Investigating online psychological treatment for adolescents with a visible difference in the Dutch YP Face IT study: protocol of a randomised controlled trial

Abstract

IntroductionThis paper outlines the study protocol for the Dutch Young People (YP) Face IT Study. Adolescents with a visible difference (ie, disfigurement) often experience challenging social situations such as being stared at, receiving unwanted questions or being teased. As a consequence, some of these adolescents experience adverse psychosocial outcomes and appearance-related distress. To address this appearance-related distress, an online psychotherapeutic intervention, YP Face IT, has been developed. YP Face IT uses social interaction skills training and cognitive–behavioural therapy. The Dutch YP Face IT Study tests whether this intervention is effective in reducing social anxiety and improving body esteem.Methods and analysisParticipants are adolescents aged 12–18 with a visible difference and experiencing appearance-related distress. In this two-armed randomised controlled trial, 224 adolescents will be randomised to care as usual or YP Face IT. Adolescents will complete questionnaires at baseline, at 13 weeks and at 25 weeks. Primary outcomes are differences in social anxiety and body esteem between YP Face IT and care as usual. Secondary outcomes are differences in aspects of self-worth, perceived stigmatisation, health-related quality of life, life engagement, appearance-related distress and depressive symptoms between the two groups.Ethics and disseminationResearch ethics approval was obtained from the medical ethics review committee in Rotterdam (reference number MEC-2018-052/NL63955.078.18). Findings will be disseminated through academic peer-reviewed publications, conferences and newsletters to patient associations and participants of the study.Trial registration numberThe Netherlands Trial Register (NL7626).

Acceptability and feasibility of an online psychosocial intervention for Dutch adolescents with a visible difference: a mixed-methods study

“…A RCT is currently being conducted in The Netherlands (van Dalen et al, 2021). Should the results of this study be positive, YP Face IT could be implemented in hospitals across The Netherlands.…”

“…The questionnaires are described in more detail in one of our previous papers (van Dalen et al, 2021). The following questionnaires were completed by participants at baseline and post-intervention:…”

“…This intervention combines SST and CBT strategies and was derived from Face IT, an intervention aimed at adults (Bessell et al, 2012). More information about YP Face IT is included in the methods section and in a trial design paper by van Dalen et al (2021). In a Randomised Controlled Trial (RCT), Face IT was found to be effective at reducing anxiety, depression and appearance concerns (Bessell et al, 2012).…”

Educational Reward and Punishment and the Effect of Psychological Intervention on Adolescent Depression

“…Merry et al found that stressful life events, as the most important stressor, are positively related to suicidal ideation [ 7 ]. Dalen et al think that, compared with the normal control group, negative life events such as low socioeconomic status and unsound families are all related to depression [ 8 ]. Podeszwa et al found that positive thinking was related to the improvement of depressive symptoms, and its effect was significantly higher than that of the control group.…”

Recruiting difficult-to-engage groups to online psychosocial interventions: Experiences from an RCT study targeting adolescents with a visible difference

“…National statistics currently indicate there are approximately 400 000 adolescents aged 12–17 in [Country] [ 31 ]. Estimates suggest that approximately 2% have a visible facial or bodily difference that deviates from the norm [ 32 ], which means that around 8000 young people aged 12 to 17 could possibly be relevant for inclusion. Based on estimates of study power and retention, we aimed to recruit 160 young people with any appearance-altering condition, injury, or treatment side-effect, who also self-identified as experiencing appearance-related distress, teasing, or bullying.…”