Parents and carers of Australians living with eating disorders rate the ANZAED Eating Disorder Credential highly and overwhelmingly prefer treatment from credentialed clinicians, yet the credential alone has not dissolved the practical obstacles that stand between families and effective care, according to a new survey-based study published in the Journal of Eating Disorders. The research, led by Madalyn McCormack and colleagues including Phillipa Hay at Western Sydney University, surveyed 51 carers whose family member, young person, or loved one had received eating disorder treatment from either an ANZAED Credentialed Eating Disorder Clinician or a clinician without the credential. The findings arrive at a moment when eating disorder rates in Australia are rising, with estimates suggesting that around four per cent of Australians are currently living with an eating disorder, while many affected individuals still fail to access timely or appropriate treatment.
The ANZAED Eating Disorder Credential was developed in collaboration with the National Eating Disorder Collaboration and officially launched in June 2022. It was designed to ease the burden on people living with eating disorders, their carers, and supporting health professionals by making it simple to identify mental health professionals and dietitians who meet a minimum standard of knowledge, qualifications, and ongoing supervision and professional development. To hold the credential, dietitians and mental health professionals must have at least two years of prior clinical experience and must have completed introductory and treatment provision training through an NEDC approved course. Maintaining the credential requires a minimum of 15 hours of eating disorder relevant ongoing professional development and at least six hours of eating disorder relevant supervision each year, at least three hours of which must be individual supervision. General practitioners were initially eligible to apply only as mental health professionals if they were providers of focused psychological strategies, but in 2024 ANZAED expanded the credential with a new pathway specifically for GPs, recognising their role in assessment, diagnosis, referral, and ongoing medical care.
The study itself took the form of an exploratory mixed-methods cross-sectional survey. Of the 51 participants, 26 had cared for someone treated by at least one credentialed clinician and 25 had experience with a non-credentialed clinician, either currently or in the past. Recruitment ran through Australian eating disorder services and community organisations, including the SWAN Centre, Eating Disorders Families Australia, the Butterfly Foundation, Eating Disorders Queensland, Eating Disorders Victoria, and the Inside Out Institute, as well as through ANZAED and NEDC membership databases. Participants completed an anonymous Qualtrics survey with open- and closed-ended questions covering demographics, eating disorder history, treatment history, experiences with the credential’s Find a Treatment Provider search directory, attitudes towards the credential, and perceived barriers to seeking and accessing treatment. The study was approved by the Western Sydney University Human Research Ethics Committee, and all participants gave informed consent.
The sample was not representative of the full diversity of Australian carers. Most carers identified as women, most reported an Oceanic ethnic background, resided in metropolitan areas, were married or living as married, and had completed university or a college diploma. Employment ranged widely, with most employed full time or part-time or casually. More than three quarters of participants were caring for someone who was currently experiencing eating disorder symptoms, and the most commonly reported diagnosis was anorexia nervosa. Carers with experience of a credentialed clinician had a median age in the early 50s, while those with experience of a non-credentialed clinician had a median age in the late 40s. There were no significant differences in the characteristics of the two groups. The researchers excluded one participant who answered only demographic questions and 16 who were unsure whether they had seen a credentialed clinician, and because partial responses were retained for the questions actually completed, sample sizes varied across analyses.
When the researchers compared attitudes towards the credential, they found no significant differences between the two groups. Across both groups, the vast majority of participants preferred treatment from a credentialed clinician, reported greater trust in the advice of a credentialed clinician, valued the existence of the credential, and agreed that the credential would make specialised care more accessible and improve health outcomes for people with eating disorders. The authors caution, however, that because participants were asked about their attitudes rather than their direct experiences, it remains unclear whether these views are informed by differences in the care they encountered or simply reflect general perceptions about the credential itself.
Perceptions of therapeutic success told a more nuanced story. Among participants whose loved one had seen a credentialed clinician, almost half, 47.8 per cent, believed that the success of therapy is influenced by whether treatment is provided by a credentialed or non-credentialed clinician. That view was less common, at 29.2 per cent, among those whose loved one was treated by a non-credentialed clinician, but the difference did not reach statistical significance. The authors note that small participant numbers may have led to a Type 2 error in this nonsignificant finding, and they emphasise that credentialing status was considered less important than other factors when carers weighed what makes treatment work. Those other factors included access to treatment, collaborative care, therapeutic rapport, and individualised treatment, echoing the team’s earlier qualitative work with 13 carers, which found high appreciation for providers who had detailed insight into the eating disorder and a perceived positive impact on the therapeutic relationship.
The treatment histories recorded in the survey illustrate how families actually find and use credentialed care. Among those with experience of at least one credentialed clinician, 65 per cent were currently receiving such care and 35 per cent had received it in the past. The most common pathway to finding a credentialed clinician was through a GP or other health professional, cited by 50 per cent, followed by referrals from family, friends, or another carer at 15 per cent, independent advertising at 10 per cent, and other or unknown routes at 25 per cent. From the time carers first sought credentialed treatment, the median wait was 1.8 months, with an interquartile range of one to three months, and the median treatment duration was 24 months, with an interquartile range of 12 to 30 months. Treatment was delivered in person for 95 per cent of participants and via Telehealth for 70 per cent. Because participants could select multiple professionals, the percentages are not mutually exclusive: psychiatrists were involved in 57.9 per cent of cases, psychologists in 52.6 per cent, and dietitians in 42.1 per cent.
