Today’s post features an interview I did with Dr. Marla Deibler, a licensed Psychologist and the Director of the Center for Emotional Health of Greater Philadelphia.  She discusses her experience on the A&E program, “Hoarders,”  tells how she works with patients,  and shares helpful resources.

1.  What is your area of expertise and how long have you been practicing?

I am a licensed clinical psychologist who specializes in the treatment of anxiety disorders including obsessive-compulsive spectrum disorders, such as trichtotillomania (hair pulling) obsessive-compulsive disorder, and compulsive hoarding. My experience with these disorders began in 1999 at the nationally-recognized Behavior Therapy Center of Greater Washington; I then spent three years as a pre-IRTA research fellow studying obsessive compulsive spectrum disorders at the National Institute of Mental Health.  I am now the founder and director of The Center for Emotional Health of Greater Philadelphia, LLC, where I specialize in the treatment of these disorders.

2.  Who is your typical client?

I treat children, adolescents, and adults with a range of anxiety, mood, and adjustment disorders.  My typical client comes to me specifically seeking cognitive behavioral therapy for anxiety/panic, OCD, compulsive hoarding, or trichotillomania.

3.  You were recently on the A&E show, Hoarders. What was that experience like?

I was honored to have been invited to work with the show and very much enjoyed the experience.  I was particularly impressed with the respect, professionalism, and integrity of the show and its contributors.  Working with the show’s participant “Jill” and her family was very rewarding. Overall, the experience was extremely positive and I am looking forward to the opportunity to work with A&E’s Hoarders further.

4.  Do you continue working with the people profiled on Hoarders after filming ends?

Participants are offered aftercare, both psychotherapy and organizational services, following their participation on the show.  Some accept these services, while others do not.  We have found that those who accept aftercare therapy services tend to have better long-term outcomes. Although theoretically we could continue to work with the show’s participants after filming, this is not usually logistically possible.  Participants are chosen from around the country and the psychologists and organizers travel to them for the shoot.  If a participant lived near the psychologist or organizer on their shoot, I imagine follow-up services with those professionals could be arranged; however, our geography as well as our state(s) licensure preclude us from providing services outside of our area.

5.  Would you say the show accurately depicts the way you would normally work with a patient?  Do you tend to utilize a team approach?

The show is accurate in its depiction of a crisis intervention. Psychotherapy for compulsive hoarding would be longer-term and would involve a greater depth and variety of treatment components.  For example, for the show, we introduce ourselves to the participant, briefly discuss their situation and tour the home, provide them with education regarding compulsive hoarding and treatment, and then lead them through the two-day intervention in collaboration with the organizer, where we help the client to practice good decision making skills and work through their emotions.

Cognitive-Behavioral Therapy for compulsive hoarding involves helping individuals to change the way they think about and make decisions about their possessions in order to effectively control the behavior. This process involves a comprehensive behavioral assessment, psychoeducation, cognitive restructuring, exposure/response prevention, and excavation exposure. The individual must also be assessed for co-occurring psychopathology, as other psychological difficulties are common to compulsive hoarding such as anxiety, depression, bipolar disorder, and trauma. In these cases, their co-occurring difficulties must also be treated in order to effectively reduce/eliminate the hoarding behavior.

I do not typically have the luxury of working in collaboration with an organizer, although I very much enjoyed the experience of working collaboratively on “Hoarders.”  In fact, I have spent recent weeks getting to know organizers from the show and others who are experienced in chronic disorganization, as I value this team approach and would like to incorporate it into my work. I believe working collaboratively can have added benefit for the client.

6.  Do you involve a client’s family members during therapeutic sessions?

Whether I involve the client’s family members depends on the client and their particular situation.  If a client with compulsive hoarding is single and lives alone, I do not typically involve family members, unless the client requests to have such involvement.  If there are others living in the home, I may involve those family members, but not usually in the de-cluttering process.  I believe it is important to have family therapy sessions to address how the behavior has affected other family members, provide education, and improve communication. The de-cluttering process (excavation exposure) is important for the client to independently process and experience. Family members can complicate this process and pose additional challenges.

7.  How do you know when you’ve achieved success with a client?  Is it realistic for them to expect that their disorder will, at some point, permanently go away?

I like to work collaboratively with my clients. We use rating scales to rate their level of distress across anxiety-provoking situations and we continually assess and re-assess their progress, but ultimately, I view success by the improvement of the client’s mood and daily functioning.  I also hold open communication as my highest value in therapy; therefore, my clients are invited to provide feedback on a regular basis.

There is no “cure” for compulsive hoarding; thus, it is unlikely that an individual’s hoarding behaviors will entirely and permanently abate; however, treatment can help individuals with compulsive hoarding to effective control the behavior and prevent the behavior from impairing their functioning or the use of their home.

8.  Are there books or resources that you would recommend if someone wanted to get more information on specific types of illnesses, such as hoarding or obsessive-compulsive disorder (OCD)?

For information on the web about compulsive hoarding and OCD:

• http://www.ocfoundation.org
• http://childrenofhoarders.com
• http://thecenterforemotionalhealth.com
• http://compulsivehoarding.org

For the treatment of compulsive hoarding and OCD:

• http://thecenterforemotionalhealth.com (NJ, PA, DE)
• http://behaviortherapycenter.com (DC, MD, VA)
• http://lakesidecenter.org (MN)
• http://compulsivehoarding.org (CT)
• http://anxietytreatmentexperts.com (CA)
• http://biobehavioralinstitute.com (NY)

Recommended reading about compulsive hoarding and OCD:

• Tolin, D., Frost, R.O., & Steketee, G.  Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding. Oxford University Press:  2007.
• Steketee, G. & Frost, R.O.  Compulsive Hoarding and Acquiring.  Oxford University Press:  2006.
• Foa, E.  Stop Obsessing!: How to Overcome Your Obsessions and Compulsions. Bantam:  2001.

About Dr. Marla Deibler

Dr. Marla Deibler is the director of the Center for Emotional Health of Greater Philadelphia, LLC, and holds a doctorate in Clinical Psychology with a concentration in Health Psychology/Neuropsychology. She has gained experience at some of the finest institutions in the nation, including the National Institute of Mental Health at the National Institutes of Health, National Institute of Neurological Disorders and Stroke, Children’s National Medical Center, and the Kennedy Krieger Institute at Johns Hopkins University Medical Center.

Dr. Deibler holds licenses to practice psychology in New Jersey (Lic. No. 35S100438000) and Pennsylvania (Lic. No. PS0157790). She has presented her works at regional, national, and international meetings and has published her work in peer-reviewed scientific journals and books. Dr. Deibler is a member of the International OCD Foundation (formerly the Obsessive Compulsive Foundation), Trichotillomania Learning Center, and the Anxiety Disorders Association of America and has been involved in working with the Obsessive-Compulsive Spectrum Disorders community since 1999. She has also appeared on A&E’s Hoarders.

Connect With Dr. Deibler: Web |E-mail | Facebook | Twitter | 856.220.9672

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