UNITS SOCIAL: Understanding Needs and Interventions for the Treatment of Scarring (UNITS): Self-help for Overcoming Challenges in Interpersonal and Associated Life Situations (SOCIAL)

The original UNITS study (2018 - 2022), funded by the Scar Free Foundation, generated evidence indicating that the most common psychosocial challenge experienced by UK ex-Service personnel with an appearance altering injuries (AAI) was unwanted public attention and managing difficult social situations (Keeling et al., 2024; Keeling et al., 2022).

In response to these findings, a self-help guide to manage difficult social situations was created based on existing materials developed for civilians with AAI and adapted for the military context. The self-help guide was subsequently acceptability and feasibility tested with ex-Service personnel with AAI and with health professionals who work with them, with positive outcomes. Now, the research team has acquired additional funding from the Scar Free Foundation to support the evaluation of the self-help guide.

The research aims to evaluate the effectiveness of the self-help guide for managing difficult social situations among UK ex-Service personnel with AAI. The proposed evaluation has the potential for considerable and measurable impact for (ex) Service personnel with AAI. If the evaluation shows the self-help guide to do no harm and to be beneficial, especially for lowering social anxiety and social avoidance, the guide will be made available to UK ex-Service personnel with AAI with the potential to greatly improve their psychosocial well-being. Additionally, it is envisaged that the guide may be of interest internationally with potential future scope for adaptation and evaluation in other countries. 

A pre-post evaluation method will be used to address the project aim.

Participants recruited to the study will be asked to complete a pre-intervention questionnaire which will include questions about demographic, military service, and injury characteristics, collect  'baseline' data on the key outcomes of interest (social anxiety, social avoidance), ask questions about current difficulties with social situations, and ask questions about any previous support or help received for any psychosocial difficulties related to their AAI.

The participants will then be asked to download and read the self-help guide and to spend the next four weeks implementing the techniques and information gained from the guide. After four weeks, participants will be asked to complete a post-intervention questionnaire which will collect post-intervention data on the same key outcomes of interest using the same questions and ask about their experience of using the self-help guide and of implementing what they learnt from it and the difference it made to them.

UK ex-Service personnel who sustained AAI during military service, such as limb loss and/or scarring, any time since 1969, who report experiencing difficulties with social situations. A minimum of 50 participants are needed to ensure suitable power is achieved for a meaningful comparison of pre and post intervention scores for the group.