scholarly journals Credentialing for eating disorder clinicians: a pathway for implementation of clinical practice standards

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Siân A. McLean ◽  
Kim Hurst ◽  
Hilary Smith ◽  
Beth Shelton ◽  
Jeremy Freeman ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Clinical Practice ◽  
New Zealand ◽  
Health Professionals ◽  
Eating Disorder Treatment ◽  
Practice Standards ◽  
Training Standards ◽  
Disorder Treatment ◽  
And Training

Abstract Advances are needed to ensure safe and effective treatment is available for people with eating disorders. Recently developed clinical practice and training standards for mental health professionals and dietitians represent a significant step in this direction by providing a consensus statement on eating disorder treatment as a foundation on which to build competent practice. This commentary argues that a credentialing system could promote implementation of these practice standards through formal recognition of qualifications, knowledge, training and professional activities to meet minimum standards for delivery of safe and effective eating disorder treatment. Drivers for credentialing include the imperative to provide safe and effective care, promotion of workforce development in eating disorder practice and, importantly, readily available and transparent information for referrers, consumers, and carers to identify health professionals credentialed to provide eating disorder treatment. However, a number of factors must be considered to ensure that credentialing does not restrict access to care, such as prohibitively narrow criteria to become credentialed, absence of pathways for education, training, or professional development opportunities, and lack of consultation with or endorsement by stakeholders of the credentialing criteria, application and approval processes, and ways of identifying credentialed practitioners. Further work, including development of credentialing criteria and aligned training opportunities, currently being undertaken by the Australia & New Zealand Academy for Eating Disorders and the National Eating Disorders Collaboration in consultation with stakeholders in the eating disorders sector and health professions will advance understanding of the feasibility of a system of credentialing for eating disorders within Australia and New Zealand. The availability of clinical practice and training standards, supported by implementation pathways, including credentialing of eating disorders practitioners, aim to improve quality of life, reduce financial burden, and close the treatment gap.

scholarly journals ANZAED practice and training standards for dietitians providing eating disorder treatment

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Gabriella Heruc ◽  
Susan Hart ◽  
Garalynne Stiles ◽  
Kate Fleming ◽  
Anjanette Casey ◽  
...  
Keyword(s):  
Mental Health ◽  
Eating Disorder ◽  
Clinical Practice ◽  
Clinical Supervision ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Eating Disorder Treatment ◽  
Training Standards ◽  
Disorder Treatment ◽  
And Training

Abstract Introduction Dietitians involved in eating disorder treatment are viewed as important members of the multidisciplinary team. However, the skills and knowledge that they require are not well characterised. Therefore, as part of a broader project to identify the key principles and clinical practice and training standards for mental health professionals and dietitians providing eating disorder treatment, the Australia & New Zealand Academy for Eating Disorders (ANZAED) sought to identify the key practice and training standards specific to dietitians. An expert working group of dietitians was convened to draft the initial dietetic standards. After expert review, feedback on the revised standards was then provided by 100 health professionals working within the eating disorder sector. This was collated into a revised version made available online for public consultation, with input received from treatment professionals, professional bodies and consumer/carer organisations. Recommendations Dietitians providing treatment to individuals with an eating disorder should follow ANZAED’s general principles and clinical practice standards for mental health professionals and dietitians. In addition, they should also be competent in the present eating disorder-specific standards based around the core dietetic skills of screening, professional responsibility, assessment, nutrition diagnosis, intervention, monitoring and evaluation. Conclusions These standards provide guidance on the expectations of dietetic management to ensure the safe and effective treatment of individuals with an eating disorder. Implications for professional development content and training providers are discussed, as well as the importance of clinical supervision to support professional self-care and evidence-informed and safe practice for individuals with an eating disorder.

