Examining the Role of Fire Prevention on Hoarding Response Teams: Vancouver Fire and Rescue Services as a Case Study

Kwok, Navio; Bratiotis, Christiana; Luu, May; Lauster, Nathanael; Kysow, Kate; Woody, Sheila R.

doi:10.1007/s10694-017-0672-0

Cited by 15 publications

(12 citation statements)

References 16 publications

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“…Limited resources did not permit the team a budget for decluttering services or maintenance visits to monitor for setbacks. In addition, assessments were limited to the CIR and violations of the fire code (see Kwok et al, ). Other communities may prefer a more thorough assessment battery, including the Uniform Inspection Checklist (Mathews, ) or the HOMES Multi‐Disciplinary Hoarding Risk Assessment (Bratiotis et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Bratiotis () has described processes that community agencies use to develop hoarding task forces to collaborate on issues related to hoarding. More recently, Kwok et al () described the role of fire prevention on a dedicated hoarding response team in Vancouver, finding that hoarding cases involving fire code violations take longer to resolve than do typical fire code cases (i.e. restaurant inspections).…”

Section: Introductionmentioning

confidence: 99%

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How can cities tackle hoarding? Examining an intervention program bringing together fire and health authorities in Vancouver

Kysow

Bratiotis

Lauster

et al. 2020

Health Soc Care Community

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Hoarded homes can pose a threat to public safety, with heightened risks of fire hazards, pest infestations and noxious odours in both the home and neighbouring dwellings. Communities across North America are responding to these public safety concerns through a harm reduction approach. This descriptive study explores the implementation and outcomes of the City of Vancouver's approach involving a partnership between fire prevention and public health. Data were collected from the team's 2016–2018 case tracking systems, consisting of health records and team intervention record, as well as notes taken from case briefing meetings. Study objectives included describing the intervention model, providing descriptive statistics on clients and their clutter volume, the interventions undertaken, and exploring predictors of clutter volume and case outcome through exploratory analyses. The sample included 82 cases involving severely hoarded conditions or more moderate hoarding conditions paired with additional client vulnerabilities (e.g. health conditions, frailty). Results from paired samples t‐tests and regression analysis, suggest the Hoarding Action Response Team's (HART) model of a community‐based intervention for hoarding was associated with clutter reduction and tenancy preservation. HART successfully maintained engagement with most clients, and most cases were closed within six home visits. Despite these successes, the team dealt with several barriers including client avoidance and limited resources. This paper provides guidance for communities who are working to develop a coordinated response to problems associated with hoarding and begins to establish expectations for what can be achieved through a community‐based hoarding intervention model.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

How can cities tackle hoarding? Examining an intervention program bringing together fire and health authorities in Vancouver

Kysow

Bratiotis

Lauster

et al. 2020

Health Soc Care Community

Self Cite

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“…Thus, instead of relying solely on measures like the Clutter Image Rating Scale to initially assess hoarding problems, clinicians should also assess for the presence of safety hazards. Previous harm reduction studies have relied on fire officers to make assessments based on local fire safety codes (Kwok, Bratiotis, et al, 2018; Kysow et al, 2020). Because fire safety codes vary internationally, it may be better to use a standardized checklist to assess home safety (e.g., Carter et al, 1997; Metchikian et al, 1999; Watson et al, 2003).…”

Section: Suggestions For Improving Hd Treatment Outcomesmentioning

confidence: 99%

A critical review of cognitive behavioural therapy for hoarding disorder: How can we improve outcomes?

David

Crone

Norberg

2021

Clin Psychology and Psychoth

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Psychological treatment for hoarding problems has historically been associated with poor outcomes. When treated as a subgroup of obsessive-compulsive disorder, individuals with hoarding beliefs were less likely to respond to treatment than individuals exhibiting other obsessive-compulsive beliefs and behaviours. When treated as its own disorder using cognitive behavioural therapy, individuals report approximately 25% improvement in symptoms on average. However, less than a third of people experience clinically meaningful change. Further, changes in functioning and quality of life are not routinely assessed. In this paper, we review the current conceptualization and treatment of hoarding problems to shed light on how treatment for hoarding disorder may be improved. Utilizing a harm reduction approach before administering treatment may be important to ensure the safety of individuals. Research should test whether treatment outcomes improve by including strategies that enhance a client's interpersonal functioning and ability to regulate emotions (i.e., based on dialectal behaviour therapy and mentalization-based treatments), especially while discarding and organizing belongings. We should also use modern learning theory to improve the delivery of exposure activities.

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“…Public health officers surveyed in this study rated these hoarding cases as representing a moderate to serious public health concern, and a serious threat to personal health. In Canada, data were collected from Vancouver Fire and Rescue Services regarding inspections of 421 residences where hoarding was indicated (Kwok et al, 2017). Of the residents where this information was available, 59% were male, the mean age was 64 years, 73% lived in multifamily dwellings, and 63% were tenants who were not homeowners.…”

Section: Introductionmentioning

confidence: 99%

Investigating the cognitive and emotional features of hoarding disorder using virtual reality

McCabe-Bennett¹

2021

Preprint

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Hoarding disorder was recently recognized as a mental disorder. It is characterized by difficulty discarding objects and excessive clutter limiting the functionality of living spaces in the home. Hoarding represents a considerable public and personal health concern, but there is still much that is unknown about its development and maintenance. Furthermore, current psychological treatments provide only modest outcomes. The present dissertation examined two key aspects of the cognitive-behavioural model of hoarding: information processing (i.e., memory, attention, decision making, categorization; Study 1) and emotional features (i.e., emotional intensity, experiential avoidance; Study 2). Exploratory questions concerning preference for cluttered spaces were also examined (Study 3). Three novel virtual reality (VR) environments were developed to examine these components with improved ecological validity. Two groups (i.e., with hoarding disorder, n = 36; without hoarding disorder, n = 40) similar in age and gender were recruited from the community. In Study 1, participants completed a series of standardized and novel VR memory and decision making tasks, and created a categorization strategy for objects in a messy VR home office. Higher attentional difficulties, poorer category efficiency, and poorer trait, but not state, memory confidence was reported in the hoarding group. Indecisiveness was positively correlated with perfectionism. There was no evidence of memory and decision making impairments specific to the hoarding group. In Study 2, participants engaged in two VR shopping trips following a negative or neutral mood induction. The hoarding group acquired more objects and at a faster rate than the nonhoarding group, and discarded fewer objects following the negative mood induction. There were no group differences on emotional intensity, but the hoarding group demonstrated higher emotional reactivity and experiential avoidance. In Study 3, reactions to different levels of clutter were observed using a VR living room that became progressively more cluttered. There were no differences in subjective or physiological reactivity to increasing clutter levels. The hoarding group reported a preference for slightly more cluttered rooms; however, they also reported higher claustrophobic fear. Results from this research advance our understanding of the cognitive-behavioural components of hoarding and offer implications for future treatment and VR research initiatives.

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Examining the Role of Fire Prevention on Hoarding Response Teams: Vancouver Fire and Rescue Services as a Case Study

Cited by 15 publications

References 16 publications

How can cities tackle hoarding? Examining an intervention program bringing together fire and health authorities in Vancouver

How can cities tackle hoarding? Examining an intervention program bringing together fire and health authorities in Vancouver

A critical review of cognitive behavioural therapy for hoarding disorder: How can we improve outcomes?

Investigating the cognitive and emotional features of hoarding disorder using virtual reality

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