Book excerpt: The cat lady. The couple who won't let anyone in their apartment. The old man with all that junk in his yard. Their severe hoarding puts them, and often others, at risk for injury, disease, and even death. Most deny needing help, and for this reason, professionals are desperate to find more effective ways to offer and provide assistance to them. In response to this growing public health problem, Clinician's Guide to Severe Hoarding refines our understanding and presents in depth and innovative alternative to traditional interventions. Arguing that although treatment for hoarding can be effective for those who are open to help, people with severe hoarding are not. The Clinician’s Guide to Severe Hoarding describes an alternative strategy to help those who adamantly refuse help and yet face significant health and safety risks due to the hoarding problem – harm reduction. This client-centered approach takes readers through harm reduction plan development, team building, goal setting, client collaboration, and progress assessment. The Clinician’s Guide also explains that a successful harm reduction plan may encourage clients to seek further help, and offers insights into working with special populations such as people who hoard animals and children who exhibit hoarding behavior. The Clinician's Guide describes in detail a range of strategies for assisting people with severe hoarding: Strategies for engaging with clients who hoard. Guidelines for assessing harm potential. Guidelines for creating a harm reduction plan, building a harm reduction team, and conducting and evaluating home visits. Skills for client self-help: decision making, time management, and more. Guidelines for navigating the ethical and legal issues that arise in assisting people who hoard. Readings, links, and other resources. With its practical common-sense approach to a complex problem, Clinician's Guide to Severe Hoarding is a unique volume not only for mental health practitioners, but also other professionals who assist people who hoard, such as home health aides, social workers, and professional organizers.