# A mixed-methods study investigating the acceptability of an early acceptance and commitment therapy (ACT) intervention to aid adjustment to appearance changes after burns

## TL;DR

This study explores whether an early acceptance and commitment therapy (ACT) intervention called ProACTive is acceptable for helping people adjust to appearance changes after burns.

## Contribution

The study introduces and evaluates the acceptability of an early ACT intervention for appearance adjustment after burns.

## Key findings

- Over two-thirds of participants completed all modules of the ProACTive intervention.
- Qualitative feedback indicated ProACTive was helpful in exploring appearance changes and building psychological flexibility.
- Acceptability may be higher for individuals with appearance concerns and those admitted to hospital.

## Abstract

Appearance concerns after burns start soon after injury. However, early psychological interventions to support individuals with their changed appearance are absent. This study investigated the acceptability of an early acceptance and commitment therapy (ACT) intervention delivered by a psychological therapist either in person or virtually to help individuals adjust to changes to their appearance after burns. As a secondary objective, the potential effectiveness of ProACTive was also investigated. Using mixed-methods, 13 adults (eight women, five men) participated. Acceptability was measured by uptake rates, module completion rates and interview data. Over two-thirds of participants completed all modules. Three main themes were identified from interviews: An acceptable intervention; Valuing the therapeutic relationship; and Early support is key. Data suggested that ProACTive may be acceptable, although some inconsistencies within the data were observed. Ratings of helpfulness were positive and qualitative feedback suggested that ProACTive seemed helpful by providing space to explore and reflect on appearance changes, developing psychological flexibility and self-compassion, and preparing individuals for being around other people. Positive and negative affect significantly decreased (moderate effect sizes) but no significant changes on appearance concerns, psychological flexibility or self-compassion (small effect sizes) were revealed. ProACTive may be an acceptable early psychological intervention to support the adjustment of appearance changes after burns. Acceptability may be higher in individuals with appearance concerns and those admitted to hospital. The intervention holds promise soon after burns but further research on acceptability and effectiveness is needed.

•ProACTive may be an acceptable early intervention after burns.•Ratings of helpfulness and qualitative feedback were positive.•ACT for appearance concerns in acute hospital settings needs further evaluation.

ProACTive may be an acceptable early intervention after burns.

Ratings of helpfulness and qualitative feedback were positive.

ACT for appearance concerns in acute hospital settings needs further evaluation.