Systematic Review: Psychosocial Interventions for Children and Young People With Visible Differences Resulting From Appearance Altering Conditions, Injury, or Treatment Effects

J Pediatr Psychol. Nov-Dec 2015;40(10):1017-33. doi: 10.1093/jpepsy/jsv048. Epub 2015 May 25.


Objective: Evaluate critically the evidence of the effectiveness of psychosocial interventions for children/young people (<18 years old) with visible differences in improving self-esteem, social experiences, psychological well-being, and behavioral outcomes.

Methods: Studies were systematically identified using electronic databases, appraised according to eligibility criteria and evaluated for risk of bias. Findings were reported using the PRISMA checklist.

Results: Studies were identified that evaluated residential social camps, exercise with counseling, social skills training (SIST), behavioral therapy (BT), and cognitive behavioral therapy (CBT). Risk of bias within studies was high. Camp studies and exercise with counseling showed little or no effect postintervention on self-esteem, social experiences, and psychological well-being. The five studies evaluating SIST, CBT, and BT provided limited support for their effectiveness.

Conclusions: Evidence base is inconclusive. Further rigorous research using appropriate outcome measures to evaluate the effectiveness of interventions for young people with visible differences is required.

Keywords: burns; children; intervention outcome; psychosocial functioning; social skills and development; systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Body Image*
  • Child
  • Cognitive Behavioral Therapy / methods*
  • Counseling*
  • Exercise
  • Female
  • Humans
  • Male
  • Self Concept*