Having a full-blown hoarding mother and some tendencies myself, a friend suggested I watch a few episodes in order to better see how it affected me as a child and how serious it is. At first I thought it might be the typical exploitative program, but after watching the first episode I was having useful insights. In each episode one or two situations are introduced. Then, some kind of intervention is attempted, usually in response to some external event like threatened eviction or the city being called in. We are able to see how professional organizers approach the hoarders, and how the hoarders respond. In particular, we see all the ways they deny or minimize the problem and thus stay stuck in it.
After watching several episodes, I brought my mother over so we could watch together. Each episode turned into a few hours of regular pausing and discussion of what we were seeing. It allowed more objectivity, since we were partly discussing other people rather than ourselves. My mother reported that she had felt enthusiasm and done some cleaning of her own house later that day. There was one professional organizer who had an amazing attitude of respect for the hoarder, not pressuring but simply assisting where possible, in order to achieve the most long-term change. I will always remember her as the model for how I can be towards my mother, rather than judgmental and ultimately harmful towards her progress, not that feeling such things isn't completely understandable.
Even though the show is probably mere entertainment for most people (nothing wrong with that!), it's great that it also serves such a valuable role for viewers who also deal with hoarding as well.