Medicare supplementing costs for those eligible for services provided by North Shore Center for Hoarding & Cluttering (NSCHC)
Eileen Dacey is our new Clinical Hoarding Specialist. Although new to this role, Eileen had previously been involved as a graduate level intern for ten months in the Hoarding & Cluttering program at North Shore Elder Services (NSES). She also volunteered for the program during the summer of 2016. This past May, Eileen graduated from Simmons College with her Masters of Social Work.
After completing her Bachelor of Science degree in Psychology at the University of North Florida, Eileen moved to Massachusetts where she worked as a case manager for another Aging Services Access Point (ASAP) agency. Eileen encountered many situations that involved cluttering. She felt overwhelmed with not knowing how to address the issue with clients.
Wanting to understand more about hoarding, Eileen attended the first Hoarding Conference run by NSCHC. There she met Marnie Matthews, NSES’ Clinical Hoarding Specialist and engaged in conversation with Marnie. That meeting struck a chord with Eileen. Once accepted into the Master’s program at Simmons, it was the motivation behind Eileen wanting to do an internship at NSES. At the time, NSES was not affiliated with the social work program at Simmons. Eileen successfully worked out the details and an internship was born.
That internship solidified Eileen’s interest in the field. She had found her calling. Specializing in mental health and addiction was a good match for the hoarding program.
Eileen shared some exciting news recently. The Hoarding program will be billing Medicare for those eligible to participate in group sessions and individual counseling services offered through the program. This will allow the program to be more accessible. Eileen’s long-range goal is to expand the program and down the road be able to bill other secondary insurances.
We interviewed Eileen to find out more about the Hoarding & Cluttering program at NSES.
- Can you explain what hoarding is?
“It is important to understand that hoarding is NOT about the stuff. It is a progressive and chronic condition. We do not know what causes hoarding disorder. As of 2014, hoarding disorder is categorized as its own distinct mental health disorder. Those with the disorder commonly have one or more co-occurring psychiatric conditions, like depression, ADHD, Anxiety, and OCD.”
- How are people referred to the program at NSES?
“A good number of referrals are self-referrals, with someone identifying himself or herself as needing help. As the program gains recognition, there are more referrals coming from physicians, housing agencies, and other community partners. We also have a number of family members or caregivers who recognize the disorder and call on the behalf of someone.”
- How is it determined that someone is eligible for services through the program?
“Firstly, it is not a pre-requisite that a person has a diagnosis of hoarding disorder. We see varying levels of hoarding behaviors. We have no age or geographic restrictions. That makes our program different. I do a careful screening with the first phone call. I discuss all the services we offer, along with the cost involved. I try to gage where the person is at in their goal of receiving help. I also conduct an initial assessment, whether in the home or in the office, regardless of someone wanting to begin with individual counseling or group sessions.”
- What takes place during this initial assessment?
“I focus on the person, not the stuff. I want to develop a relationship and build a rapport with the person first. I use the Uniform Inspection Checklist, which provides an objective stance and focuses on safety. It allows us to stay focused on specifics. The checklist raises awareness and often insight into areas where someone can improve upon. It provides areas where someone can start with.” You can view the checklist at https://nselder.org/uniform-inspection-checklist/
- What follow-up is there after the initial assessment?
“It depends solely on what the person wants. We have to determine together what works best for the client. Sometimes it involves weekly visits. We establish if someone is ready to participate, whether with individual counseling or group sessions. I discuss what personal goals the client has and develop a treatment plan. A typical treatment should last three months.”
- What services does the program offer?
“We offer ten week support groups which focus on underlying issues and triggers. We work on strategies for managing behavior and maintaining progress in a skill-based group. These groups are offered year round. The next group starts Wednesday, September 27 and Friday, September 29.” See the flyer for more information at https://nselder.org/wp-content/uploads/2015/08/Group-Flyers-8.25.17.jpg
“We also now have a support group twice a year for family members or those who identify themselves as a caregiver to the person with the hoarding problem. This group is a structured model with a specific curriculum. The group runs for four weeks.”
“We conduct a thorough screening process for our different groups.”
“There is individual and family counseling sessions that also involve teaching skills and strategies for managing behavior and maintaining progress.”
“Crisis Case Management is another service we offer. After an assessment of the home and individual, a collaborative plan is developed to resolve safety issues in the home. This is a client-centered multi-disciplinary team approach. This program does not emphasize clean ups or organizational services. If someone is interested in these types of services, one may contact our program and we will provide connections with the appropriate community resources.”
“Professional educational trainings tailored to specific audience are offered.”
- What cost is there for the various services offered?
Family Support Group: $40.00 for 4 weeks
Support Group for Individuals: $250 for 10 weeks
Individual & Family Counseling: $100.00 per session
Crisis Case management: $100.00 per hour
- What goals do you have for the program?
“I would like to see the program expanded so we can offer services to more people. The Medicare billing will be instrumental in helping more people. Down the road we hope to be able to bill other insurances as well.”
“One topic I would like to explore more and include in discussions is the issue of animal hoarding. I would like to provide more education about what someone does when encountering this.”
- What kind of treatment is available?
“Cognitive Behavior Therapy (CBT) is the only psychological treatment that has been studied in the treatment of hoarding. Treatment focuses on behavior modification and skills development, like sorting and discarding. We always have open discussion about progress and regression. It is important to anticipate regression and to maintain the momentum towards progress.”
- What is the process to refer to the program?
“There is a referral form that can be found on our website ( https://nselder.org/north-shore-center-for-hoarding-cluttering-referral-form/). We need to have a completed referral form. If you have questions about the form, you can call NSES and check with Information Services.”
The most important thing Eileen wants those dealing with a hoarding disorder to know is that there is help available. “The value of my profession is to help people help themselves to see their potential.”
If you are interested in a support group, the groups start September 27 and 29th. Check our website to learn more about the North Shore Center for Hoarding & Cluttering at North Shore Elder Services https://nselder.org/north-shore-center-for-hoarding-decluttering/ or check out our blogs at https://nselder.org/hoarding/