Research projects at the Centre for Appearance Research (CAR)

Find out how the research at CAR makes a difference.

Research projects related to our themes, Visible Difference and Body Image, can be found below. Find out more about how these projects make a difference.

Visible Difference projects


This two-year international project involves developing and testing a training programme for healthcare professionals in five European countries to facilitate patient adjustment to the challenges of living with a visible difference. The training is based on the principles of Acceptance and Commitment Therapy (ACT).

CAR are collaborating with experts from eight countries to deliver the project. The training will be carried out to a range of health professionals in Romania, Greece, Cyprus, Slovenia and Estonia. The project is funded by Erasmus+. For more information, please visit ACT Now.

Appearance matters: Optimising the outcomes for vocational guidance counselling and vocational training

In collaboration with five partners from across Europe, we developed training for vocational guidance counsellors and trainers. Consequently, they could understand and recognise causes and consequences of disfigurement and/or appearance dissatisfaction in their clients. Moreover, the stigma and/or discrimination faced by these individuals.

This project was funded with support from the European Commission.

Appearance matters: Tackling the physical and psychosocial consequences of dissatisfaction with appearance

We collaborated with 34 countries representing over 55 organisations across Europe to create an approach to establishing levels of appearance-related distress and the damaging affects on physical and psychological health in European countries. Although there are examples of research and activism in the field in Europe, many researchers work in isolation, diluting the potential impact of their work. This collaboration has forged crucial links between researchers, practitioners and policymakers. Offering the potential for significant benefits to the millions of Europeans adversely affected by these issues.

Appearance Matters was funded by the Cooperation in Science and Technology (COST), with support from the European Commission. The project is COST Action IS1210.

Be positive

Be Positive

Our partners for Be Positive were from Austria, Bulgaria, Greece, Spain and Sweden. We developed an innovative method of training that empowers young unemployed individuals and/or NEETs (Not in Employment, Education or Training).

We prepared participants to adapt to stressful events and successfully assimilate these. They could also use these stressors as opportunities for positive growth based on identification and utilisation of key Positive Psychology constructs and processes. This was accomplished by developing a 'Be Positive' training curriculum. Now organisations have a resource that addresses the psychological issues that are relevant to this group in a positive way.

Be Positive was funded with support from the European Commission.

Children's Burns Trust Residential Family Weeekends

Children’s Burns Trust run regional residential family weekends to provide support to families of burn injured children. CAR has been conducting an independent evaluation of these weekends to better understand the benefits for families, children, and staff, as well as identify any barriers to engagement.

Does appearance matter?

We've been working with staff at Explore@Bristol, an award-winning science centre, to develop an interactive exhibit titled ‘First Impressions’. The aim is to encourage the public to consider their appearance-related stereotypes and to promote acceptance of diversity of appearance.

This project has been made possible with the support of the British Psychological Society and the Department of Psychology, UWE Bristol.

Face value

We collaborated with experts from seven European countries to develop a training resource for health professionals. RSBDF (Norway) and ECO's (The Netherlands) aim was to optimise psychosocial support for individuals with visible difference. The modular training course was piloted on 80 to 20 health professionals in Bulgaria, Latvia, Serbia and Turkey.

This project raised awareness and contributed to social dialogue about discrimination and social exclusion for individuals/families with disfiguring conditions.

Face Value was funded with support from the European Commission.

Identifying the psychosocial factors and processes contributing to successful adjustment to disfiguring conditions

In the largest study of its kind, we worked with researchers across the UK, to investigate psychological factors that influence adjustment to a visible difference. As a result, we developed a CBT (Cognitive Behavioural Therapy) based intervention manual. For specialists working with individuals with a visible difference. This project was supported by The Scar Free Foundation.

Innovative Health Educational Module (IHEM)

As part of a consortium of multi-disciplinary vocational training experts, we developed a modular training course to educate health professionals about the educational trajectories of common congenital anomalies such as cleft lip and/or palate. The aim of the course is to increase awareness about the need for diagnostic screening and improve access to care provision to support children's' educational development.

The Innovative Health Educational Module (IHEM) is currently being piloted with 50-100 health professionals in Bulgaria, Latvia, Serbia, Sweden and Turkey. This project was funded with support from the European Commission.

Patient Reported Outcome Measures (PROMS) in burns

Funded by Restore Burn and Wound Research, we developed patient reported outcome measures (PROMS) for use by clinicians and researchers working with people affected by burn injuries. Further funding was provided by Dan's Fund for Burns, and the Children's Burns Research Centre.

Perspectives: A photographic study

Our overall aim is to promote positive attitudes towards diversity in appearance among the public. We're working on ways to improve understanding about different forms of visible difference. In order to promote people with an unusual aspect to their appearance.

We collaborated with professional photographer, Joanne de Nobriga. Joanne created a photographic ‘portrait’ of them. The portrait had to communicate something about who they are and what they do. Participants were asked to write a short biography to accompany the photo, to introduce themselves to viewers.

Socioeconomic burden of alopecia

We are working with the charity Alopecia UK on a project funded by Pfizer UK (PDF) to investigate the social, economic and psychological impact of alopecia areata (a hair loss condition affecting around 2.5% of the population). 

The CARE study

Craniofacial microsomia: Accelerating Research and Education

Funded by the National Institutes for Health in the USA, this five-year international programme is a collaboration between the Centre for Appearance Research, Seattle Children's Hospital, and multidisciplinary researchers, clinicians, and advocacy groups based around the world. The aim of this research is to investigate the psychosocial impact and healthcare burden of craniofacial microsomia, and to implement a long-term global strategy to improve care for those affected and their families.

