C.H.E.S.S. | Clutter and Hoarding Evaluation and Supportive Services Program
C.H.E.S.S. is a collaboration between several community agencies including Brookline Health Department, Brookline Council on Aging, mental health providers and first responders (police and fire) with additional agency input and participation as needed. C.H.E.S.S. has grown out of long standing interagency relationships, including the Hoarding Task Force (HTF), to bring supportive responses to residents with complex mental health and public health related challenges.
GOALS OF C.H.E.S.S.
The goals of the C.H.E.S.S. Program include:
- Increased community capacity for respectful, empathic, collaborative responses to address issues related to clutter accumulation for Brookline residents.
- Increased access to resources, education, referrals, and training for residents/families.
- Increased interagency staff support, consultation, access to resources and development of preventive, collaborative intervention/support strategies.
OVERACCUMULATION: DIFFICULTY DISCARDING AND HOARDING RELATED CHALLENGES
Issues of overaccumulation are not always hoarding disorder – careful assessment, destigmatizing language, collaborative interventions, and thoughtful strategies are essential to building working relationships between residents/families experiencing challenges and providers enlisted to support and assist with addressing environmental challenges. The evolution of the Hoarding Task Force to CHESS (Clutter and Hoarding Evaluation and Supportive Services) Program acknowledges this important component and has moved to reflect this in our name.
Hoarding disorder is a complex problem that can cause challenges for individuals, families, human service agencies, housing complexes, and general public health. Understanding this syndrome and its features are critical to developing effective, collaborative, respectful interventions and triage responses based on severity and harm reduction approach for sustainable progress across systems (Bratiotis, Steketee, 2011).
BENEFITS OF DOWNSIZING AND DECLUTTERING
An organized house...
- Is easier to clean! Dusting, wiping down counter tops, sweeping, and vacuuming are all easier and quicker to complete when your living space is clear of clutter.
- Is easier to navigate! Piles of clutter around your home pose many safety risks, including fire hazards and fall risks. Keeping your walkways and rooms clear of clutter significantly reduces safety risks and slipping hazards.
- Helps you focus! When you live in a clutter environment, it can feel as though the walls are closing in around you. When you do have the motivation to start a task, it’s hard to figure out where to start. Reducing clutter around your space can help focus your mind and get things done.
- Saves you money! When your home is cluttered and disorganized, you can forget what you already have! When your items are organized, you won’t need to go out and buy another umbrella, backpack, or phone charger because you will already know where your things are.
- Can lift your spirits! Going through your items can provide an opportunity to rediscover your treasures and focus on what is truly important.
- Can help your community! Passing along unwanted or unneeded items to a charity of your choice can help benefit your community. Charities such as Big Brother, Big Sister, Dress for Success, and the American Red Cross all accept clothing donations. Additionally, More Than Words accepts book donations to help empower struggling young adults with entrepreneurial skills.
- It doesn’t matter where you start! You may feel more motivated to start in a room that you use more often, but it is up to you. The best place to start is wherever you want to!
- Break projects down into manageable parts. For example, you can sort through one drawer at a time instead of tackling the whole dresser. Clear off the kitchen table instead of starting with the whole kitchen. Finishing a small task can help motivate you to keep working!
- Schedule a fixed amount of time to work on your task. Decluttering requires not just work, but decision making, which can be tiring and overwhelming. If you burn yourself out in one day, you will be less likely to stick to the process.
- Employ a “one-touch” rule. Only handle an item once to decide whether you should keep it, donate it, or trash it. There is no “I’ll decide later” pile. As challenging as it may be, you must make a commitment to yourself that you will not second guess your decisions. Respect your own judgement!
- Ask for help! Depending on the size of the job, it may be too overwhelming for you to handle on your own. Asking for help is a reflection of strength and willingness to seek positive change.
TASK FORCE MATERIALS
Materials developed by the C.H.E.S.S. Team:
ADDITIONAL INFORMATION & RESOURCES
Additional clutter and hoarding resources:
- Hoarding: What Everyone Needs to Know
- Mass Housing Statewide Steering and Task Force Consortium
- Mass Housing | Hoarding Resources
- Mutual Support Resources
- Newton Massachusetts Hoarding Task Force
- The Hoarding Handbook
Resources for clinicians treating patients with hoarding disorder:
- Article: “Coordinated Community-Based Hoarding Interventions: Evidence of Case Management Practices”
- Boston University School of Social Work | Hoarding Research Project
- Boston University Training Class (for Older Adults)
- Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding (Treatments That Work) by David Tolin, Randy O. Frost, Gail Steketee
- CBT for Hoarding Disorder: A Group Therapy Program Workbook by David F. Tolin, Blaise L. Worden, Bethany M. Wootton, Christina M. Gilliam
- Digging Out: Helping Your Loved One Manage Hoarding, Clutter and Compulsive Acquiring by Michael A. Thompkins
- IOCDF International OCD Foundation | Hoarding Disorder
- Treatment for Hoarding Disorder: Therapist Guide (Treatments That Work) by Gail Steketee, Randy Frost
PUBLIC HEALTH STANDARD CODES
State codes related to hoarding:
- Codes relating to hoarding - Sanitary 105 CMR 410.000
- Hoarding Code Regulations Summary
- Mass Housing Statewide Steering and Task Force Consortium
- Potentially Condemnable Conditions
- Thinking Outside Our Box(es) Health Codes
ENVIRONMENTAL ASSESSMENT TOOLS
Hoarding assessment tools:
CLEANING AND HEAVY CHORE RESOURCES
NOTE: These resources should be used in collaboration with resident as much as safely possible.
- Houseworks | 617-928-1010, clutter removal and heavy cleaning/sanitization
- Lug Away | 617-893-9824, clutter hauling service
- Bio-One | 617-539-2709, only clean biohazard scenes including blood, urine/feces, rodent infestations, etc.