CBT for Appearance Anxiety Psychosocial Interventions for Anxiety due to Visible Difference 1st Edition by Alex Clarke, Andrew Thompson, Elizabeth Jenkinson, Nichola Rumsey, Robert Newell ISBN 1118523423 9781118523421

1. Clinical Background and Treatment Considerations

Physical and Treatment-Related Factors

• Addressing medical issues and treatment outcomes.

Socio-Cultural Factors

• Influence of culture, family, and society on treatment and self-perception.

Psychological Factors and Processes

• Impact of psychological elements like body image, emotional reactions, and cognitive processes.

Body Image Disturbance

• Overview of how body image issues manifest in clinical settings.

Clinical Problems and Presentation

• Common clinical features observed in patients with appearance-related concerns.

Common Features in Referral

• Typical reasons for seeking treatment and referral patterns.

Treatment Considerations

• Key factors to keep in mind when designing a treatment plan.

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2. A Stepped-Care Approach to Psychosocial Intervention

The PLISSIT Model

• A framework for managing sexual and psychosocial issues in appearance-related conditions.

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3. Models and Frameworks

Explanation for Choice of Therapeutic Approach

• Rationalizing the selection of therapy based on individual needs.

Behavioral Approaches:

• Fear Avoidance: Understanding avoidance behaviors related to appearance.
• Social Skills Training: Building social competence to improve confidence.

Building an Evidence Base

• Importance of data-driven approaches to validate treatment efficacy.

Cognitive Approaches:

• Comparison of Appearance Anxiety and Social Phobia: Drawing parallels to anxiety disorders.

Summary

• A recap of key points related to psychosocial frameworks and therapy models.

Deriving a Cognitive Behavioral Treatment Model

• Identifying factors contributing to successful adjustment to visible differences.

The ARC Research Programme Findings

• Insights from the ARC program on treatment effectiveness and methodologies.

Summary

• Summary of models, approaches, and their contributions.

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4. Clinical Assessment

Eliciting the Problem

• Identifying key concerns through careful questioning and evaluation.

Summarizing

• Condensing the information gathered during assessment for clarity.

Motivation and Self-Efficacy

• Evaluating a patient’s readiness and confidence in managing their condition.

Readiness for Change

• Assessing whether a patient is ready to engage in treatment.

Measurement Tools

• Utilizing assessment tools to track progress and treatment outcomes.

Regular Subjective Measures of Frequency for Events, Thoughts, and Feelings

• Monitoring key psychological and emotional states over time.

Goal Setting

• Using the SMART acronym (Specific, Measurable, Achievable, Relevant, Time-bound) to set goals.

Challenges in Treatment for Appearance-Related Problems

• Recognizing and addressing barriers to treatment.

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5. Social Skills and Coping Strategies

Staring, Questions, Comments, and Loss of Anonymity

• How to manage the reactions of others to visible differences.

Making the Most of Appearance

• Empowering individuals to develop a positive outlook on their appearance.

Developing a Positive Approach to Visible Difference

• Techniques to foster resilience and a positive self-image.

Developing Verbal Skills

• Training patients to respond confidently in social situations.

Managing Staring

• Coping mechanisms to deal with attention and unwanted focus.

Putting it into Practice

• Practical applications of coping skills in real-life situations.

Taking the Initiative in Social Encounters

• Encouraging proactive social engagement.

Managing Anger and Developing Assertiveness

• Addressing frustration and building assertive communication.

Managing Intimacy

• Navigating relationships and intimacy with a visible difference.

Disclosing a Disfiguring Condition to a Partner

• Approaches for open and honest communication in intimate relationships.

Summary

• Consolidating strategies for improving social interactions and self-perception.

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6. Cognitive Behavioral Therapy (CBT)

Techniques in Cognitive Behavioral Therapy

• Overview of CBT techniques used in treating appearance-related concerns.

Socratic Dialogue

• Engaging patients in a dialogue to challenge their negative beliefs.

Eliciting Negative Automatic Thoughts

• Helping patients identify and reframe harmful thought patterns.

