Inclusion Criteria:  Diagnosed with Primary Hoarding Disorder, currently participating in the Hoarding Disorder treatment group at the HH Anxiety Disorders Center  Exclusion Criteria:  Not clinically appropriate for a group treatment format (i.e., active suicidality or aggressive behavior, psychosis, current physiological substance dependence, or personality issues that would be expected to substantially interfere with the group milieu; cognitively intact). Participants will also be excluded if they have previously completed CBT for HD. In addition, participants in the CM portion of the treatment will be required to live within one hour travel time of the treatment facility to allow for home visits with the independent rater.