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

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.

Understanding training needs in eating disorders of graduating and new graduate dietitians in Australia: an online survey

“…Dietitians practising in the ED area may also refer to ED-specific national practice standards developed by the National Eating Disorder Collaboration (NEDC) for health care providers [ 21 ]. The Australia and New Zealand Academy for Eating Disorders (ANZAED) have recently published ED treatment principles and general clinical practice and training standards for mental health professionals and dietitians [ 22 ]. The ANZAED have also published practice and training standards specific for dietitians providing ED treatment, to ensure the safe and effective treatment of individuals with an ED [ 23 ].…”

ANZAED practice and training standards for dietitians providing eating disorder treatment

“…ANZAED established an expert working group of eight dietitians with representatives from Australia and New Zealand, each with between 12 and 30 years of clinical experience in eating disorder treatment. This was part of a broader project to develop general clinical practice and training standards [18], as well as standards specific to mental health professionals [19] and dietitians providing eating disorder treatment.…”

“…It is recommended that dietitians providing treatment to individuals with an eating disorder follow the broad principles and practice standards outlined in The Australia & New Zealand Academy for Eating Disorders treatment principles and general clinical practice and training standards for mental health professionals and dietitians [18]. In addition, to provide safe and effective treatment, it is recommended that dietitians treating individuals with an eating disorder are also competent in the dietetic-specific clinical practice standards summarised below and detailed in Table 1.…”

“…Clinicians in eating disorder practice are also advised to have clinical supervision as a form of formal learning and reflective practice [18]. Although clinical supervision is not historically utilised in the dietetics profession [42], dietitians do highly value learning from mentors [14].…”

“…The current clinical practice and training standards aim to describe the role of the dietitian in eating disorder treatment and provide a roadmap for dietitians to provide effective and safe care. This document builds on the Australia & New Zealand Academy for Eating Disorders (ANZAED) general principles and practice and trainings standards for all clinicians providing eating disorder treatment concurrently published in the Journal of Eating Disorders [18]. Based around the core dietetic skills of screening, professional responsibility, assessment, nutrition diagnosis, intervention, monitoring and evaluation, it details the knowledge and skills that dietitians require to competently manage and treat individuals with an eating disorder.…”