Self-Neglect and Hoarding by Deborah Barnett

Author:Deborah Barnett
Language: eng
Format: epub
ISBN: 9781784505691
Publisher: Jessica Kingsley Publishers
Published: 2018-01-27T16:00:00+00:00

Solution-focused assessment

The miracle question can be used in many different ways, for example to discover how a person would like to live, what they aspire to be or do and what they woud like to achieve.

Figure 5.3: The miracle question

Figure 5.4: The exception question

This question may be phrased differently to establish when the person did not:

• have clutter – can you recall a time when you were able to stop collecting and when you could move around the house? What was different, what were you doing, how did you feel, what did you see?

• feel anxious – can you recall a time when you did not feel anxious and you felt safe and secure? What was different, what were you doing, how did you feel, what did you see?

Consider the exception question in any situation where it would be helpful to determine whether the person has managed things effectively in the past, even if it was only for a brief period of time. Exploring what was different then and how the person explains why the problem did not happen is insightful. It may also be helpful to ask how it was possible for the person to achieve that and how they did it. Scaling can be helpful to understand how important things are or how affected the person is by a situation. For example, on a scale of 0–10, how important is…to you? How anxious does that make you feel? How frightened are you? How lonely does that make you feel?

A seven-step model of solution-focused therapy was developed to consider the process of change (Visser 2013). It may be helpful when working with someone self-neglecting and hoarding who wants to change but is struggling. This should be completed only when the person feels ready and comfortable.

Clarify the desire for change

• Establish what has evoked that desire.

• Is this the presence of something positive or negative, for example a desire to reconnect with family or to prevent eviction?

• Acknowledge any difficulties or problems and how those problems came about to better understand the desire for change.

Define the desired state

• Help the person to describe this as vividly as possible and as positively as possible.

• It may be helpful to use story boards, for example ask the person to find pictures of how they would like their shelves to look. Create a mood board for how they would like their room to look.

• Identify how they would like things to be different and what the advantages would be for example ‘If your shelves looked like this, what difference would that make? What could you do that you can’t do now?’

Determine the platform

• The platform is the current state of play, the situation, the place in which change begins to move towards the desired state.

• Sometimes people like to take photographs when they are at the beginning of a change process. When they lose commitment or motivation to move forward the photographs are useful reflection tools to identify how much progress has been made.

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