Individuals living with a visible difference in appearance experience high levels of social anxiety, yet self-help interventions for this heterogeneous population are not available. We conducted a pilot trial of a novel Acceptance and Commitment Therapy (ACT) based self-help intervention.Individuals with anxiety about having a visible difference in appearance (n = 284) were randomized to an ACT-based four-week intervention (n = 145) or a waitlist control condition (n = 139). We collected pre and follow-up (four-weeks after the completion of the intervention) data. Primary outcomes included social anxiety and impairments in functioning. Psychological flexibility (PF) was also examined. ANCOVAs, controlling for pre scores, indicated significant improvements in functioning by the intervention group. No significant differences were observed for anxiety and PF between conditions at follow-up. Drop out was 68% for the intervention and 41% for the control group, with no differences in the groups in age, origin, gender, or type of visible difference. Participants in the intervention group found the intervention almost equally, useful (77%) and helpful (73%). An ACT-based self-help intervention can alleviate distress related to visible difference in appearance. More sophisticated designs are needed now, to collect idiographic and longitudinal data and examine personalized changes across time in this population.

外表存在明显差异的个体会经历高度的社交焦虑，但目前还没有针对这种异质人群的自助干预措施。我们对基于接受和承诺疗法 (ACT) 的新型自助干预进行了试点试验。对外表明显差异感到焦虑的个体 (n = 284) 被随机分配接受基于 ACT 的为期四周的干预 ( n  = 145) 或候补名单控制条件 ( n  = 139)。我们收集了术前和随访（干预完成后四个星期）的数据。主要结局包括社交焦虑和功能障碍。还检查了心理灵活性（PF）。控制预评分的ANCOVA表明干预组的功能显着改善。随访时，未观察到不同条件之间的焦虑和 PF 存在显着差异。干预组的退出率为 68%，对照组的退出率为 41%，各组在年龄、出身、性别或可见差异类型方面没有差异。干预组的参与者认为干预措施几乎同样有用（77%）和有帮助（73%）。基于 ACT 的自助干预可以减轻与外观明显差异相关的痛苦。现在需要更复杂的设计来收集具体和纵向数据并检查该人群随时间的个性化变化。