Understanding Hoarding

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Publisher : Sheldon Press
ISBN 13 : 1529375576
Total Pages : 160 pages
Book Rating : 4.5/5 (293 download)

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Book Synopsis Understanding Hoarding by : Jo Cooke

Download or read book Understanding Hoarding written by Jo Cooke and published by Sheldon Press. This book was released on 2021-05-13 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt: If you are living with, are close to, or are yourself someone who is hoarding, you'll know that the disorder goes far deeper than most people realise, affecting the whole family and presenting huge challenges to the physical, mental, emotional and even financial wellbeing of anyone involved. Jo Cooke is Director of one of the UK's leading support services for people affected by hoarding and clutter, and has written this sensitive and empathetic book to help anyone experiencing hoarding difficulties. She gives insight into Hoarding Disorder - explaining what it is and, importantly, what it isn't - and what may trigger hoarding. There are strategies for how to assess the scale of situation and lay the groundwork to address it, and insights into who can help and how they can do it. An 8 step-plan gives practical steps to tackle the hoarding, supported by suggestions for what to do with the 'stuff', and advice on safeguarding - as well as techniques to support the hoarder as they attempt to stay clutter-free. There is space in the book for individuals and their own stories of hoarding, giving an empowering voice to people affected by the condition, and replacing the morbid curiosity that often accompanies it. With plenty of information on resources and therapies that can help, this is a warm and hugely practical guide that can only help anyone affected in any way by hoarding.

Understanding Hoarding

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Author :
Publisher : Sheldon Press
ISBN 13 : 1847094546
Total Pages : 128 pages
Book Rating : 4.8/5 (47 download)

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Book Synopsis Understanding Hoarding by : Jo Cooke

Download or read book Understanding Hoarding written by Jo Cooke and published by Sheldon Press. This book was released on 2017-05-18 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hoarding can make life a misery for individuals and their families, affecting health and lifestyle, and posing a significant risk of fire and other dangers. Research suggests that 25% of accidental domestic fire deaths involve hoarding. Hoarding affects the whole family, making it difficult to receive social visits and in extreme cases, affecting living space and basic freedoms such as space in which to do homework or even sleep. Other challenges in hoarded homes can include restricted entry and exit, difficulties gaining access to gas and electricity areas, water leaks, mould, and rat and other infestations. Financial implications may include not having access to paperwork, leading to unpaid bills and other complications. Previously viewed as part of obsessive-compulsive disorder, hoarding disorder was recognised as a mental health disorder in its own right within the Diagnostic and Statistical Manual of Mental Disorders (DSM) in May 2013. This book aims to help those who are affected by hoarding difficulties, including friends and family. Topics include: What is Hoarding Disorder - the five diagnostic criteria What triggers hoarding - abuse, bereavement, childhood issues, and so on Who can help a hoarder and how to help How to assess clutter Why an intense clear-out doesn't work Taking steps to deal with it - an 8-step plan Where does my stuff go? Safeguarding - working with local councils and social services Therapies and resources Case histories

Buried in Treasures

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Author :
Publisher : Oxford University Press
ISBN 13 : 0199329273
Total Pages : 200 pages
Book Rating : 4.1/5 (993 download)

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Book Synopsis Buried in Treasures by : David Tolin

Download or read book Buried in Treasures written by David Tolin and published by Oxford University Press. This book was released on 2013-10-18 with total page 200 pages. Available in PDF, EPUB and Kindle. Book excerpt: While most people find it relatively easy to manage their possessions, some find it extremely difficult. If you have a problem resisting the urge to acquire and you find your home cluttered and filled to capacity with items many people would find useless and unnecessary, you may suffer from a condition known as hoarding disorder. Hoarding is a behavioral problem consisting of clutter, difficulty discarding items, and excessive buying or acquiring. Hoarding is often associated with significant reduction in quality of life, and in extreme cases, it can pose serious health risks. If you or a loved one has hoarding disorder, this book can help. This fully updated Second Edition of Buried in Treasures outlines a scientifically based, effective program for helping those with hoarding disorder dig their way out of the clutter and chaos of their homes. Written by scientists and practitioners who are leaders in studying and treating hoarding disorder, this book outlines a program of skill-building, learning to think about possessions in a different way, and gradual challenges to help people manage their clutter and their lives. It also provides useful information for family and friends of people who hoard, as they struggle to understand and help. Discover the reasons for your problems with acquiring, saving, and hoarding, and learn new ways of thinking about your possessions so you can decide what you really need and what you can do without. Learn to identify the "bad guys" that cause and maintain your hoarding behavior and meet the "good guys" who can help motivate you and put you on the path to change. Useful self-assessments will help you determine the severity of your problem. Training exercises, case examples, organizing tips, and motivation boosters help change the way you think and behave toward your possessions. This book provides easy-to-understand strategies and techniques that anyone can use.

