A social training program for clients with facial disfigurations

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Abstract
Disfigurations are a particularly grave consequence of surgical treatment necessary in malign facial tumors. After such drastic treatment procedures, patients often react with total social withdrawal which is frequently caused by the inadequate reaction of their environment to their disfiguration. Consequently, many such patients suffer from social anxiety, negative self-evaluation and depression. This study investigated the effectiveness of a social training program for this group of handicapped people. The training consists of 36 different training situations relevant for the everyday-life of facially disfigured clients. They were trained in group therapy in a form of role play. Ten training sessions of 2 hours duration each were held. Generalization to real-life situations was to be facilitated through practice at home. The training method is described and examples of training situations are given. Clients (17) participated in the study under experimental or control group conditions. They were treated by a team of 1 male and 1 female therapist. Pre- and post-training measures were taken. In addition, follow-up data were collected two years after therapy. In the experimental group, data showed significant improvements in self-confidence, reduction of contact anxiety and anxiety in relevant social situations; these improvements could be maintained over the two-year follow-up period. There were no improvements in the negative self-image and self-discontent. Results are discussed and suggestions for further improvement of the training are given. The paper concludes with general considerations concerning psychological rehabilitation of clients with facial disfigurations.

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