas.
These areas can include mental health, aged and community
care, housing, children’s welfare, homelessness, fire and
rescue, local government, councils, and trustee and
guardianship issues.
Roles within each of these areas will be both regulatory and
support (case management) roles.

Service roles
Two basic roles can help motivate the change process – regulatory roles
and support roles.
Regulatory Roles
Articulate the regulatory requirements (eg local council laws) and
enforce the consequences of not meeting these requirments.
Examples of regulatory roles:
Police
Housing Providers (if applicable)
Council
RSPCA
Child Protection
26

Service roles
Support Roles
Provide assistance to meet regulations to avoid a negative
outcome (may be case management roles).
Examples of support roles:
Case Management Services
Tenant advocacy services
Tenancy support services
Mental health services
Family support services
Home Care Services
Any other form of community services
27

Service roles
Having two roles helps individuals separate out the
negative feelings from the positive feelings so that (with
support) they can act on their positive feelings and engage
in resolving their hoarding problem.
The regulatory and support roles work best when they are
two different individuals or agencies, communicating
together.
Roles need to maintain a “united front”- this is where joint
case management is effective. (4)
28

To successfully address this issue
we need to look at all aspects
of the persons life
health
Mental Health
Legal
Financial
Family/friends
Living skills
29

Service coordination
30
 Without coordination, people fall through service gaps, often because
agencies need the specialist knowledge and expertise of additional
agencies to respond effectively.
 Sometimes the physical environment where hoarding and/or squalor are
present is excessively risky and people’s complex needs require share
care planning.
 Service coordination is essential for preventing harm, or deteriorating
living conditions, for family members and the hoarder themselves.
 Intervening in hoarding and squalor cases is a complex process that
requires significant knowledge, understanding, expertise and time. (1)
 It is vital for services to have a thorough understanding of a wide range of
services in their area to address client needs holistically.
www.hoardingresources.org.au

Approaches
31
Hoarding and Squalor are two different issues
and at times they co-exist.
It is important workers understand there are
different approaches when working with both of
these issues.

Approaches: hoarding
32
Hoarding usually requires:
A focus on building rapport first (meet the person outside the home first
i.e. out for coffee).
A longer-term strategy includes more frequent, regular visits to assist the
person to reduce and/or store excessive items.
Sensitivity to the fact that many people who hoard have not allowed
anyone into their home in years; a useful goal can be to encourage the
person to allow family and friends into their home on a regular basis.
Meetings with the person and appropriate services to review progress.
Planning to achieve short term goals.
Discussing impediments to the process and fostering continued
cooperation is paramount. (1)

Approaches: hoarding
33
There is little evidence to indicate that the nature of
items hoarded makes a difference to the type of
strategy applied, with two exceptions:
1.when animals are collected and kept in great
numbers, the condition of the home is typically
compromised, and
2.when hoarded items include rotten food, body
products or similar items, a squalid living condition can
be severe. (11)

Approaches-squalor
34
Squalor often requires:
A short term, intensive plan with the need for
ongoing services commencing soon after the initial
intervention is complete.
The initial intervention to include a clean-up with
permission of the person concerned.
Effective interventions in cases of severe domestic
squalor are commonly expensive and require good
inter-agency collaboration.
Budgetary support must be available to enable
appropriate services to take on cases and provide
case management. (1)

Approaches: animal hoarding
 Depending on if there are signs of neglect to animals it
may be necessary to involves regulatory services i.e.
Council and RSPCA.
 You may also need to discuss with regulatory services
regarding legislation and animals.
 If a hoarder believes that animals may be going to a
home in which they will be cared for and loved, this may
assist in removing excess animals from a property. There
may be animal rescue/adoption services in your area.
 Explore discounted de-sexing and animal care services to
minimise increase in animals- possibly discuss with
council, RSPCA or animal rescue/adoption services.
35

Approaches: no “quick fixes”
36
Discussion:
Who has been involved in hoarding and
squalor cases where a “quick fix” has
occurred?
Did it bring about long term change for the
clients hoarding and squalor behaviour?
What impact did the “quick fix” have on the
client?