From Hoarding to Hope

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Author :
Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781506148359
Total Pages : 0 pages
Book Rating : 4.1/5 (483 download)

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Book Synopsis From Hoarding to Hope by : Geralin Thomas

Download or read book From Hoarding to Hope written by Geralin Thomas and published by Createspace Independent Publishing Platform. This book was released on 2015-04-05 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: From Hoarding to Hope is designed to be a strategic guidebook to help you assemble the right team of profesional service providers: clinicians, social workers, home health-care workers, professional organizers, public-health workers, professional organizers, public-health workers or animal control. (back cover).

Hoarding

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Author :
Publisher : Oxford University Press
ISBN 13 : 0190946415
Total Pages : 216 pages
Book Rating : 4.1/5 (99 download)

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Book Synopsis Hoarding by : Gail Steketee

Download or read book Hoarding written by Gail Steketee and published by Oxford University Press. This book was released on 2020-08-01 with total page 216 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hoarding disorder is the excessive saving of objects and difficulty parting with them to a point that interferes with one's ability to properly use rooms and furnishings in the home. Hoarding can become dangerous, sometimes resulting in structural problems and fires, or in hazardous sanitary conditions. Studies indicate that around one in every 25 people suffers from hoarding. This means that almost all of us know someone who hoards. Hoarding: What Everyone Needs to Know® demystifies this complex problem, what it looks like and why it may develop, and how it can be treated. With their combined expertise in psychological treatments for hoarding and community interventions, Drs. Steketee and Bratiotis explain how to understand hoarding as a mental illness, describing the disorder in layman's terms and explaining the various facets and manifestations of the behavior. Chapters focus on one or more common questions regarding diagnosis, features, how to assess severity, and treatment. The book will dispel myths and help readers identify hoarding that touches their own lives. As such it will be of great value not only to those who suspect a loved one may be hoarding, but also to first responders, such as firefighters, public health officials, and housing and social service personnel, who will find here an essential resource for use in the field.

The Hoarder in You

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Author :
Publisher : Rodale Books
ISBN 13 : 1609611322
Total Pages : 243 pages
Book Rating : 4.6/5 (96 download)

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Book Synopsis The Hoarder in You by : Robin Zasio

Download or read book The Hoarder in You written by Robin Zasio and published by Rodale Books. This book was released on 2012-11-13 with total page 243 pages. Available in PDF, EPUB and Kindle. Book excerpt: We all have treasured possessions—a favorite pair of shoes, a much-beloved chair, an ever-expanding record collection. But sometimes, this emotional attachment to our belongings can spiral out of control and culminate into a condition called compulsive hoarding. From hobbyists and collectors to pack rats and compulsive shoppers—it is close to impossible for hoarders to relinquish their precious objects, even if it means that stuff takes over their lives and their homes. According to psychologist Dr. Robin Zasio, our fascination with hoarding stems from the fact that most of us fall somewhere on the hoarding continuum. Even though it may not regularly interfere with our everyday lives, to some degree or another, many of us hoard. The Hoarder In You provides practical advice for decluttering and organizing, including how to tame the emotional pull of acquiring additional things, make order out of chaos by getting a handle on clutter, and create an organizational system that reduces stress and anxiety. Dr. Zasio also shares some of the most serious cases of hoarding that she's encountered, and explains how we can learn from these extreme examples—no matter where we are on the hoarding continuum.

Stuff

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Publisher : Houghton Mifflin Harcourt
ISBN 13 : 0547487258
Total Pages : 309 pages
Book Rating : 4.5/5 (474 download)

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Book Synopsis Stuff by : Randy O. Frost

