Changing faces changing lives

Children with a visual difference such as a disfigurement, burn scars, birth marks, skin conditions or scars that affect their appearance are often ignored, bullied, harassed or victimised by other children.

These attitudes impact not only on the child or young person but the whole family.

Now, a new role at the Royal Hospital for Children (RHC) is providing children and young people with a disfigurement with support to build their self-esteem and cope with living with an unusual appearance.

Fiona McLeod is currently the only Changing Faces Practitioner in Scotland. Based at the RHC as part of the Paediatric Clinical Psychology Service, she is providing children with a visual difference with support, advice and information to develop their self esteem and confidence in dealing with the complex medical and psychosocial difficulties they face due to society’s pressure on appearance.

Fiona’s role is to support children and young people with visible differences, including:

  • children or young people with dermatological conditions such as eczema, birth marks, acne or epidermolysis bullosa (EB);
  • craniofacial conditions such as Apert syndrome (a genetic disorder characterised by the premature fusion of certain skull bones);
  • burns or scars acquired from an accident either early in life or later in adolescence;
  • young people referred from plastic surgery for issues related to surgery, change in appearance following an accident, or conditions such as radial dysplasis or congenital shortened fingers.

By working with the child, their families and other health professionals, Fiona is able to offer children a better understanding of their condition and to explore their feelings about it. She works with the children to develop new ways for them to manage other people’s reactions and social situations effectively, build their confidence and allow them space to consider treatment options outwith the medical setting.

Fiona also liaises with schools regarding the impact of visible difference by helping to enhance teachers’ knowledge and support to the young person and promoting an environment of inclusion and equality.

Fiona said: “Around half of children with a disfigurement have experienced bullying which can have a devastating effect on their lives affecting their mental health and wellbeing.

“My role is to offer psychosocial support to children, young people and their families in dealing with the complex medical and psychosocial difficulties they face with respect to the appearance of the child or young person.

“Seeing the resilience that many of these children have facing difficulties and managing their conditions, which can impact greatly on their everyday lives, is inspiring and I am privileged to be part of their journey.”

Sue Robinson is a Consultant Clinical Psychologist and leads the Paediatric Clinical Psychology Service. She has seen the effect a disfigurement can have on a child’s life.

Sue is delighted that children will benefit from of a dedicated Changing Faces Practitioner who can provide additional support and advice not only for the child and their families, but also work alongside other professionals in increasing their understanding of the psychosocial issues affecting young people with a disfigurement and ways to best support them..

She said: “Our medical, nursing and allied health professional colleagues all provide emotional support to children and young people with disfigurements and their families. The introduction of the Changing Faces Practitioner post enhances this care by offering timely, tailored help utilising the Changing Faces package of support, which has already been used successfully in other health settings across the UK.

"This is helping large numbers of children and young people to deal with the effects that living with a visible difference can have on daily life.

“By assisting these children and families early in managing their circumstances better, their potential need for more specialist psychological support in the future is reduced.”

Fiona's post is a collaboration between NHS Greater Glasgow and Clyde and Changing Faces, the UK’s leading charity for everyone who has a mark, scar or condition that makes them look different.

Initial funding for the post was provided through the Big Lottery in Scotland via Changing Faces. However, the post will continue through dedicated funding from NHS Greater Glasgow and Clyde.

Rob Murray, Changing Faces Scotland Manager, said: “We are delighted by the forward-thinking approach NHS Greater Glasgow and Clyde have taken to supporting children, young people and their families who have a scar, mark or condition which alters their appearance.

“Having a dedicated Changing Faces Practitioner within the Royal Hospital for Children gives children the opportunity to get the support, advice and information they need to live the life they want.

“This work is groundbreaking and we thank the Big Lottery in Scotland for their confidence in this model and indeed Sue Robinson and her team.”

Marcus having a good laugh with his friends. Photo courtesy of Christopher Thomond.

Top image - 13 year old Marcus with Jacob Tremblay, star of 2017 movie Wonder.