Den här kvalitativa studien syftar till att undersöka socialarbetares erfarenheter av att arbeta med patologiska samlare, med fokus på vilka socialpsykologiska faktorer som kan tänkas ha betydelse för att främja samarbete. Fjorton intervjuer har genomförts med socialarbetare som arbetar inom socialpsykiatrin inom olika stadsdelsförvaltningar inom Stockholms län. Resultatet har analyserats med hjälp av attributionsteori, samspelsinriktad teori och strukturell teori. Resultatet visar på att det finns flera faktorer som påverkar samarbetet med patologiska samlare. Samarbete upplevs vara avgörande för att den patologiska samlaren ska göra framsteg och det är också viktigt att yrkesverksamma är eniga kring hur man ska angripa problemet. Socialarbetarna betonar olika strategier för att bygga relation med klienten, som i många fall går utöver den konventionella handläggarrollen. Socialarbetarna är överens om att det är viktigt att gå försiktigt fram samt att låta processen ta tid. Socialarbetarna understryker betydelsen av att vara finkänslig men samtidigt tydlig med klienten. De framhåller att balansen mellan att vara finkänslig och tydlig är svår eftersom det har hänt att klienterna blivit kränkta när socialarbetarna reagerat vid möten. Socialarbetarna framhåller svårigheten att kunna hjälpa klienter som inte vill, varav den fria viljan kan sätta stopp för att kunna hjälpa klienterna. Samtidigt framhåller de att frivilligheten inte alltid ter sig frivillig när det föreligger underliggande vräkningshot. / This qualitative study aims to examine social workers experiences of working with hoarders, focusing on what social psychological factors may be thought to play a role in promoting collaboration. Fourteen interviews have been conducted with social workers in social psychiatry units in various districts of Stockholm county. The results have been analyzed using attribution theory, interaction theory and structural theory. The results show that there are several factors that affect the collaboration with the hoarder. Collaboration is considered vital for the hoarder to make progress and it is also important that there is consensus among professionals about how to approach the problem. Social workers experience a strong resistance in working with clients, which places high demands on the professional role to be persistent and patient. The social workers in this study emphasize different strategies for building relationships with the client, which in many cases go beyond the conventional role of the social worker. The social workers agree that it is important to proceed cautiously and allow the process to take time. The social workers in this study emphasize that it is important to think about being sensitive and at the same time direct with the client. They believe that the balance between being sensitive and direct is difficult as they have experienced that the clients has been offended by them showing strong reactions. The social workers emphasize the difficulty of being able to help clients that do not want to, of which the free will can create problems to be able to help the clients. At the same time, they point out that voluntary is not always voluntary when there are underlying eviction threats.

Hoarding disorder is a mental illness that affects about 2-5 % of the population. The most prominent symptoms of hoarding disorder are the inability to discard things and the excessive acquisition of possessions. The home becomes cluttered, often to the point where one no longer can use the rooms for their intended purposes. For example, one can no longer sleep in the bed or use the kitchen for cooking because of the clutter that takes up space. People with hoarding disorder often experience shame because of their disability and as a consequence they withdraw from social engagements and risk isolation. The purpose of this study was to give a literary review of treatment methods for hoarding disorder and their efficacy in Swedish, but also to show the impact of shame on treatment effect through Thomas Scheff’s theory of shame. The primary treatment method is Cognitive behavioral therapy designed especially for hoarding disorder, and has been tested in different forms such as individual-, group-, and internet based treatment. New treatments using Compassion-focused therapy and Acceptance and commitment therapy have also been developed. Studies on hoarding disorder and shame have shown a correlation between shame, symptom severity and identity. These new treatments address the shame experienced and they can hopefully increase the efficacy rate for hoarding treatment. Important factors for treatment progress were, among others, continued high motivation, frequent contact with clinician and a supportive family. A surprising result was that one study showed almost equal result in treatment led by a non-professional as a professional. More research is needed to further develop effective treatment.