This proposed continuation grant application aims to examine the impact of cognitive behavioral counseling strategies and patient support groups on the psychological experiences of individuals who are undergoing orthognathic surgery, conventional orthodontics only, or conventional orthodontics after deciding against surgery. The current grant has permitted a descriptive analysis of the psychological changes and emotional upheavel created by orthognathic surgery and orthodontics. It appears that both forms of treatment result in psychological disturbance among patients at various times during the course of treatment. The proposed study attempts to test the effect of a group intervention strategy on treatment outcomes and on psychological well-being. Each group will be compared with comparable samples of patients who receive individual consultations with a psychologist or receive their usual care only from the surgeon or orthodontist. The design of this study has been modified slightly from the original proposal. There will be three experimental groups, each receiving individualized or group attention from the group leader. One group will receive face-to-face individual attention and information. They will be yoked with the other two groups in that they will receive the same information. The second will also receive skills training in coping; the third will participate in support groups as well as skills training. In addition, there will be a control group receiving usual type of care. One-hundred twenty (120) subjects will be selected in each of three years and randomly assigned to these conditions.
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