Download or read book Stuff written by Randy O. Frost and published by Houghton Mifflin Harcourt. This book was released on 2010-04-20 with total page 309 pages. Available in PDF, EPUB and Kindle. Book excerpt: The New York Times bestseller. “Gripping . . . By turns fascinating and heartbreaking . . . Stuff invites readers to reevaluate their desire for things.”—Boston Globe “Amazing . . . utterly engrossing . . . Read it.”—The Washington Post Book World What possesses someone to save every scrap of paper that’s ever come into his home? What compulsions drive a person to sacrifice her marriage or career for an accumulation of seemingly useless things? Randy Frost and Gail Steketee were the first to study hoarding when they began their work a decade ago. They didn’t expect that they would end up treating hundreds of patients and fielding thousands of calls from the families of hoarders. Their vivid case studies (reminiscent of Oliver Sacks) in Stuff show how you can identify a hoarder—piles on sofas and beds that make the furniture useless, houses that can be navigated only by following small paths called goat trails, vast piles of paper that the hoarders “churn” but never discard, even collections of animals and garbage—and illuminate the pull that possessions exert over all of us. Whether we’re savers, collectors, or compulsive cleaners, very few of us are in fact free of the impulses that drive hoarders to extremes. “Authoritative, haunting, and mysterious. It is also intensely, not to say compulsively readable.”—Tracy Kidder, Pulitzer Prize-winning author “Fascinating . . . a good mix of cultural and psychological theories on hoarding.”—Newsweek “Pioneering researchers offer a superb overview of a complex disorder that interferes with the lives of more than six-million Americans . . . An absorbing, gripping, important report.”—Kirkus Reviews (starred review)

Compulsive Hoarding and Acquiring

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Author :
Publisher : Oxford University Press
ISBN 13 : 0198041071
Total Pages : 240 pages
Book Rating : 4.1/5 (98 download)

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Book Synopsis Compulsive Hoarding and Acquiring by : Gail Steketee

Download or read book Compulsive Hoarding and Acquiring written by Gail Steketee and published by Oxford University Press. This book was released on 2006-12-07 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: The problem of compulsive hoarding and acquiring is more widespread than commonly believed. It often goes undiagnosed, either because sufferers are ashamed of their compulsions or because they dont believe it is a problem that merits professional attention. As much as two percent of the U.S. population suffers secretly from this condition. However, compulsive hoarding can be an emotionally exhausting, uncontrollable, and sometimes dangerous problem. Written by the developers of this groundbreaking treatment, this manual is the first to present an empirically supported and effective CBT program for treating compulsive hoarding and acquiring. This guide gives clinicians the information to understand hoarding and proven tools to help clients overcome their compulsive behaviors. It teaches individuals how to recognize errors in thinking and uses both imagined and real exposures to teach them the skills they need to manage their problem. Home visits by the clinician are a part of the treatment, as well as consultations with other professionals who might assist if necessary. Homework exercises include behavioral experiments to test personal beliefs about possessions, developing an organization plan and filing system, and sorting and organizing items room-by-room. Designed to be used in conjunction with the corresponding workbook, this therapist guide provides numerous assessment and intervention forms to help clients use the methods described in this program. Complete with case examples and strategies for dealing with problems, this user-friendly guide is a dependable resource that no clinician can do without. TreatmentsThatWorkTM represents the gold standard of behavioral healthcare interventions! · All programs have been rigorously tested in clinical trials and are backed by years of research · A prestigious scientific advisory board, led by series Editor-In-Chief David H. Barlow, reviews and evaluates each intervention to ensure that it meets the highest standard of evidence so you can be confident that you are using the most effective treatment available to date · Our books are reliable and effective and make it easy for you to provide your clients with the best care available · Our corresponding workbooks contain psychoeducational information, forms and worksheets, and homework assignments to keep clients engaged and motivated · A companion website (www.oup.com/us/ttw) offers downloadable clinical tools and helpful resources · Continuing Education (CE) Credits are now available on select titles in collaboration with PsychoEducational Resources, Inc. (PER)

Treatment for Hoarding Disorder

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Author :
Publisher : Oxford University Press
ISBN 13 : 0199334943
Total Pages : 202 pages
Book Rating : 4.1/5 (993 download)

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Book Synopsis Treatment for Hoarding Disorder by : Gail Steketee

Download or read book Treatment for Hoarding Disorder written by Gail Steketee and published by Oxford University Press. This book was released on 2013-11 with total page 202 pages. Available in PDF, EPUB and Kindle. Book excerpt: This Second Edition of Treatment for Hoarding Disorder is the culmination of more than 20 years of research on understanding hoarding and building an effective intervention to address its myriad components.

