Buried in Treasures (BiT) Group Application, February 2020 Cohort
Thank you for your interest in joining the Buried in Treasures clutter skill-building and support group!
This group was developed to address moderate to severe cluttering behaviors. The questions on this application will help us to determine whether the group is likely to be a good match for your needs. Please answer honestly; this is not a test, there are no right or wrong answers, and no questions will automatically qualify or disqualify you from participation.
We may follow up with additional questions for you, so please make sure to provide up-to-date contact information. You are also welcome to contact us with additional questions at any time; you can reach Jules Plumadore, PEERS Senior Programs Manager, by email at
, or by phone at 510-567-7612.
Our group begins in February 2020 (date TBD).
Please tell us your name.
Please give us the contact information you would prefer us to use for you (phone or email).
Where did you hear about PEERS' BiT group?
Flyer posted in the community
Another PEERS Group
On a scale of 1 - 10, how would you rate your current level of clutter? (1 is no clutter at all; 5 is enough clutter to make it difficult to use areas of your home for their intended purpose; 10 is enough clutter to put you at risk of eviction.)
Are any of the following true for you?
Clutter causes strain on my personal relationships.
Clutter creates health and/or safety hazards in my home.
Clutter limits my ability to use my living space for its intended purpose.
Clutter threatens my housing security/puts me at risk of eviction.
Clutter isolates me.
None of these statements is true for me.
How do you feel about your clutter? (Please check all that apply.)
My clutter gives me a sense of security.
My clutter represents parts of who I am/things I value about myself.
My clutter makes me feel ashamed.
My clutter makes me feel prepared.
The thought of getting rid of my clutter makes me feel anxious.
I feel deeply attached to my clutter.
When I think about my clutter, I feel overwhelmed.
I am afraid of throwing something important out by mistake.
I feel like my clutter helps me to remember things I would otherwise forget.
I worry about other people finding out how much clutter I really have.
What is your motivation for seeking clutter support? (Please check all that apply.)
I want to do it to make things better for myself.
I want to do it for other people in my life.
I am worried about negative consequences (eviction, isolation, injury, etc.) if I don't get support.
Someone (landlord, family member, therapist, etc.) told me I need to get support.
I don't know but I just can't live like this anymore.
How motivated are you to change your cluttering behaviors?
Not very motivated
Not at all motivated
How confident are you in your ability to learn new skills to manage your clutter?
Not very confident
Not at all confident
How open are you to sharing your challenges with clutter to others in a group setting?
Not very open
Not at all open
I have tried other clutter support options in the past.
I am willing to put in an average of 2 extra hours a week outside of group sessions to practice clutter management skills.
Is there anything else you'd like for us to know about you, your current situation, or your relationship to clutter?
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