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

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Gabriella Heruc ◽  
Kim Hurst ◽  
Anjanette Casey ◽  
Kate Fleming ◽  
Jeremy Freeman ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Clinical Practice ◽  
Health Professionals ◽  
Multidisciplinary Care ◽  
Evidence Based ◽  
Expert Group ◽  
Eating Disorder Treatment ◽  
Training Standards ◽  
Disorder Treatment ◽  
And Training

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.

scholarly journals ANZAED practice and training standards for mental health professionals providing eating disorder treatment

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Kim Hurst ◽  
Gabriella Heruc ◽  
Chris Thornton ◽  
Jeremy Freeman ◽  
Anthea Fursland ◽  
...  
Keyword(s):  
Mental Health ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Eating Disorder Treatment ◽  
Care Assessment ◽  
Training Standards ◽  
Disorder Treatment ◽  
And Training

Abstract Introduction The Australia & New Zealand Academy for Eating Disorders (ANZAED) recently developed general principles and clinical practice standards recommended for mental health clinicians and dietitians providing treatment for people with eating disorders. Separate mental health practice and training standards were then devised as a foundation for strengthening the workforce and providing guidance to professional training programs and service providers on the minimal standards required for practice in the eating disorder field. Recommendations The present recommendations for mental health professionals providing eating disorder treatment describe the following practice and training standards: eating disorder treatment foundations (including co-ordination of services, establishing a positive therapeutic alliance, professional responsibility and knowledge of levels of care), assessment, diagnosis, intervention (including evidence-based intervention, managing psychiatric risk and managing co-morbid mental health problems), and monitoring and evaluation. Conclusions Further work is required to disseminate these standards to clinicians providing services across Australia to people with eating disorders, and to support adherence in the clinic room where they can translate to improved outcomes for clients. Pathways to supporting adherence include expert supervision of practice, incorporation in training and supervised practice in university settings, and support with checklists that can be used by consumers and referring professionals.

Novel Ways to Use Exposure for Eating Disorders

2019 ◽  
pp. 165-172
Author(s):  
Carolyn Black Becker ◽  
Nicholas R. Farrell ◽  
Glenn Waller
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Clinical Practice ◽  
Magical Thinking ◽  
Interoceptive Exposure ◽  
Imaginal Exposure ◽  
Eating Disorder Treatment ◽  
Disorder Treatment ◽  
Novel Approaches

Three relatively novel approaches to the use of exposure for eating disorders are considered. Each is relatively experimental in treating eating disorders but is well established in treating anxiety-based disorders. Interoceptive exposure can be used to treat distress over bodily cues (e.g., fullness). Imaginal exposure can be used to elevate and treat anxiety as a prelude to in vivo exposure, although it should be used only when necessary. Finally, exposure can be used to address “magical thinking,” such as thought–shape fusion. These methods show promise with eating disorder treatment but are in the early stages of conceptualization and development. Their use should be treated as experimental at present, and clinicians should be alert to their impact in clinical practice.

scholarly journals Life is different now – impacts of eating disorders on Carers in New Zealand: a qualitative study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Louise Fletcher ◽  
Henrietta Trip ◽  
Rachel Lawson ◽  
Nicki Wilson ◽  
Jennifer Jordan
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
New Zealand ◽  
Thematic Analysis ◽  
Online Survey ◽  
Family Members ◽  
Qualitative Interview ◽  
Eating Disorder Treatment ◽  
Disorder Treatment ◽  
Inductive Thematic Analysis

Abstract Background Eating disorders are widely recognized as serious illnesses, with complex psychological and physiological comorbidities. Affected individuals face a protracted and challenging treatment journey which, particularly for children and adolescents, requires significant input from family members as carers. This study investigated the perspectives and experiences of those caring for family members with an eating disorder diagnosis. Method Participants were carers of affected individuals with an eating disorder, and were recruited from an online survey, subsequently consenting to a semi-structured qualitative interview. Inductive thematic analysis was undertaken to identify themes. Results Most participants in the sample were parents of affected individuals. Significant and ongoing psychological and emotional impacts were identified across the sample. The diagnosis, treatment journey and overall impact of the carer role created a situation captured by the over-arching theme ‘life is different now’. Impacts profoundly influenced relationships and were felt across all aspects of life by carers, affected individuals and other family members. Heightened worry and vigilance experienced by carers continued beyond improvement or recovery. Conclusions This research highlighted challenging and often exhausting impacts felt by carers due to their pivotal role in eating disorder treatment. Inadequate support for most carers in this sample has clear implications for families as well as service and funding providers. Further research should more fully investigate carer experience with different eating disorders to explore the type of support necessary to build capacity and resilience to reduce carer burden.