37
Trying to address Hoarding through a quick fix, such as an enforced
physical clean-up, has proven to be ineffective and is discouraged for the
following reasons:
it will severely impact on the person living there, in most cases causing
extreme anxiety and trauma as the clean-up was not willingly done or
enforced by the person with the hoarding behaviour.
the home will return to its original state very quickly, filled to the brim
with newly collected items.
it does not deal with the psychological disorder which is of course, the
cause of the resulting behaviour to hoard. (11)

38
 Trying to remove evidence of the psychological disorder does not bring
about change, health (including mental health) and community services
need to work with the person concerned to ensure sustained gradual
change.
 Many people who have experienced a quick fix have had terrible
reactions such as severe depression and in some cases suicide. In some
USA states or counties, quick fixes as a compulsive hoarding
intervention have been banned for those reasons.
 It may be necessary to do quick clean-ups etc if the safety to others and
the neighbouring community. If this is to occur its vital emotional
support is linked in prior to this occurring. (11)

Video: Lee Shuer
39
Lee lives in America with his wife Becca. Here Lee shares his experiences and
success to manage his hoarding tendencies.
Click on
green box
for video

Assessing risk
Hoarding and squalor environments pose risks for fire, physical falls,
collapse of buildings, poor sanitation and other health risks that
potentially affect people and animals. Mental health is also a risk
factor.
Risk includes:
Risk to self (person living in hoarding and/or squalor)
Risk to others (family, carers, dependents, animals)
Risk to workers
Risk to neighbours
Note:
Each organisation will also have their own risk assessment polices
and procedures that should be considered
40

Risk to workers
The following possibilities should be considered:
When managers/workers or supervisors are planning for workers to access a
dwelling, consider whether the environment is impacted upon by hoarding (which
would restrict movement) or squalor (which provides greater ability to walk
around, but may present organic concerns) or both hoarding and squalor which
would combine both considerations when planning worker protection and
support.
Before entering a squalid environment, workers would benefit by wearing
protective clothing (for example, gumboots or heavy waterproof shoes, overalls or
older clothing and disposable gloves if needed.
Workers may need to take clean newspapers for multiple uses (for example, to
cover chairs if workers want to sit down, for table tops, to wrap things in and so
on). Keep in mind that stepping in or over organic matter is likely to occur, and
that the risk of slips and falls is heightened.
Workers may only meet at the door or where they can visually see it is safe. This
may need to happen to assist first in building rapport. (1)
41

 Some workers will wear head protection of some kind (for example,
hats to protect themselves from fleas, if animals are involved) or
different types of face masks to allow the worker to breathe more
easily in dwellings with high ammonia levels (due, for example, to
high levels of animal urine or faeces
 In the case of a hoarding household or property, be aware of stacked
items (no matter how high), and don’t lean on them for support.
Make sure workers are instructed to always walk on the ground, and
not on scattered material. Workers also need to be aware of their
own safety with regard to electricity, gas and water.
 The fire risk inside a hoarding household is significant, and it is
recommended that smoke alarms are arranged to be installed inside
the home prior to the introduction of workers, including those
involved in large-scale removal. (1)
 Tools to assist with risk assessment will be discussed later in training 42
Risk to workers

Tools: ECCS
The Environmental Cleanliness and Clutter Scale (ECCS)
This scale rates the degree of various aspects of cleaning. Areas with varying
functions (such as toilet, kitchen, and bedroom) are rated, along with other
indicators of squalor (for example, odour, and vermin).
The ECCS can be used by workers to gain an objective rating of the degree of
squalor in a living environment. It also provides a measure of risk of entry for
workers.
Ratings (from none to severe) are indicated on a scale. A score greater than
12 usually indicates moderate to severe hoarding. (1)
Please watch this You Tube video from a self proclaimed Hoarder.
Activity: Based on video just watched- complete ECCS individually- discuss as
group
43

Tools: CIR
The Clutter Image Rating (CIR) Scale
The CIR scale was developed to overcome problems associated with
people who over-report or under-report the severity of hoarding
symptoms.
This tool is one of the most effective for objectivity recording the
change in clutter in the standards of room of the home (living room,
kitchen and bathroom).
To gain an accurate perspective of a clutter situation, this series of
nine pictures in each room was developed in various stages of clutter
from completely clutter free to very severely cluttered. (1)
44

Tools: CIR cont
The Clutter Image Rating (CIR) Scale (cont.)
People (either the person themselves, a worker or both together)
can select a picture in each sequence they think comes closest to the
clutter scale in the living room, kitchen and bedroom.
The decision requires some degree of judgment, because no two
rooms look exactly alike and clutter can be higher in some parts of the
room than others.
This rating scale works well to measure clutter. It also eliminates
reliance on language, enhancing ease of use.
In general, clutter reaches the level of picture #4 or higher impinges
enough on people’s lives that the person should be encourages to
seek assistance with hoarding behaviour. (1)
Activity: Based on video just watched, complete CIR individually-
group discussion.
45

