The aim of this paper is to describe working with the carers (families) of adults with anorexia nervosa (AN), which is different from working with families of younger adolescents. The main difference is in the area of rights and responsibilities of both parties. Moreover, as AN in adults is often a chronic condition, the treatment goal may not focus on recovery, but instead on improvement in quality of life. Thus the spectrum of nature and degree of parental involvement in the treatment of adults with AN is much broader than in children and adolescents. Our framework for intervention is based on a clear model of carer distress, from which targets for intervention follow. The paper outlines some of the core components of this work.