Once a hoarder cleans their home, the process if far from over. We can't take a bottle from an alcoholic and think their problems are solved. Remember that hoarding is a psychological disorder, and like all disorders it is a disorder for life. This doesn't mean a hoarder will return to clutter, it just means they need to educate themselves, and then manage the disorder indefinitely. There are many steps that we can set up for the hoarder and they can set up for themselves. If these steps are followed there is a much better chance the hoarder will live a clutter free life. Therapy is an ongoing need for a hoarder. Once they discover the underlying causes of their hoarding, the therapist will need to continue to work on those issues for months or even years. Remember that hoarding typically happen over years, so we can't expect the problem to be repaired in a couple weeks. Other programs to put in place are regular house cleaning from an outside agency. This service can be weekly. every other week, or even monthly. The importance of maintaining the clean home is imparitive. I also suggest giving the cleaning crew a couple phone numbers for emergency contacts so if they see the clutter returning, they can make a phone call and get family, friends or even the therapist involved quickly before the clutter can become anything close to serious again. Another important item that must be replaced in a hoarders life after the cleanup is social interaction. You need to find social events that they can get involved with to find friends and activities to keep them happy an involved. This helps make them feel worthy and brings joy into their lives that they probably have given up on up until this point. They need to also have systems in place to help with basic functions of daily life should they need assistance. Home health and home services for things like meals, errands, chores and other basics can be provided. This will also put another checks and balances in place if clutter starts to return. There may also be the need to repair damage caused to the home by hoarding, or the replacement/repair of appliances, toilets, heating or air conditioning. All of these things will bring the hoarders life back to normal once again and will hopefully provide that spark for the zest of life they somehow lost along the way while providing a safety net should they slip back to old ways.