Tools for assessing risk: fire
 Fires in hoarding homes increase the risk for the occupant,
their neighbours and firefighters. Metropolitan Fire Brigade
(MFB) research has identified that people who hoard aged
50+ are at particular risk and account for 24 per cent of all
preventable fire deaths between 1999 and 2009.
 MFB recommends that in the first instance, individuals or
agencies assisting those affected by hoarding should:
 Unblock exits
 Widen internal pathways
 Check utilities are connected
 Prioritise removing clutter from around cooking area and stove
tops, as 39 per cent of fires in hoarding homes result from
cooking
 Ensure clutter is removed from around heaters and electrical
items and discourage the use of open flame as combined these
factors account for 44 per cent of fires in hoarding homes (1)
46

Tools for assessing risk: fire
Hoarding and Fire Risk Flyer
Hoarding Fire Video
Advice from Fire Brigade is there is no legislation that workers
MUST notify the Fire Brigade if hoarding poses as a major fire
risk. It is suggested to minimise risk to the client and fire crew,
workers can notify Fire Brigade of the address. If
confidentiality is an issue, an anonymous notification can be
provided.
47

Practical strategies: language
48
 Seek to understand the hoarder’s perspective (i.e., be
curious)
 Asking instead of telling
 I see you have some books by the window here.
 What led you to put them here?
 I don’t see why you have books by the window.
They go on a book shelf. (4)

Use “I” statements to express your concern rather
than telling the person what to do
I’m concerned that if you don’t clear this area, you
won’t pass the next inspection
You have to clear this area or you’ll fail the next
inspection next inspection (4)
49

Match the person’s language
Avoid speaking about the person as a ‘hoarder’.
Match the person’s language:
E.g., Use their words (e.g., “collections” “things”)
Use respectful language
Avoid judgmental expressions, whether verbal (e.g.,
“trash”) or non verbal, be aware of body language (e.g.
facial expressions) (4)
50

Practical strategies: progress
Photos:
Using photos are an effective tool to show the person you are working with
progress that is being made.
Photos are also an effective tool to demonstrate to regulatory bodies progress
that is being made.
Photos can also assist in boosting motivation to demonstrate what the client has
previously achieved.
Photos can also be used as a tool to assess progress against the clutter image
rating scale.
Technology:
Use of computers can show that any information can be sourced, this can elevate
the stress of relinquishing literature/newspapers/magazines.
51

Practical strategies: progress
52
Kitchen after
Kitchen before

Practical strategies: work “hands
on”
 Working hands on with the person at a slow pace i.e.
pack 2 boxes a week to start cleaning entries and exits to
prevent churning
 Worker to take goods away ONLY with persons consent.
 You may clean with the client (if your role). You may
decide to work on entries and exits first.
 Set up “plans of action”. See example in training folder.
53

Practical strategies: sorting
Only Handle It Once (OHIO) Rule
If you pick something up, make a decision then and there about it, and either
put it where it belongs or discard it. Don’t fall into the trap of moving things from
one pile to another, again and again. (6)
Suggestions when assisting someone to work at discarding goods:
Keep/donate/maybe approach
Stickers- put difference coloured stickers on goods to keep/donate/throw away
54

Practical strategies: sorting
Questions to help with the sorting process
How many do I have, and is that enough?
Have I used this in the past year?
Do I have a specific plan to use the item again, in what timeframe?
Does this seem important just because I am looking at it now?
Is it current?
Is it of good quality, accurate, and/or reliable?
55

Practical strategies: maps
MAPS
Many people who hoard are extremely visual.
They often fear that if they put something away they will not remember where it
is because it is not out in the open. A trick could be to label the outside of a draw,
a storage bin, or create a map of where important items have been put away. (1)
Set guidelines for ‘helpers’
i.e. only disregard when client is present. May draw up an agreement as to what
can/can’t be thrown out. (8)
56

Practical strategies: rewards
Examples:
Take person out for lunch/to movies when reached a certain point (if your role
allows it, if now be creative on rewards).
Have the grandchildren over to play if there is a clear space.
Encourage the person to set personal rewards
i.e. once they have sorted for 10 minutes they can reward themselves.
57

Joint case coordination
Joint case coordination
One plan for all services involved if possible
See resources for tools to assist with joint case planning:
•Shared Support Plan
•Review of shared support plan
•Shared action plan check list
•Additional tools can be found at
http://www.health.vic.gov.au/pcps/sctt.htm to assist with joint
planning
Resource to find other services: www.hoardingresource.org.au
58

