‘Outlook’: A Psychological Service for Children with a Different Appearance

‘Outlook ’ is a unit within North Bristol Trust which has been developing a psychosocial service for children, young people and adults with a different appear-ance resulting from congenital abnormalities such as cleft lip and palate and also burns and other forms of trauma. This study presents data collected from 29 children aged between 5 and 16 who received individual therapeutic interventions. The baseline assessment included a semistructured interview schedule, visual analogue scales and the CBCL (Achenbach, 1991) to provide the parents ’ view of their children’s behaviour profile. Measures were repeated post intervention and at 6 months follow-up. The intervention consisted of four sessions of cognitive-behavioural therapy (CBT) including social skills and problem-solving components. Statistical analyses revealed significant outcomes on a range of measures. At 6 months follow-up children reported a reduction in the frequency of teasing and in the degree of distress it caused both in the classroom and in the playground. Parents reported reductions in their children’s ’ somatizing behaviour and levels of anxiety. These outcomes suggest that this approach represents an effective therapy for children with appearance-related psychological problems. K E Y WO R D S CBT, children, disfigurement, psychological need In nature there’s no blemish but the mind; None can be called deformed but the unkind