Identifying Effective Psychological Interventions

Understanding Needs and Interventions for the Treatment of Scarring
Understanding the Needs and Interventions for the Treatment of Scarring (UNITS)


This research aims to investigate the psychosocial impact of appearance-altering injuries (e.g. blast injuries resulting in scarring and limb loss, scarring from burns or gunshot wounds) sustained during operational deployment or field training on UK military personnel, ex-service personnel, and their families. This research has a specific focus of understanding how issues and concerns surrounding body image, self-esteem, identity and overall adjustment to an altered appearance, may affect psychosocial wellbeing.  The overall objective of this project is to determine how to adapt existing civilian interventions and/or develop new interventions tailored to the needs of the Armed Forces community to help support adjustment and psychosocial wellbeing.


Research conducted with members of the general population indicates that, an appearance which is different from ‘the norm’ and considered to be disfiguring by the affected person or others, can present significant psychological and social challenges.  These can include negative impacts on body image, self-esteem, confidence and feelings of anger and hostility. Social difficulties can include managing the stigmatising reactions and behaviours of others (such as staring, inappropriate comments, avoidance and unsolicited questions about their appearance), concerns about its impact on the ability to maintain and establish intimate relationships (particularly after burns or limb loss), and barriers to fulfilling employment. For some, this can result in social avoidance and isolation associated with the distressing belief that they are being negatively evaluated based on how they look.

Although there is considerable similarity in the challenges facing people with an unusual appearance regardless of its type or cause, research with those who have sustained a burn injury indicates trauma symptoms are positively associated with appearance concerns. This highlights the importance of paying particular attention to appearance-related issues when supporting patients affected by traumatic appearance-altering injuries. Yet, despite a sizeable body of evidence into the psychosocial issues surrounding visible difference, there is a dearth of published research focusing on understanding the specific psychological and social needs of men and women who have sustained disfiguring injuries as a result of military conflict (for example, burn injuries, scarring, or limb loss).  Likewise, the needs of their families have been overlooked by research.


To address the aims and objectives of this project four studies are being conducted:

  1. A gap analysis consisting of a review of existing literature and stakeholder engagement to determine what is already known about the experiences, needs and service provision for this specific group of serving/ex-service personnel and their families.
  2. A qualitative study of one-to-one interviews aimed at gaining an understanding of the experiences of serving/ex-service personnel who sustained appearance-altering injuries during deployment or field training and family members of serving/ex-service personnel with these injuries. The focus of these interviews will be to understand the effect of any appearance-related concerns on overall psychosocial wellbeing and adjustment. An additional qualitative study of interviews with civilian health professionals will be conducted at the same time to understand civilian health professionals’ perspectives of the appearance-related challenges and service needs of ex-service personnel with these injuries.
  3. A quantitative study using surveys to determine in what ways the experiences and needs of serving/ex-service personnel who sustained appearance-altering injuries in a military context differ or are similar to the experiences and needs of individuals without a military background who have sustained similar injuries.
  4. Testing the acceptability and feasibility of psychosocial interventions to meet the needs of people affected by appearance changes due to military conflict.

Current Research Participation Opportunities

A survey is now launched and ready for veterans and civilians with appearance altering injuries to take part in a 30 minute questionnaire. Please follow the links below to find out more including the opportunity to be entered in to a prize draw of up to £100 Amazon vouchers or donation to a charity of your choice. Your participation could help the development of tailored psychological support.

Veteran questionnaire
Civilian questionnaire

Research Team

Identifying Effective Psychological Interventions

Dr Mary Keeling

Identifying Effective Psychological Interventions

Dr James Kiff

Identifying Effective Psychological Interventions

Dr Heidi Williamson

Identifying Effective Psychological Interventions

Professor Diana Harcourt

Treatment of Historic Existing Scars – Scar Laser Project