Supporting families/carers
Click on green
square for
video with
Becca Shuer.
(partner of Lee
Shuer)
59
Tips that may be helpful for families/carers see Resources for Helping
others with motivation. (7)

Supporting children
Working with children and hoarding
Children of people who hoard are also significantly effected.
Children may experience social isolation due to not being
able to have other children over and may have exclusion
from other family members due to inability to have visits.
May be child protective factors due to risk within the some.
As support is important to also support children around
these issues or refer to the most appropriate service.
There is a children's book around hoarding:
An Ordinary House- Written by Tania Reid.
Published by For Crowded House.
60

Caring for yourself?
 Have regular supervision with your
supervisor.
 Debrief with work colleagues regularly
where relevant.
 Know your limits.
 Seek advise when needed- when working
with hoarding and squalor you should not
be doing it alone.
 Adopt self care strategies such as:
• Taking regular leave
• External supervision
61

Client self help
Buried in treasures has a number of tools that can be used by clients (7)
Contract with yourself
Client to complete contract
Is my home Safe?
Client to complete to determine what safety issues need to be
addressed in house.
Home Environment Index
Client to complete to determine any sanitation issues
Are your daily activities impaired by hoarding?
Client to complete to determined impact of hoarding and/or squalor on
daily living
Weekly calendar, My Category List, My Preparing for Organizing Form.
Assist client with weekly planning for discarding of items/goal setting
More resources can be found in Buried in Treasures book (7)
62

Challenges
Lack of resources – not being able to pay for big clean
outs/industrial cleans or ongoing cleaning services is a
challenge for many people who do not qualify for very low
income programs.
Lack of counselors/psychologist- individuals trained to work
with people who hoard are limited.
Lack of reporting- first responders need to report to protective
services as a means of identifying people who are self-
neglecting. Without the initial report hoarding stays unknown
until a crisis happens, this is often when workers become
aware of the severity of the situation.
63

Hoarding knowledge and expertise
 This training has been developed using:
 existing resources around hoarding and squalor (paper and web based).
 lived experiences of Lee and Becca Shuer and other clients to compliment
training material from a client and carers perspective.
 Buried in Treasures resources.
 Hoarding and squalor specialists are available in Australia such as Dr Chris
Mogan, Tania Reid and many others.
64

References
1. Hoarding and Squalor: A practical resource for service providers
http://www.health.vic.gov.au/agedcare/publications/hoarding/hoarding_resource.pdf
2. Pathways to Dealing Effectively with Hoarding & Squalor in Australia
http://hoardingsqualorconference.com.au/2014/wp-content/uploads/2014/03/HS-Conference-Report-2014.pdf
3. Hoarding; a lethal fire risk
http://www.mfb.vic.gov.au/Community-Safety/Home-Fire-Safety/Hoarding-a-lethal-fire-risk.html
4. How to talk to someone with a hoarding problem
file:///C:/Documents%20and%20Settings/caddier/My
%20Documents/Downloads/How_to_Talk_to_Someone_with_Hoarding_Problem.pdf
5. Squalor Survivors
http://www.squalorsurvivors.com/pictures/index.shtml
6. World of Psychology
http://psychcentral.com/blog/archives/2011/03/19/compulsive-hoarding-and-6-tips-to-help/
7. Buried in Treasures
Tolin, D.F., Frost, R.O., Steketee, G. (2014) Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding, 2nd
edition. New York, Oxford University Press.
Buried in treasures downloadable tools
http://global.oup.com/us/companion.websites/umbrella/treatments/hidden/pdf/Tolin_Worksheets_Online_Final.pdf
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References
8. An Ordinary House
Reid, T. (2014) An Ordinary House. Australia, For the Crowded House.
An Ordinary House. Published by For the Crowded House, 2014. Author Tania Ried.
9. Hoarding Web Based Resource
Web based resources- www.hoardingresources.org.au.
10. Catholic Community Services: Squalor & Hoarding Toolkit
http://squalorandhoarding.catholiccommunityservices.com.au/getting-started/definitions-of-squalor-and-hoarding.
11. Discussion Paper :Hoarding & Squalor
http://www.health.vic.gov.au/agedcare/publications/hoarding/hoarding_squalor.pdf.
Training Video’s
Sunrise Interview- https://www.youtube.com/watch?v=HLYZb-Y_DjE
Hoarding Assessment Video- https://www.youtube.com/watch?v=EbZxjNRCm2o
Hoarding Fire Video- http://www.tlc.com/tv-shows/hoarding-buried-alive/videos/buried-alive-fire-in-the-kitchen/
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