For more information, please contact Dr Nicola Stock ( 

The Scar Free Foundation

Funded by The Scar Free Foundation, we're members of the Burns Collective, alongside clinicians and researchers at:
  • North Bristol NHS Trust
  • University of Bristol
  • University of Bath
  • Cardiff University

We work on a psychosocial stream within this exciting new, multi-disciplinary research group. The programme aims to improve the provision of care for young people and their families affected by burn injuries.

Find out more about the Children's Burns Research Centre.

UNITS study

Understanding needs and interventions for the treatment of scarring: The psychosocial impact of conflict-related disfigurement

Funded by the Scar Free Foundation as part of the Scar Free Foundation Centre for Conflict Wound Research, this research aims to explore the experiences of military personnel and veterans who have sustained appearance-altering injuries during military operations or training since 1969, and their family members, to understand the role of appearance and body image in their adjustment.

The overall purpose of this three-year project is to develop tailored support for those affected by appearance-altering injuries sustained during military operations and training.

For more information, please contact Dr Mary Keeling or email the UNITS study team at

Vocational Training Charitable Trust (VTCT) Foundation

This major programme of work is driven by priorities set by charities that work directly with people and their families who are living with visible difference. With support from the VTCT Foundation, we will embark on a new programme of research, to help charities in this sector maximise their impact.

Find out more about the VTCT Foundation project.

When looks get in the way

Optimising patient outcomes through the training of health care professionals

We led an EU-funded collaboration between universities and non-governmental organisations across six European countries. An academic programme was created for health professionals from a variety of specialist areas (doctors, nurses, dentists, occupational therapists, physiotherapists etc). 

The programme provided training to enable them to identify and support patients with appearance-related issues and thus optimise patient outcomes. This was in response to research showing many patients may have concerns about their appearance or body image. Which impacts their health and psychosocial well-being, and influences their healthcare decision making and their recovery.

This project was funded with support from the European Commission.

YP Face It

We worked with young people with a visible difference to develop an online psychosocial support tool. The NIHR-funded feasibility trial to evaluate YP Face IT in primary care, ended in October 2016. We're now seeking funding for the definitive trial.

Body Image projects

Appearance matters on Facebook

We're exploring the ways in which young people use Facebook and how they feel about themselves and their bodies. The study will contribute to our understanding of body image concern in adolescents. Through investigating one potential contributing source, that of social networking sites, which have now become an integral part of young people’s lives.

We're in the process of recruiting approximately 1,000 adolescent girls and boys between the ages of 13 and 16 years. The findings will inform a theoretical model to explain the relationship between Facebook use and body dissatisfaction and help to promote safe and healthy use of technology.

This project is funded by UWE Bristol. Find out more information about the Appearance Matters on Facebook project.

Cosmetic surgery interventions

This project focuses on assessing the feasibility of routinely using a brief psychological screening and follow-up tool for patients seeking cosmetic surgical procedures.

This project is funded by The Scar Free Foundation and The British Association of Aesthetic Plastic Surgeons.

Dove Self-Esteem Project

In partnership with the Dove Self-Esteem Project, we conducted three streams of research to improving body image in young people. This has included the:

  • Development and randomised controlled evaluation of a school-based body image intervention for high school students, designed for delivery by teachers (Confident Me)
  • Randomised controlled evaluation of an online information and resource hub for parents of adolescent girls
  • Developing and evaluating a body image programme (Free Being Me) for delivery by youth leaders to girl guiding groups, conducted in collaboration with the World Association of Girl Guides and Girl Scouts.

These resources are now being disseminated by Dove worldwide, with over eight million young people reached since 2012. We were shortlisted for a Times Higher Education Award in 2016.

Find out more about the Dove Self-Esteem Project.

Future Quest Body Image Programme

This project will evaluate three classroom-based programmes for improving young people's body image. Delivered by teachers to 13 to 14 year old girls and boys across 14 secondary schools. We are comparing the Dove Confident Me programme to interventions based on cognitive dissonance and mindfulness.

This is funded by the Higher Education Funding Council for England (HEFCE) and is in collaboration with Future Quest.

Mirror, mirror project

We developed a teacher training pack that addresses the consequences of negative body image. The project aimed at lowering dropout rates and increasing completion rates of VET (vocational education and training) students in partner countries through focusing on precisely those dropout aspects seemingly ignored or avoided by others when addressing the same issue. Promoting awareness about these issues to teachers ultimately contributes to an easier and more successful training completion and access to the job market for the students.

This project was funded with support from the European Commission.

Find out more about the Mirror, Mirror project.

Projects covering Visible Difference and Body Image

Breast cancer and body image

With the support of Breast Cancer Now, we examined the psychosocial impact of breast cancer, those impacts being:

  • breast reconstruction
  • DCIS (Ductal Carcinoma in Situ)
  • the experiences of Black and South Asian women
  • interventions to support patients affected by chemotherapy-related hair loss.

Cosmetic procedures and body image

This project will examine the characteristics of those presenting for cosmetic procedures and explore the psychological impact of undergoing such procedures. In addition, piloting a psychological screening tool with cosmetic surgery patients.

Promoting shared decision making about appearance-altering surgery

We developed an intervention called PEGASUS, to support shared decision making. Between health professionals and their patients who are considering surgery that will alter their appearance. Research to date has explored its use with women contemplating breast reconstruction after mastectomy, or breast augmentation as a cosmetic procedure.

For more information, visit Pegasus Decision Making

PhD research

View our current and completed PhD research.

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