scholarly journals The role of sociocultural perspectives in eating disorder treatment: A study of health professionals

2017 ◽  
Vol 22 (6) ◽  
pp. 541-557
Author(s):  
Su Holmes
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Health Professionals ◽  
Qualitative Interviews ◽  
Eating Disorder Treatment ◽  
Sociocultural Perspectives ◽  
The Social ◽  
Feminist Perspectives ◽  
Disorder Treatment ◽  
And Gender

Eating disorders are now often approached as biopsychosocial problems, because they are widely recognised as multifactorial in origin. However, it has been suggested that there is a substantial and unwarranted imbalance within this biopsychosocial framework, with the ‘social’ aspects of the equation relegated to secondary or facilitating factors within treatment contexts. Drawing on data from 12 qualitative interviews with health professionals in a UK region, this article examines the extent to which sociocultural perspectives on eating disorders are valued and explored in eating disorder treatment, with a particular focus on the relationship between eating disorders and gender. As girls/women are widely acknowledged to be disproportionately affected by eating problems, the article draws on feminist perspectives on eating disorders to explore whether the relationships between cultural constructions of femininity and experiences of body/eating distress are actively addressed within treatment. The study reveals high levels of inconsistency in this regard, as while some participants see such issues as central to treatment, others have ‘never really considered’ them before. In addition, the study examines the potential limitations of how such sociocultural issues are conceptualised and addressed, as well as why they might be marginalised in the current climate of evidence-based eating disorder treatment. The article then considers the implications of the findings for thinking about feminist perspectives on eating disorders – and the significance of gender in treatment – at the level of both research and practice.

scholarly journals A Review of Cook-Cottone's Embodiment and the Treatment of Eating Disorders: The Body as a Resource in Recovery

2021 ◽  
Vol 55 (2) ◽  
Author(s):  
Sarah Nutter
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Disordered Eating ◽  
Theoretical Framework ◽  
The Body ◽  
Practice Recommendations ◽  
Eating Disorder Treatment ◽  
Disorder Treatment

Embodiment and the Treatment of Eating Disorders: The Body as a Resource in Recovery by Catherine Cook-Cottone provides over its 13 chapters a theoretical framework and practice recommendations for infusing embodiment in eating disorder treatment via her Embodied Approach to Treating Eating Disorders model. Part 1 of the book provides an overview of the model and Part 2 provides a framework for integrating the model into treatment, using several aspects of embodiment. Cook-Cottone includes numerous resources in the book to support counsellors in integrating this model into practice. For clinicians working with clients struggling with disordered eating or eating disorders, Cook-Cottone’s book provides an engaging addition to eating disorders treatment.

Eating Disorder Comorbidity with OCD

2017 ◽  
Author(s):  
Marina Gershkovich ◽  
Olivia Pascucci ◽  
Joanna Steinglass
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Empirical Support ◽  
Future Research ◽  
Weight History ◽  
Eating Disorder Treatment ◽  
Weight Restoration ◽  
Disorder Treatment ◽  
Support Treatment ◽  
Shed Light

This chapter discusses the comorbidity of eating disorders with OCD, including epidemiology, neurobiology, clinical features, and treatment. These disorders frequently cooccur. There are hints that eating disorders and OCD may share underlying neural mechanisms of illness, but these neurobiological models are preliminary. Cooccurrence of eating disorders and OCD is more common in clinical populations than community samples, highlighting the importance of assessing eating and weight history among patients with OCD. Treatment for bulimia nervosa includes psychotherapy and medication options, all with good empirical support. Treatment for anorexia nervosa emphasizes behaviorally based approaches to weight restoration treatment, with no clear evidence for medication treatments. When these illnesses occur together, treatment focused on the eating disorder yields improvement in OCD symptoms. Integrating exposure and response prevention techniques into eating disorder treatment may yield synergistic improvement in both illnesses. Future research may shed light on shared and distinct neurobiological mechanisms of these illnesses.

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