Psychology and licensing of non-surgical cosmetic procedures


In this guest blog, with the aesthetic sector on the cusp of the ‘biggest shakeup in a generation’, Kimberley Cairns, a specialist integrative psychologist and JCCP board member, explores the importance of psychology in aesthetic licensing.

The Health and Care Act, 2022 gives the Government the power to introduce a licensing scheme for practitioners who operate in England. The critical work is now underway to decide what the licensing scheme will look like, following the launch of a consultation into unregulated cosmetic procedures. Once established, licensing will then be introduced via secondary legislation for which the timescale is yet to be outlined, but is expected to be in 2025/26. Once in force, this legislation will make it an offence to perform particular procedures without a licence. For more on the new legislation and licensing, read Hamilton Fraser’s guide - The Health and Care Act 2022: What practitioners need to know.

Why is psychology important in aesthetic licensing?

As the Government takes forward the introduction of the licensing scheme in the aesthetic and non-surgical cosmetic sector, the case for the inclusion of an improved emotional, psychological and mental health framework for a safer sector is fundamental. The inclusion of psychology in the proposed licensing scheme is necessary due to the risk of harm associated with ill-informed, and poorly performed non-surgical cosmetic procedures. The JCCP — in partnership with a range of other organisations - have acknowledged the need for the licensing scheme to improve the ways in which the sector represents, contributes and responds to the emotional and psychological needs of the consumer. Particular attention has been given to the advertising standards that implicate body image development, and the potential harm this poses to young people and vulnerable groups when they are exposed to unrealistic imagery and exaggerated claims of aesthetic treatments.

What do we know about psychology and licensing so far?

A collection of academic, organisational, professional and personal accounts have been presented to the Government to assist with their enquiry. Selected specialists and lay people from the cosmetic community were invited to submit oral evidence to the Health and Social Care Select Committee. Here, the candid lived experience of consumers was given substantial time and consideration. These honest testimonies, along with the latest research and expert insights, gave a powerful and focused direction for the need to protect and prevent psychological harms in those seeking aesthetic treatments. The Government has since reiterated its plans to raise awareness, improve psycho-education, emotional literacy, interpersonal competence and the visibility and effectiveness of specialist support for those that may be under the influence of poor mental health at the time of seeking a treatment. This notion extends further to those who may experience emotional disturbance, psychological harm or the onset of longer-term mental health deterioration after having had an aesthetic intervention.

What is the relationship between aesthetic practice and psychology?

Psychological ambitions and outcomes in aesthetic practice and intervention can give rise to the most rewarding patient experiences that can be life enhancing when conducted, monitored and supported safely and effectively. However, the psychological fall out from predatory advertising, coercive promotional offers and poor consultation techniques can quickly deteriorate a quality aesthetic journey and break down informed consent processes, having disastrous and sometimes lasting unwanted and unexpected consequences. Complications, poor risk benefit advice, financial overspending, unidentified emotional and psychological contraindications, as well as unmet mental health needs, are all possible areas where investment in aesthetics could prove more harmful than beneficial in the longer term, which further uncovers the multi-faceted and at times precarious demands of suitability and selection. Read Hamilton Fraser’s guide to patient selection for more advice on this important topic.

The next steps for psychology in cosmetic licensing

The psychology of appearance is a fundamental driver that can be attributed to both the success and downfall of the sector. The mental health of both the practitioner and the consumer should therefore be given equal parity to that of physical health when considering the proposed licensing scheme. The Joint Council for Cosmetic Practitioners (JCCP) , British Beauty Council (BBC) and the Chartered institute for Environmental Health (CIEH) set out four main areas for the Government to tackle through the proposed licensing of the sector. This could mean greater psychological safeguards and creating psychologically safer practice. In a previous blog for Hamilton Fraser I explore the topic of mental health, safeguarding and fitness to practice.

Based on the Government's response and indications so far, below are some suggestions to assist your preparedness for psychology and licensing:

  1. Core training and awareness: To equip practitioners with an appropriate level of training and awareness to spot the common signs and symptoms associated with body image and related mental health conditions that may implicate maladaptive aesthetics, and to curate and promote psychologically safe aesthetic intervention. For related content, read Hamilton Fraser’s guide to body dysmorphic disorder and the role of the aesthetic practitioner.
  2. Emotional literacy: To have access to the necessary training, tools, and resources to support healthy and informed discussions about the decisions people choose to make about their bodies.
  3. Specialist access in your network:  Be prepared and equipped to signpost consumers to psychological professionals, giving consumers the right access to the right services at the right time through a multidisciplinary team approach.
  4. Media literacy: Managing the portrayal of healthy, representative and inclusive body types, shapes and colours across all media channels and advertising. This essential practice can protect the emotional and psychological health of the public and can be regarded as a social and ethical responsibility.
  5. Advertising and marketing: The ASA and CAP have provided guidance on acceptable campaigns, including calls for models, training providers, and aesthetic treatment sales. Misleading, unsafe and exaggerated advertisements that breach legal guidance will be met with serious consequences.
  6. Proficiency and supervision: If not already doing so, start building a GDPR compliant portfolio of work by making a log with personal and professional reflection, including any experienced complications and opportunities for learning. This can inform your CPPD to improve patient outcomes. For related content, read my previous blog for Hamilton Fraser on data protection in aesthetics.

Whilst the sector awaits the findings of the public consultation on the licensing of non-surgical cosmetic procedures, you may wish to keep informed and update your knowledge with these useful resources. The JCCP and Hamilton Fraser have prepared a separate public guide to the Government consultation, with a clear explanation of what it means and how to respond to it. This can be foundhere.The JCCP'sFAQ guide also covers the scope of the proposed licence, and answers questions related to practitioner related issues, education and training, age restrictions and key stages of the consultation. You can read the full FAQ guide here. 

Resources / Further reading:

JCCP and me

MH foundation

Be real campaign

Every mind matters campaign NHS England

Mind in the mirror  

About the author

Kimberley Cairns

Kimberley Cairns

Kimberley is an award winning, dynamic, inclusive published wellness expert and member of the British Psychological Society. Her innovative integrated psychological approach to aesthetics encompasses her combined 16 years of acute mental health and aesthetic clinic management experience. Specialising in psycho-aesthetic solutions, Kimberley has numerous key appointments including that of clinical advisory and fitness to practise within the JCCP and more recently as a board member. Her contributions to aesthetics in the interest of public health protection and the promotion of patient safety are extensive.

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