independent psychological evaluation of patients under 18 requesting cosmetic surgery

The current Medical Board of Australia guidelines for medical practitioners who perform cosmetic medical and surgical procedures require the following:

“Before any major procedure, all patients under the age of 18 must be referred for evaluation to a psychologist, psychiatrist or general practitioner, who works independently of the medical practitioner who will perform the procedure, to identify any significant underlying psychological problems which may make them an unsuitable candidate for the procedure”.

The available psychological literature suggests that the effects of cosmetic surgery in adults are largely positive. The notable exceptions are the minority of individuals with significant psychological problems, who choose to conceal these internal aspects of themselves from their surgeon, and manage to do so.

The literature on psychological outcomes of cosmetic procedures for young people under eighteen is less substantial. The findings from adults need to be applied with great care, taking into account the context of adolescence.

Independent psychological evaluation

Parks Clinic offers a friendly, respectful and non-judgemental experience for any young person required to attend an independent psychological evaluation during the three month “cooling off” period.

Before the first meeting, they are provided with an information sheet which outlines: the three-step process, the options for parental involvement in the evaluation, and the full costs and possible rebates under Medicare and private medical health insurance.

  1. Testing

At the first meeting, the young person is administered a standardised, comprehensive test of personality and psychopathology[i].

  1. Interview

At the second meeting, the psychologist and the young person go through the results of the testing, together. Any areas of possible concern are discussed in a non-judgemental, exploratory process aimed at deepening understanding of the young person’s motivation for seeking change in their appearance. Any signs of serious underlying psychological problems, such as a Body Dysmorphic Disorder, are addressed at this time.

  1. Report

At the third and final meeting, the young person is presented with the report which will be sent to the referring surgeon, and provided with an opportunity to discuss the report. The recommendation falls into one of three categories.

Green light

The psychologist finds no evidence of any significant underlying psychological problems likely to make this person an unsuitable candidate for the procedure

Orange light

The psychologist finds one or more areas of concern, specified in the report, which the surgeon may want to consider before arriving at their decision to proceed.

Red light

The psychologist finds evidence of significant underlying psychological problems likely to make this person an unsuitable candidate for the procedure.

Where the evaluation revealed evidence of significant psychological problems (“red light”), with the young person’s agreement, a referral to a suitable psychologist or psychiatrist for treatment might be made.

Where the young person disagrees with the psychologist’s opinion in this regard, the options for seeking a second independent opinion are discussed.

The whole psychological evaluation process is entirely transparent.

Download the patient information sheet here.

 

[i] The MMPI-A-RF (Minnesota Multiphasic Inventory – Adolescent – Restructured Form) is the most up-to-date, empirically based personality assessment tool for adolescents. It is a development of the MMPI, the most widely used personality test in the mental health field. Unlike many self-report inventories, it contains built-in checks against inconsistent responding and deliberate attempts at “impression management”.

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