Approximately, 3%–5% of the U.S. population suffers from compulsive hoarding but others suffer as well, in particular, the family members who care about them. This article describes the manifold ways family members suffer because of their loved one's hoarding behavior, including the frustration and hopelessness many family members experience in the face of their loved one's steadfast refusal to accept help for their hoarding problem. The article presents harm reduction as a way for family members to help a loved one who is unwilling to accept treatment of the hoarding problem. The article then presents two clinical examples—a private hoarding situation and a public hoarding situation—to illustrate the application of harm reduction to hoarding. © 2011 Wiley Periodicals, Inc. J Clin Psychol: In Session 67:1–10, 2011.