CBT for Appearance Anxiety: Psychosocial Interventions for Anxiety Due to Visible Difference
Open accessAbstract
This clinical manual provides a CBT-based psychosocial intervention for use with individuals distressed about their appearance due to a disfigurement from birth, accident or illness, or those coping with another visible difference. Contains a wealth of case material with specific relevance to physical health conditions that affect appearance, practical advice on assessment, and session-by-session guidance for addressing common issues Written by leading academics and clinicians working in the management of disfigurement and rational appearance anxiety Uses a flexible stepped-care model that allows for use by experienced CBT practitioners as well those wishing to deliver a more basic psychological intervention Identifies the psychological factors involved in appearance anxiety while also addressing the practical concerns of living with a visible difference, such as managing the reactions of others
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Appearance-related distress is an emotion maintained by dysfunctional cognitive processes, such as fear of negative evaluation, social comparison, negative attributions, and selective and self-focused attention.
“In this model, as shown in Figure 1, appearance-related distress is an emotion maintained by dysfunctional cognitive processes , such as fear of negative evaluation, social comparison, negative attributions, and selective and self-focused attention.”
From A Novel Psychological Group Intervention Targeting Appearance-Related Distress Among People With a Visible Disfigurement (Inside Out): A Case Study (2023) · cites this paper as Clarke et al., 2013
These cognitive processes cause a person to interpret social encounters as potentially threatening, thereby encouraging feelings of anxiety, shame, or anger.
“These cognitive processes cause a person to interpret social encounters (e.g. staring, questions about appearance) as potentially threatening, thereby encouraging feelings of anxiety, shame, or anger.”
From A Novel Psychological Group Intervention Targeting Appearance-Related Distress Among People With a Visible Disfigurement (Inside Out): A Case Study (2023) · cites this paper as Clarke et al., 2013
Behavioral strategies, such as social avoidance and safety behaviors, may sustain appearance-related distress in the long run by preventing changes in cognitive appraisal and/or by providing further exposure to triggers.
“Behavioral strategies, such as social avoidance and safety behaviors (e.g., mirror checking, multiple layers of clothing, excessive makeup, avoidant eye-contact, poor social skills), may sustain appearance-related distress in the long run by preventing changes in cognitive appraisal and/or by providing further exposure to triggers.”
From A Novel Psychological Group Intervention Targeting Appearance-Related Distress Among People With a Visible Disfigurement (Inside Out): A Case Study (2023) · cites this paper as Clarke et al., 2013
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“Others may feel that although other people have issues about their appearance, personally they are not ashamed of their appearance, but they maybe nevertheless worried by anticipated negative reactions of others (10).”
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“Other responses could include active ignoring with confident nonverbal communication, leaving the situation, seeking out friends’ support, telling the person to stop, using friendly humor, and/or getting help from an appropriate adult (Clarke et al., 2013).”
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“…also be helpful, such as that advocated by the National Institute of Clinical Excellence to address mental health concerns (National Institute for Clinical Excellence, 2001), and the model employed by the Centre for Appearance Research at the University of the West of England (Clarke et al., 2013).”
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“Finally, for youth with body image disturbance, cognitive-behavioral strategies can also be effective in addressing appearance-related distress and impairment in daily functioning (Clarke et al., 2014; Harcourt et al., 2018).”
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“Researchers and clinicians working with patients with appearance altering conditions such as Bessell and Moss(34), Clarke et al.(35) and Jenkinson(36) have indicated that interventions employing cognitive behavioural therapy (CBT) techniques have the potential to reduce levels of social anxiety and unhelpful thought p…”
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“In line with broader research, the data therefore suggest that psychological interventions could seek to address appearance-related anxiety using evidence-based approaches, preferably starting in early adolescence (eg, Clarke et al., 2013).”
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“Taken together, this corroborates existing evidence that intervening in one domain may also indirectly improve adjustment in other domains (Clarke et al., 2013; Feragen et al., 2015).”
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“Clinical severity of a visible difference is a poor predictor of psychological distress, and even evidence about the visibility of one’s difference predicting distress is equivocal (Clarke et al. , 2013; Thompson & Kent, 2001).”
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“Content adapted from existing manual (Clarke et al., 2013).”
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“This fits with existing research about the role played by the salience of appearance within self-concept in adjustment to conditions affecting appearance (Clarke et al., 2013).”
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- Authors
- Clarke, A., Thompson, A., Jenkinson, E., Rumsey, N., & Newell, R.
- Venue
- Wiley eBooks
- Publisher
- Wiley
- Published
- 2013-11
- OpenAlex
- W118598555
- Cited by
- 84
- References
- 0
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 7 · 2023: 4 · 2022: 4 · 2021: 4 · 2020: 14 · 2019: 8 · 2018: 6 · 2017: 5 · 2016: 6 · 2015: 5 · 2014: 6 · 2013: 3
- FWCI
- 5.08
- Type
- book
- Language
- en
- Open access
- green
- eprints.uwe.ac.uk
- Licence
- Locations
- Wiley eBooks (publishedVersion)
- UWE Research Repository (UWE Bristol) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- appearance anxiety, cognitive behavioral therapy, disfigurement, visible difference, body image, psychosocial interventions, stepped care, assessment, case materials
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