It seems next to impossible for the hoarders to get rid of their possessions on the show (for the most part). Since it's usually caused by losses, and they need counselling, I think there would be a greater chance of them being willing to part with stuff if they receive counselling BEFORE the psychologist and junk removal trucks arrive. Then they can start to digest it all and get to the root of the problem prior to de-hoarding their stuff. Also continue to receive counselling afterwards. Just my opinion.