{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:12:26Z","timestamp":1792102346426,"version":"4.4.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018379","name":"VTCT Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018379","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Alongside the typical challenges of parenting, parents and carers of children with visible differences can experience additional psychosocial challenges including anxiety, stress, guilt, and concerns about stigma and discrimination. The Visible Difference Parenting Toolkit is an ACT-based intervention aimed at improving psychosocial well-being for this group of parents\/carers. This study examined the acceptability and potential benefit of the intervention utilizing a mixed-methods single-arm pre-post design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Parents\/carers (baseline n\u2009=\u2009173) completed an online survey at three time points: (1) baseline, (2) post-intervention, and (3) 2-month follow-up. Paired t-tests on available matched data assessed differences in outcome measures between timepoints (83 pairs at post-intervention, 62 at follow-up). Open-ended responses were analyzed using content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Statistically significant reductions in parent-reported depression and anxiety and statistically significant improvements in parent-reported self-efficacy were found between baseline and post-intervention. Additionally, significant reductions in parent-reported depression and anxiety and significant improvements in self-compassion, self-efficacy, and psychological flexibility were found between baseline and follow-up. Parenting stress did not significantly improve post-intervention immediately, but showed significant change at follow-up. Responses to open-ended questions indicated that although some ongoing concerns remained about future challenges, the intervention helped parents\/carers feel more knowledgeable and confident in supporting their child.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study suggests the Visible Difference Parenting Toolkit is an acceptable and potentially useful intervention for supporting parents\/carers of children with a visible difference. This novel intervention addresses a gap in the current support provision in the visible difference field and is now freely available through www.VisibleDifferenceSupportHub.com.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jpepsy\/jsag043","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T17:25:30Z","timestamp":1783790730000},"page":"778-790","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the Visible Difference Parenting Toolkit: an ACT-based intervention to improve parental\/carer stress and psychosocial well-being of carers of children with appearance affecting conditions and injuries"],"prefix":"10.1093","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3547-8840","authenticated-orcid":false,"given":"Maia","family":"Thornton","sequence":"first","affiliation":[{"name":"Centre for Appearance Research, School of Social Sciences, College of Health, Science & Society, University of the West of England 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