In Augustine's case, that involved bringing a therapist and a cleanup crew to her home. Producers spent an hour telling her story, detailing how a woman known for always looking nice and well put together, could become so debilitated by hoarding she loses custody of her child and crews pulling mounds of material from her home discover two dead cats buried under the refuse.

And while it may be frustrating for viewers to watch therapists try to get hoarders to sort through and pick out the stuff to be tossed -- Spaulding cites one family who sent a hoarder on vacation and then hired her company to clean while her was gone -- experts say participation is key to dealing with the disease.

"The person has to own up to what they want, if they want to get better," said Eric Storch, who treats hoarders as director of the obsessive compulsive disorder program at All Children's Hospital in St. Petersburg.

Though Storch worries that programs such as Hoarders can be too melodramatic, he agreed that the subjects -- who sometimes cope with stress by adopting hoarding habits, in the way OCD sufferers develop debilitating rituals -- must participate in their recovery to avoid falling back into the same behaviors after the cleanup is done.

Flynn doesn't avoid the notion that there's a bit of a bargain here -- hoarders trade exposing a normally secretive, embarrassing illness for the resources to clena their homes and therapy to get better. But she said the show offers some aftercare, sticking with subjects for an average of six months to help them get better.

"Many of these peole have spent most of their money on hoarding," said Spaulding. "and this is one of the few servicxes we offer whih isn't covered by homeowner's insurance....So (appearing on the show) sounds like a win-win to me."