For carers whose loved ones saw non-credentialed clinicians, most reported treatment from a dietitian at 76 per cent, a psychologist at 80 per cent, or a psychiatrist at 76 per cent, with 52 per cent currently in treatment and 48 per cent treated in the past. The median wait time to access treatment was one month, with an interquartile range of one to three months, and most treatment occurred in a metropolitan setting at 84 per cent. The most commonly experienced treatment modalities were individual therapy at 68.2 per cent, inpatient therapy at 59.1 per cent, medical or psychiatric treatment at 63.6 per cent, Family Based Treatment at 54.5 per cent, and nutritional counselling and physical health counselling at 45.5 per cent. Ratings of barriers affecting access to or use of outpatient or inpatient treatment showed no significant differences between the two groups overall, although the distributions hinted at a statistical trend, below the conventional threshold of significance, for carers with experience of a credentialed clinician to rate social and work barriers as extremely impactful more often than those with experience of a non-credentialed clinician.
The free-text responses laid bare the systemic frustrations that persist regardless of credentialing status. Carers in both groups highlighted the lack of autonomy or control over the treatment available to their loved one, with comments about the age of a daughter leaving parents with no say in decisions, and about being zoned for a public hospital they did not think was good but having no choice but to go there. Readiness of the affected person to engage in treatment, and the impact on carers’ own finances, marriages, families, and support networks, were also cited. Participants described a fractured public health service with a lack of public treatment options to be referred to, and stressed that access must extend beyond simply finding treatment to accessing the right professionals with the appropriate knowledge and expertise for safe and effective care. Treatment, they said, needed to be flexible and tailored to the individual and the family’s unique situation and preferences, including care that considered the whole child, broader circumstances, and comorbid conditions. One parent reported that no appropriate support was available for their adolescent given the family’s particular structure, and another described a treating team’s refusal to consider that their child might have autism, stating that the inability of the inpatient treating team to consider autism as a possibility severely hindered their daughter’s ability to be supported appropriately and that the team caused more harm than good. Some carers with experience of non-credentialed clinicians additionally reported a lack of collaboration within the treatment team and between the team and the family, describing doctors who failed to communicate all options effectively, did not communicate with nurses and each other, and did not listen to the parents.
The authors conclude that the credential is an important step towards improving the standards of care and treatment experiences for individuals with eating disorders and their families, but that addressing ongoing barriers to access and delivery of care will be critical to realising its full potential. They point out that decisions about engaging a credentialed or non-credentialed clinician may be constrained by clinician availability and wait times, and that increasing the availability of credentialed clinicians would allow credential status to play a larger role in families’ decision-making. The predominance of GP and health professional referrals to credentialed clinicians underscores the critical role these clinicians play in early identification and intervention, and the authors suggest that increased awareness of the credential, alongside improved education in recognising symptoms, conducting assessments, and making timely referrals, could help bridge the treatment delays commonly observed in eating disorders. The study carries important limitations: the sample was predominantly women in metropolitan areas caring for people with anorexia nervosa, with limited representation of culturally and linguistically diverse backgrounds and no representation of Aboriginal and Torres Strait Islander peoples; selection bias may have attracted carers with strong opinions about the credential; the survey did not capture whether participants had received treatment exclusively from one type of clinician or both, so barrier comparisons should be interpreted cautiously; and perceptions may shift as the credential matures. Future research, the team recommends, should explore how specific caregiving roles shape perceptions, how well carers understand the training and competency requirements behind the credential, and how referral pathways and credentialing status influence carers’ views over time.
Subject of Research: Carers' experiences and perceived barriers to eating disorder treatment from ANZAED credentialed and non-credentialed clinicians in Australia
Article Title: Integrating carers’ experiences and barriers to treatment from ANZAED Credentialed Eating Disorder Clinicians and non-credentialed clinicians in Australia
Article References: McCormack, M., Conti, J., Heruc, G., McLean, S. A., Prnjak, K., Barns, R., & Hay, P. (2026). Integrating carers’ experiences and barriers to treatment from ANZAED Credentialed Eating Disorder Clinicians and non-credentialed clinicians in Australia. Journal of Eating Disorders, 13(S1), Article 300. https://doi.org/10.1186/s40337-026-01811-7
Image Credits: AI Generated
DOI: 10.1186/s40337-026-01811-7
Keywords: eating disorders, ANZAED credential, carers, Australia, treatment access, anorexia nervosa, credentialing, Family Based Treatment, mental health professionals, dietitians, health workforce, Integrating
News Source: Glenn Wilkins. (November 5, 2026). Carers value eating disorder credential but say access barriers persist. Scienmag.
