Empowered to 'face it'

A randomised controlled trial testing an online intervention tool for adults with a visible medical condition

Pointillism faces of different bright colours

Empowered to 'face it'

A randomised controlled trial testing an online intervention tool for adults with a visible medical condition

Title: Empowered to 'Face It': A randomised controlled trial testing an online intervention tool for adults with a visible medical condition

Funded by: Norway Regional Health Authorities

Funding amount: 4,950,000 NOK

Location: Norway

Dates: 2026–2029

Project partners: PI Dr Kristin Billaud Fergen (Centre for Rare Diseases, Oslo), Co-App Professor Ingela Lundin Kvalem (University of Oslo), Co-App Associate Professor Tine Nordgreen (University of Bergen)

University of Plymouth Co-App:

Professor Alyson Norman

Overview

Looking different can be demanding in appearance-focused societies. Many medical conditions include visible characteristics that may attract unwanted attention. As a result, individuals with such conditions may struggle with low self-esteem and appearance-related concerns that will impact mental well-being and health care decisions.

Health care systems lack clinical expertise on appearance-related challenges. The Plymouth-based self-help tool known as FaceIT can help. We will test its modernised Norwegian version (N-FaceIT) to provide clinical evidence for its effectiveness. Dr Alyson Norman developed the original UK-based version and has supported in the development of the translation and will further support in evaluating the new version of the tool in Norway.

Objectives

Evaluate N-FaceIT's effectiveness and economic benefit by comparing an intervention group with a waitlist control group before and after access to the intervention (quantitative data).
Explore and identify predictors (e.g., age, sex, baseline distress levels) that clinicians can use to identify patients that may benefit from using N-FaceIT (quantitative data).
Assess FaceIT's perceived usefulness and cultural relevance for adults with visible differences in Norway, including potential needs for cultural adaptations (qualitative data).
Examine and understand support needs and experiences with health care provision among adults with a visible medical condition (qualitative data).
Disseminate results to the healthcare system and implement Face It on the Norway national health platform, Helsenorge, so that adults with a visible difference can find support.

Context of the issue

Research indicates that 30–50% of individuals with conditions that affect appearance may struggle with low levels of self-esteem, appearance-related concerns, psychosocial difficulties, depression, and social anxiety. The visibility of a medical condition adds a unique layer of daily challenges by leading to unwanted attention (staring, intrusive questions, comments about appearance) that has been proven to be emotionally distressing and difficult to manage for many.

We also know that some adults with a visible difference feel devalued and unattractive, impacting social interactions and the formation of romantic relationships, a major aspect of adult life. Appearance-related issues will also affect health care decision-making, where aesthetic and reconstructive surgery can be chosen to fix concerns that are not necessarily solved by medical treatment.

How the project addresses the issue

The new N-FaceIT programme could provide a form of psychosocial support to adults with visible differences, enabling to reduce their appearance-related distress.

People live with the impact of their visible medical conditions through stigma, prejudice, staring, comments and unwanted questioning. Through advances in digital technology, we can now provide a range of supportive resources that people can access without having to attend face-to-face therapy, which can be incredibly overwhelming for those who look different.

Professor Alyson Norman
Associate Head of School for Teaching, Learning, Quality and Student Experience

Centre for the Psychology of Health and Wellbeing

The Centre for the Psychology of Health and Wellbeing (CPHW) at the University of Plymouth brings together researchers in clinical, cognitive, social, and environmental psychology to understand and improve health in real-world contexts.

The CPHW's interdisciplinary research addresses health and wellbeing across the lifespan, and integrates theoretical models and methods from neuroscience, cognition and applied social and health psychology.

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