OCDs and especially hoarding fascinate me. As this is a US reality TV series, I didn't have high hopes to begin with. However, the concept of involving a psychologist into the process and providing after care funds for the participants gave me a positive surprise.
In the first few seasons, the series really focuses on the mental part of the hoarding. You can see how hard it is for people to let go and they even fail some times. There isn't always success. I really did like that part.
However, in the following seasons it gets worse and worse. The show is trying to have more sensational cases, more extreme filth or huge family fights. The last season is not a show about hoarding anymore, but a very weird mash up of not well done Horror, Home Remodel, Makeover, Family Crisis. While I found it not helpful to show the family the "stat the house is in" in season 5, in my opinion it is completely useless to spend a night in the home and explain to a shaky hand cam how scary and disgusting it is.
The first few seasons are a nice watch, but I would recommend to stop after Season 4. Nothing good coming after that.