A 58-year-old woman is brought to the PMHNP at the insistence of her adult daughter, who believes her mother has a hoarding problem. The client is adamant she does not have a problem with hoarding. Of the following assessment tools, which one will the PMHNP choose?

Choice A reason: ADL-H evaluates functional impairment in hoarding but does not provide a standardized severity assessment, making it less practical for diagnosis. Choice B reason: The HEI measures environmental conditions and clutter but is less focused on subjective hoarding severity. Choice C reason: The CIR provides visual assessment of clutter severity but may not capture the patient’s functional impairment or insight. Choice D reason: The Hoarding Rating Scale is a validated tool assessing severity, distress, and impairment associated with hoarding behaviors, making it most appropriate for clinical evaluation.