Online tool helps people with facial disfigurement



People who have a noticeable facial disfigurement often report staring, comments and curiosity from others, particularly when meeting them for the first time.>/p>

A support tool called ‘Face IT online’, designed to help people manage these everyday reactions to their appearancehas been launched. ‘Face IT online’ will encourage people with disfigurement, who find that their appearance makes some social situations difficult, to build social skills and self-confidence.

Devised by a research team at the world renowned Centre for Appearance Research (CAR) at UWE Bristol, the on-line tool will be used in clinics by health care professionals to help people develop strategies to ensure that social situations go well. The tool was funded by the UK’s leading disfigurement charity, Changing Faces, and the EU.

Lead researcher Dr Alyson Bessell, who is now based at the University of Plymouth, focused on the development and evaluation of the tool for her PhD study when she was based at CAR.
Dr Bessell explains that social anxiety resulting from appearance is a widespread problem affecting many people, “There are around one million people in the UK who have some kind of visible difference (542,000 facial). Each year there are around 2000 new cases of mouth cancer, which often leads to surgical intervention leaving facial scarring, and around 2000 children are born with a congenital abnormality. Figures suggest that around 48% of adults with a visible difference may experience at least borderline levels of anxiety. The emphasis within the medical profession is purely on treating the physical injury, and psychological support is often lacking. Research has identified the importance of psychosocial support in helping individuals to positively adjust to altered appearance, and support from health professionals is a fundamental part of this process.

“‘Face IT online’ will help people with disfigurement to manage negative assumptions about how they think others see them. For example, it is easy to misinterpret eye contact which is part of normal communication, as staring at a particular feature on the face. This tool is about challenging this sort of assumption.

“People with facial disfigurement have to deal with reactions to their appearance on a daily basis but the problem also exists for those with concealed disfigurements like burns or scarring on the torso. These people also have to face up to the reaction of others if they go swimming or before embarking on an intimate relationship.”

‘Face IT online’ is a social skills training tool that takes people through an eight week programme of activities to help address common problems. It will be used by health professionals working with people who need more help to build the positive strategies that people who adapt positively to an unusual appearance use successfully on a daily basis.

Having a disfiguring condition need not be a barrier to living the same happy and fulfilling life as anyone else.

Michelle Gemelos is a user who has found the Face IT tool really helpful. She said, “Face IT is such a valuable tool because it not only demonstrates in a clear and easy-to-use way how to be confident and open to new social experiences, it also explores the possible consequences of different types of reactions you might have in certain everyday situations. It allows users to consider and reconsider their responses to challenging and sometimes downright difficult encounters. Moreover, it shows you that if you act confident (even when feeling intimidated), you can truly become confident in your everyday life.”

The tool has been well received by clinicians and patients. Alex Clarke, Consultant Clinical Psychologist at the Royal Free Hospital in London, has worked with Dr Bessell on developing Face-IT online, she says, “This online tool is a real breakthrough in allowing us to reach people who cannot access specialised psychological support locally. We know from the evaluation studies that this is a very effective way of teaching social skills and reducing anxiety which continues to improve as the individual practises in their day to day life. Contrary to popular belief, older people and those unfamiliar with computers made equally positive gains and found this way of working entirely acceptable.

“NHS leaders have called for clinicians and researchers to work together to take better advantage of technology – and here is a first class example of just that, with increased access for people with no compromise on quality and at lower cost.”

You can view Face IT online at