™Resource
Clutter Image Rating (CIR) Scale
A standardised tool used by professionals to assess hoarding severity across kitchen, living room, and bedroom — on a scale of 1 to 9.
What is the CIR scale?
The Clutter Image Rating scale was developed by Frost, Steketee, Tolin, and Renaud (2008) as a reliable, evidence-based way to assess hoarding severity. It uses reference descriptions — and in the original published version, photographs — showing rooms at each level from 1 to 9.
A score of 4 or above in any room is generally considered the threshold at which specialist support should be considered. Scores of 7 or above indicate serious risk to health and safety and may require urgent multi-agency intervention.
At Hoarding Helpers, we use CIR scores to plan our approach and ensure the right level of support is provided from the first visit.
Download the CIR scale photographs (PDF)
The original photographic CIR scale — all nine levels across kitchen, living room, and bedroom. Reproduced with thanks to the International OCD Foundation, who make it freely available for professional use.
CIR scale — levels 1 to 9
Each level describes what a typical room looks like at that score, and what action is appropriate for professionals.
No clutter
Score 1 of 9
Kitchen
All surfaces clear. Appliances stored away. Sink empty. Floor fully accessible.
Living room
Furniture fully accessible. No items on floor. Seating all usable.
Bedroom
Bed clear and usable. Wardrobe accessible. Floor clear throughout.
Professional guidance
No concern. Normal living conditions.
Minimal clutter
Score 2 of 9
Kitchen
A few items on worktops. Sink mostly clear. All appliances accessible.
Living room
Some items on surfaces. All seating usable. Floor largely clear.
Bedroom
Bed accessible. Some items on floor or chair. Wardrobe usable.
Professional guidance
Within normal range. No intervention required.
Mild clutter
Score 3 of 9
Kitchen
Worktops noticeably cluttered. Some items blocking access to cupboards.
Living room
Surfaces cluttered. One or two seats may be unusable. Floor mostly clear.
Bedroom
Items accumulating on floor. Bed may have items on it. Wardrobe harder to access.
Professional guidance
Monitor. Consider a gentle conversation about support.
Moderate clutter
Score 4 of 9
Kitchen
Most surfaces covered. Sink difficult to use. Some appliances inaccessible.
Living room
Multiple seats unusable. Items on floor creating narrow pathways.
Bedroom
Significant floor coverage. Bed partially covered. Getting dressed is difficult.
Professional guidance
Referral threshold. Specialist support should be considered.
Significant clutter
Score 5 of 9
Kitchen
Cooking very difficult. Sink blocked. Fridge may be inaccessible.
Living room
Most seating unusable. Pathways narrow. Items stacked on furniture.
Bedroom
Bed largely inaccessible. Items stacked high. Changing clothes is a challenge.
Professional guidance
Specialist referral recommended. Risk assessment advised.
Considerable clutter
Score 6 of 9
Kitchen
Room barely functional. Cooking impossible. Hygiene concerns present.
Living room
Room largely unusable for its purpose. Items floor to ceiling in places.
Bedroom
Bed completely inaccessible. Person may be sleeping elsewhere.
Professional guidance
Multi-agency response likely needed. Safeguarding review recommended.
Severe clutter
Score 7 of 9
Kitchen
Room inaccessible. Serious hygiene and fire risk. Rotting food likely.
Living room
Completely unusable. Structural items (doors, windows) may be blocked.
Bedroom
Room inaccessible. Person sleeping in another room or on a chair.
Professional guidance
Urgent intervention. Fire service notification may be appropriate.
Extreme clutter
Score 8 of 9
Kitchen
Completely inaccessible. Serious structural and health risks.
Living room
No floor space visible. Serious risk of falls, fire, and structural damage.
Bedroom
Completely inaccessible. Serious health and safety risk.
Professional guidance
Emergency response may be required. Adult safeguarding referral.
Hazardous clutter
Score 9 of 9
Kitchen
Uninhabitable. Immediate risk to life from fire, falls, or structural failure.
Living room
Uninhabitable. Immediate risk to life.
Bedroom
Uninhabitable. Immediate risk to life.
Professional guidance
Emergency services involvement. Immediate safeguarding action required.
Using the CIR scale in practice
When completing a referral to Hoarding Helpers, you can record a CIR score for each room you were able to access. You do not need to have accessed every room — simply leave unvisited rooms blank.
If you are unsure of the exact score, use the descriptions above as a guide and select the closest match. Even an approximate score is helpful — it allows us to plan the right level of resource and support before our first visit.
The Clutter Image Rating scale was developed by Randy O. Frost, Gail Steketee, David F. Tolin, and Stefanie Renaud. Published in: Journal of Psychopathology and Behavioral Assessment, 2008;30(3):193–203. The photographic scale PDF is reproduced here with thanks to the International OCD Foundation who make it freely available for professional use.