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Acceptance and commitment therapy for appearance anxiety: three case studies

Shepherd, Laura, Turner, Anna, Reynolds, Darren P. and Thompson, Andrew R. ORCID: 2020. Acceptance and commitment therapy for appearance anxiety: three case studies. Scars, Burns & Healing 6 10.1177/2059513120967584

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Introduction: Due to scarring, appearance anxiety is a common psychological difficulty in patients accessing burns services. Appearance anxiety can significantly impact upon social functioning and quality of life; thus, the availability of effective psychological therapies is vital. Acceptance and Commitment Therapy (ACT) is considered useful for treating distress associated with other health conditions and may lend itself well to appearance anxiety. However, no published research is currently available. Methods: Three single case studies (two male burns patients; one female necrotising fasciitis patient) are presented where appearance anxiety was treated using ACT. A treatment protocol was followed and evaluated: the Derriford Appearance Scale measured appearance anxiety; the Work and Social Adjustment Scale measured impairment in functioning; the Acceptance and Action Questionnaire measured acceptance (willingness to open up to distressing internal experiences); and the Committed Action Questionnaire measured engagement in meaningful and valued life activities. Measures were given at every treatment session and patient feedback was obtained. One-month follow-up data were available for two cases. Results: After the intervention, all patients had reduced functional impairment and were living more valued and meaningful lives. No negative effects were found. Discussion: These case studies suggest that ACT may be a useful psychological therapy for appearance anxiety. The uncontrolled nature of the intervention limits the conclusions that can be drawn. Conclusion: A pilot feasibility study to evaluate the effectiveness of ACT for appearance anxiety is warranted.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Additional Information: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (
Publisher: SAGE Publications
ISSN: 2059-5131
Date of First Compliant Deposit: 9 May 2022
Last Modified: 25 May 2023 10:37

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