The Oxford Handbook of Hoarding and Acquiring

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Author :
Publisher : Oxford Library of Psychology
ISBN 13 : 0199937788
Total Pages : 433 pages
Book Rating : 4.1/5 (999 download)

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Book Synopsis The Oxford Handbook of Hoarding and Acquiring by : Randy O. Frost

Download or read book The Oxford Handbook of Hoarding and Acquiring written by Randy O. Frost and published by Oxford Library of Psychology. This book was released on 2014 with total page 433 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hoarding involves the acquisition of and inability to discard large numbers of possessions that clutter the living area of the person collecting them. It becomes a disorder when the behavior causes significant distress or interferes with functioning. Hoarding can interfere with activities of daily living (such as being able to sit in chairs or sleep in a bed), work efficiency, family relationships, as well as health and safety. Hoarding behavior can range from mild to life-threatening. Epidemiological findings suggest that hoarding occurs in 2-6% of the adult population, making it two to three times more common than obsessive-compulsive disorder. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) now includes Hoarding Disorder as a distinct disorder within the OCD and Related Anxiety Disorders section, creating a demand for information about it. The Oxford Handbook of Hoarding and Acquiring is the first volume to detail the empirical research on hoarding. Including contributions from all of the leading researchers in the field, this comprehensive volume is divided into four sections in addition to introductory and concluding chapters by the editors: Phenomenology, Epidemiology, and Diagnosis; Etiology; Assessment and Intervention; and Hoarding in Special Populations. The summaries of research and clinical interventions contained here clarify the emotional and behavioral features, diagnostic challenges, and nature of the treatment interventions for this new disorder. This handbook will be a critical resource for both practitioners and researchers, including psychiatrists, psychologists, neurologists, epidemiologists, social workers, occupational therapists, and other health and mental health professionals who encounter clients with hoarding problems in their practice and research.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

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Author :
Publisher : American Psychiatric Publishing
ISBN 13 : 9781955245180
Total Pages : pages
Book Rating : 4.2/5 (451 download)

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Book Synopsis Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by : American Psychiatric Association

Download or read book Diagnostic and Statistical Manual of Mental Disorders (DSM-5) written by American Psychiatric Association and published by American Psychiatric Publishing. This book was released on 2021-09-24 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Digging Out

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Publisher : New Harbinger Publications
ISBN 13 : 1572245948
Total Pages : 210 pages
Book Rating : 4.5/5 (722 download)

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Book Synopsis Digging Out by : Michael A. Tompkins

Download or read book Digging Out written by Michael A. Tompkins and published by New Harbinger Publications. This book was released on 2009 with total page 210 pages. Available in PDF, EPUB and Kindle. Book excerpt: In Digging Out, two psychologists who specialize in compulsive hoarding show readers with a friend or family member who hoards how to use harm reduction, a proven-effective model, to help their loved one live safely and comfortably in his or her own home and improve their relationship with the hoarder.

Compulsive Hoarding

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Author :
Publisher : Speedy Publishing LLC
ISBN 13 : 1634284127
Total Pages : 90 pages
Book Rating : 4.6/5 (342 download)

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Book Synopsis Compulsive Hoarding by : Bowe Packer

Download or read book Compulsive Hoarding written by Bowe Packer and published by Speedy Publishing LLC. This book was released on 2014-07-14 with total page 90 pages. Available in PDF, EPUB and Kindle. Book excerpt: Is Your House Full Of Unneeded Stuff? Are You or Someone You Know A Compulsive Hoarder? Are you ready to understand Compulsive Hoarding and how you can treat it? Author Bowe Packer, has more than 20 do-it-yourself, how-to and self help books in print and audio format being sold worldwide. He has done it again, with his newest release -- Compulsive Hoarding: Understanding & Treating Compulsive Hoarding. This practical guide is designed to the fundamental aspects of hoarding disorders and simple, yet effective treatments for hoarding. Let's face it, you cannot heal your hoarding condition before you understand it and know of the help for hoarding that is available to you. Here is just a bit of what you will discover in the pages of Compulsive Hoarding: Understanding & Treating Compulsive Hoarding: * The Three Features of Compulsive Hoarding Behavior. * In Focus: Hoarding & Impairment. * The Warning Signs to Watch Out For. * The Four-Step Communication Model For Communicating With Hoarders. * Properly Forming the Core Support Team. ??? Compulsive Hoarding is a debilitating condition and can be treated. Gaining the knowledge of hoarding disorders and applying a sound hoarding treatment plan will have you on your way to eliminating this condition once and for all from your life!.

