Innovations in providing psychosocial support to people living with conditions affecting appearance

Abstract

Background: Changing Faces is the UK’s leading charity supporting people living with an injury, mark, scar or condition that affects appearance. This evaluation is the first to examine the effectiveness of Changing Faces Practitioners (CFP’s) delivering the Changing Faces psychosocial intervention package, FACES in three NHS hospitals (Great Ormond Street Children’s hospital, Sheffield Children’s hospital, and Salisbury Hospital). Method: A case study approach involved systematic recording of activity undertaken and preparation of illustrative case studies across hospitals. Effectiveness of the CFP service was established by examining session by session outcome measures. Improvements in psychosocial distress were examined using The Reliable Change Index and clinically significant change in scores on individual measures of depression, anxiety, appearance concern or Child Outcomes Rating Scale. Satisfaction and impact on service provision was evaluated using questionnaires and interviews with clinicians and service users. Findings: Clinical and/or reliably significant improvement in psychosocial distress was reported by children and adults attending two or more CFP sessions. Feedback questionnaires and interviews suggest that CFP services meet the needs of patients moderately to extremely well, and could be characterised into three main themes 1. Helpful strategies to manage appearance concerns, 2. Feeling listened to and 3. CFP input as a necessary adjunct to the MDT. Conclusions: Having CFP’s present in medical appointments to provide psychosocial support and signposting as part of an MDT approach was beneficial for service users and clinicians. There is a need for appropriate psychosocial support around appearance-related distress as an adjunct to medical care.