ANZAED eating disorder treatment principles and general clinical practice and training standards

Gabriella Heruc; Kim Hurst; Anjanette Casey; Kate Fleming; Jeremy Freeman; Anthea Fursland; Susan Hart; Shane Jeffrey; Rachel Knight; Michelle Roberton; Marion Roberts; Beth Shelton; Garalynne Stiles; Fiona Sutherland; Chris Thornton; Andrew Wallis; Tracey Wade

doi:10.1186/s40337-020-00341-0

ANZAED eating disorder treatment principles and general clinical practice and training standards

J Eat Disord. 2020 Nov 10;8(1):63. doi: 10.1186/s40337-020-00341-0.

Authors

Gabriella Heruc^{1

2

3}, Kim Hurst^{4

5

6}, Anjanette Casey⁷, Kate Fleming⁸, Jeremy Freeman⁴, Anthea Fursland⁸, Susan Hart^{9

10}, Shane Jeffrey^{4

11

12}, Rachel Knight^{13

14}, Michelle Roberton¹⁴, Marion Roberts^{4

15}, Beth Shelton¹⁶, Garalynne Stiles¹⁷, Fiona Sutherland^{4

18}, Chris Thornton¹⁹, Andrew Wallis²⁰, Tracey Wade²¹

Affiliations

¹ Australia & New Zealand Academy for Eating Disorders, Sydney, Australia. g.heruc@westernsydney.edu.au.
² School of Medicine, Western Sydney University, Campbelltown, Australia. g.heruc@westernsydney.edu.au.
³ Eating Disorders Service, Northern Sydney Local Health District, St Leonards, Australia. g.heruc@westernsydney.edu.au.
⁴ Australia & New Zealand Academy for Eating Disorders, Sydney, Australia.
⁵ School of Psychology, Griffith University, Gold Coast, Australia.
⁶ Eating Disorders Service, Robina Private Hospital, Robina, Australia.
⁷ Centre for Psychotherapy, Hunter New England Local Health District, Newcastle, Australia.
⁸ The Swan Centre, Perth, Australia.
⁹ Nutrition and Dietetics, St Vincent's Hospital, Darlinghurst, Australia.
¹⁰ The Boden Collaboration of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Camperdown, Australia.
¹¹ River Oak Health, Brisbane, Australia.
¹² Royal Brisbane and Women's Hospital, Brisbane, Australia.
¹³ Occupational Therapy, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia.
¹⁴ The Victorian Centre of Excellence in Eating Disorders, Melbourne, Australia.
¹⁵ Department of General Practice and Primary Health Care, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand.
¹⁶ National Eating Disorders Collaboration, Sydney, Australia.
¹⁷ School of Sport, Exercise and Nutrition, College of Health, Massey University, Palmerston North, New Zealand.
¹⁸ The Mindful Dietitian, Melbourne, Australia.
¹⁹ The Redleaf Practice, Sydney, Australia.
²⁰ Eating Disorders Service, Sydney Children's Hospital Network, Sydney, Australia.
²¹ Blackbird Initiative, Órama Institute, Flinders University, Bedford Park, Australia.

Abstract

Introduction: Eating disorders are complex to manage, and there is limited guidance around the depth and breadth of knowledge, skills and experience required by treatment providers. The Australia & New Zealand Academy for Eating Disorders (ANZAED) convened an expert group of eating disorder researchers and clinicians to define the clinical practice and training standards recommended for mental health professionals and dietitians providing treatment for individuals with an eating disorder. General principles and clinical practice standards were first developed, after which separate mental health professional and dietitian standards were drafted and collated by the appropriate members of the expert group. The subsequent review process included four stages of consultation and document revision: (1) expert reviewers; (2) a face-to-face consultation workshop attended by approximately 100 health professionals working within the sector; (3) an extensive open access online consultation process; and (4) consultation with key professional and consumer/carer stakeholder organisations.

Recommendations: The resulting paper outlines and describes the following eight eating disorder treatment principles: (1) early intervention is essential; (2) co-ordination of services is fundamental to all service models; (3) services must be evidence-based; (4) involvement of significant others in service provision is highly desirable; (5) a personalised treatment approach is required for all patients; (6) education and/or psychoeducation is included in all interventions; (7) multidisciplinary care is required and (8) a skilled workforce is necessary. Seven general clinical practice standards are also discussed, including: (1) diagnosis and assessment; (2) the multidisciplinary care team; (3) a positive therapeutic alliance; (4) knowledge of evidence-based treatment; (5) knowledge of levels of care; (6) relapse prevention; and (7) professional responsibility.

Conclusions: These principles and standards provide guidance to professional training programs and service providers on the development of knowledge required as a foundation on which to build competent practice in the eating disorder field. Implementing these standards aims to bring treatment closer to best practice, and consequently improve treatment outcomes, reduce financial cost to patients and services and improve patient quality of life.

Keywords: Clinical practice; Dietetics; Dietitian; Eating disorder; Mental health professional; Psychological; Standards; Training; Treatment.