Dirty Secret

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Publisher : Simon and Schuster
ISBN 13 : 9781439192535
Total Pages : 336 pages
Book Rating : 4.1/5 (925 download)

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Book Synopsis Dirty Secret by : Jessie Sholl

Download or read book Dirty Secret written by Jessie Sholl and published by Simon and Schuster. This book was released on 2010-12-28 with total page 336 pages. Available in PDF, EPUB and Kindle. Book excerpt: A fascinating look at compulsive hoarding by a woman whose mother suffers from the disease. To be the child of a compulsive hoarder is to live in a permanent state of unease. Because if my mother is one of those crazy junk-house people, then what does that make me? When her divorced mother was diagnosed with cancer, New York City writer Jessie Sholl returned to her hometown of Minneapolis to help her prepare for her upcoming surgery and get her affairs in order. While a daunting task for any adult dealing with an aging parent, it’s compounded for Sholl by one lifelong, complex, and confounding truth: her mother is a compulsive hoarder. Dirty Secret is a daughter’s powerful memoir of confronting her mother’s disorder, of searching for the normalcy that was never hers as a child, and, finally, cleaning out the clutter of her mother’s home in the hopes of salvaging the true heart of their relationship—before it’s too late. Growing up, young Jessie knew her mother wasn’t like other mothers: chronically disorganized, she might forgo picking Jessie up from kindergarten to spend the afternoon thrift store shopping. Now, tracing the downward spiral in her mother’s hoarding behavior to the death of a long-time boyfriend, she bravely wades into a pathological sea of stuff: broken appliances, moldy cowboy boots, twenty identical pairs of graying bargain-bin sneakers, abandoned arts and crafts, newspapers, magazines, a dresser drawer crammed with discarded eyeglasses, shovelfuls of junk mail . . . the things that become a hoarder’s “treasures.” With candor, wit, and not a drop of sentimentality, Jessie Sholl explores the many personal and psychological ramifications of hoarding while telling an unforgettable mother-daughter tale.

The Hoarding Impulse

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Author :
Publisher : Routledge
ISBN 13 : 1317549635
Total Pages : 150 pages
Book Rating : 4.3/5 (175 download)

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Book Synopsis The Hoarding Impulse by : Renee M. Winters

Download or read book The Hoarding Impulse written by Renee M. Winters and published by Routledge. This book was released on 2015-06-19 with total page 150 pages. Available in PDF, EPUB and Kindle. Book excerpt: There has been an increased awareness of hoarding in recent years, but clinical treatments aimed at helping people with this condition often have low success rates. In The Hoarding Impulse Renee M. Winters explores how depth psychology can enrich current conceptual models and treatment standards for compulsive hoarding. The book presents case studies of prominent sufferers including Edie and Edith Beale, the Collyer Brothers, and Andy Warhol and explores common themes of loss, shame and object clusters. Winters sets out to provide a clear understanding of a hoarder’s lived experiences and their core schemas of value, worth and personal identity, revealing a direct connection to excessive acquisition of objects. She illuminates the process of how objects can come to possess a hoarder and become not only their main source of happiness but also part of their identity and in doing so puts forward a new treatment plan based on providing a deeper understanding of and potent treatment approach to what is a core issue for hoarding individuals: the wounding of the soul. This new perspective to treating individuals who hoard helps them in the long term understand their processes, value system, and struggles with negative interpersonal relationships. Providing a fascinating insight into the psyche of people who struggle with hoarding, this book will be essential reading for depth psychologists, Jungian psychotherapists, psychiatrists, social workers, students of analytical psychology and anyone interested in understanding the dynamics of this complex condition.

The Social Determinants of Mental Health

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Author :
Publisher : American Psychiatric Pub
ISBN 13 : 1585625175
Total Pages : 260 pages
Book Rating : 4.5/5 (856 download)

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Book Synopsis The Social Determinants of Mental Health by : Michael T. Compton

Download or read book The Social Determinants of Mental Health written by Michael T. Compton and published by American Psychiatric Pub. This book was released on 2015-04-01 with total page 260 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the "take-away" messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a "Call to Action," offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.

Severe Domestic Squalor

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Author :
Publisher : Cambridge University Press
ISBN 13 : 1139576801
Total Pages : pages
Book Rating : 4.1/5 (395 download)

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Book Synopsis Severe Domestic Squalor by : John Snowdon

Download or read book Severe Domestic Squalor written by John Snowdon and published by Cambridge University Press. This book was released on 2012-09-27 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Should you intervene in the life of the 48-year-old woman whose dwelling is stuffed with accumulated rubbish and who will not let anyone help get rid of it – or the 78-year-old surrounded by putrescent food and filth – or the 'animal accumulator'? Cases of severe domestic squalor (sometimes called Diogenes Syndrome) are among the most complex and difficult faced by community agencies. Local councils, housing officers, health professionals, social services, animal welfare agencies, public guardians and of course relatives and neighbours often feel powerless and lack confidence about what to do when faced with such situations. The guidelines, recommendations and case examples in Severe Domestic Squalor will help concerned people to understand what can be done and how, by providing an understanding of the causative factors and who should take the lead in dealing with them.