Nichola Rumsey

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 issuesWritten by leading academics and clinicians working in the management of disfigurement and rational appearance anxietyUses a flexible stepped-care model that allows for use by experienced CBT practitioners as well those wishing to deliver a more basic psychological interventionIdentifies 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

Several years ago Coleman (1981) reported that in 1979 one of the many in­ ternational cosmetics companies had an annual sales figure of $2. 38 billion, nearly 1. 25 million sales representatives, and over 700 products, the majority of these being for the face. Cash and Cash (1982) noted that in 1979 U. S. consumers spent over $4 million on cosmetic products. They stated that, "Although this practice would seem to be a fascinating aspect of human be­ havior on the basis of its generality and resilience, social-behavioral scientists have largely ignored the phenomenon so plainly (or pleasingly) in front of their eyes. " Why should people be so concerned with their facial appearance? Many psychologists have argued (e. g. , Kleck & Rubenstein, 1975) not only that facial information is usually the first that is available to the perceiver, but also that it is continuously available during social interaction. Maruyama and Miller (1981) stated that "appearance is often the first dimension upon which a stranger can be evaluated. Since people tend to see others as integrated and consistent units, rather than as collections of situation-specific behaviors, a potent and immediately evident basis for an evaluation, such as physical appearance, should intrude into and affect any overall and subsequent evalua­ tion.