Manipulating Safety Behaviours

• Addressing behaviors that reinforce anxiety or avoidance.

Cost–Benefit Analyses

• Assessing the trade-offs of current behaviors versus desired outcomes.

Some Techniques for Dealing with Appearance-Related Self-Criticism and Shame

• Addressing self-criticism through functional analysis and reframing techniques.

Functional Analysis of Self-Criticism

• Exploring the underlying causes and effects of self-critical thoughts.

Summary

• Summary of CBT methods and their relevance to appearance concerns.

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7. Planning Treatment and Sessional Guides

Introduction

• Overview of treatment planning and structuring sessions.

Working at Different Levels

• Level 1 (Table 7.1): Initial interventions for mild issues.
• Level 2 (Table 7.1): More intensive interventions for moderate concerns.
• Level 3 (Table 7.1): Advanced treatment for severe conditions.

Session 1

• First session goals, assessment, and treatment planning.

Working at Level 3 Using FaceIT (www.faceitonline.org.uk)

• Introduction to the FaceIT online resource for managing visible difference.

Working at Level 4 Using CBT

• Advanced CBT techniques for patients with complex needs.

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8. The Emerging Adult

Introduction

• Understanding the transition to adulthood and its impact on appearance-related concerns.

Introducing the Problem of Transition

• Challenges faced by young adults with visible differences.

Transition from Different Perspectives

• Young Person’s Perspective: Unique challenges in this life stage.
• Parents’ Perspective: Understanding family dynamics.
• Health Professionals’ Perspective: How professionals can guide the transition.

Guidance for Improving Transitional Care

• Best practices for supporting young people during this transition.

Issues Pertinent to Caring for Young People with Appearance Concerns

• Specific issues in managing care for adolescents and young adults.

The Salience of Appearance to Young People

• Why appearance is particularly important during this stage of life.

Reluctance to Seek or Accept Support

• Addressing barriers to treatment acceptance in young adults.

Factors that Can Promote Adjustment to a Visible Difference among Young People

• Identifying factors that help young adults cope with visible differences.

Romantic Issues

• Addressing challenges related to dating and relationships.

Transition as an Opportunity for Those with a Visible Difference

• Viewing transition as a chance for growth and self-discovery.

Concluding Remarks

• Summary of key points related to emerging adulthood and appearance concerns.

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9. Psychological Assessment for Cosmetic Surgery

Introduction

• Overview of psychological assessments in the context of cosmetic surgery.

Is Cosmetic Surgery Effective?

• Examining the outcomes of cosmetic surgery from a psychological perspective.

Access to Surgery in the NHS

• Discussing access to surgery within the National Health Service.

Psychological Screening by the Surgeon

• Understanding the role of psychological evaluation before surgery.

NICE Guidelines

• Guidelines for assessing candidates for cosmetic surgery.

Onward Referral

• When and how to refer patients for further psychological support.

What Does the Surgeon Want from a Psychological Assessment?

• Surgeons’ expectations in evaluating a patient’s readiness for surgery.

What Does the Patient Want from a Psychological Assessment?

• Patients’ concerns and motivations for undergoing psychological assessments.

A Framework for Psychological Assessment

• A structured approach to evaluating candidates for surgery.

Case Examples

• Illustrative case studies of psychological assessments.

Common Problems in Referral

• Common issues faced during the referral process.

Summary

• Key takeaways related to psychological assessments in cosmetic surgery.

Additional Resources

• Additional materials and resources for professionals.

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10. Models of Service Delivery

Lay-Led Support

• Community-based support systems for individuals with appearance concerns.

Specialist Services

• Dedicated services for managing appearance-related issues.

Embedded Services

• Services integrated into broader healthcare systems.

Access to Psychology Services

• How to ensure patients have access to appropriate psychological care.

Access to Mental Health Services

• Facilitating access to mental health support for individuals with appearance-related concerns.

Mapping Service Models onto Stepped Care

• Aligning service delivery models with a stepped-care approach to treatment.