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Clinical Child Psychology and Psychiatry
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‘Outlook’: A Psychological Service for Children with a Different Appearance

Lynn H. Maddern

Downend Clinic, Bristol, UK

Julia C. Cadogan

Frenchay Hospital, Bristol, UK

Michael P. Emerson

University of the West of England, UK

‘Outlook’ is a unit within North Bristol Trust which has been developing a psychosocial service for children, young people and adults with a different appearance 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 cognitivebehavioural 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.

Key Words: CBT • children • disfigurement • psychological need

Clinical Child Psychology and Psychiatry, Vol. 11, No. 3, 431-443 (2006)
DOI: 10.1177/1359104506064987
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