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Background: Psychological and mental health difficulties are common in children and young people (CYP) living with skin conditions and can have a profound impact on wellbeing. There is limited guidance on how best to assess and support the mental health of this population, who are at risk of poor health outcomes., Objectives: To provide consensus-based recommendations on the assessment and monitoring of and support for mental health difficulties in CYP with skin conditions (affecting the skin, hair and nails); to address practical clinical implementation questions relating to consensus guidance; and to provide audit and research recommendations., Methods: This set of recommendations was developed with reference to the AGREE II instrument. A systematic review and literature appraisal was carried out. A multidisciplinary consensus group was convened, with two virtual panel meetings held: an initial meeting to discuss the scope of the study, to review the current evidence and to identify areas for development; and a second meeting to agree on the content and wording of the recommendations. Recommendations were then circulated to stakeholders, following which amendments were made and agreed by email., Results: The expert panel achieved consensus on 11 recommendations for healthcare workers managing CYP with skin conditions. A new patient-completed history-taking aid ('You and Your Skin') was developed and is being piloted., Conclusions: The recommendations focus on improved mental health assessments for CYP presenting with a skin condition, with clinical guidance and suggested screening measures included. Information on accessing psychological support for CYP, when required, is given, and recommendations for staff training in mental health and neurodiversity provided. Embedding a psychosocial approach within services treating CYP with skin disease should ensure that CYP with psychological needs are able to be identified, listened to, supported and treated. This is likely to improve health outcomes., Competing Interests: Conflicts of interest: T.McP. reported personal fees from Sanofi, AbbVie and L’Oreal outside the submitted work and is Trustee of Dipex Charity, being Lead Clinician on the Skins section of their patient experiences site Healthtalk.org and Expert Advisor to NICE and MHRA for matters relating to dermatology. J.R. is Expert Advisor to NICE and MHRA for matters relating to dermatology and Medical Advisor to Nottingham Eczema Support Group. R.A. reported personal fees from Pfizer, AbbVie and Sanofi outside the submitted work. R.B. reported personal fees from UCB outside the submitted work and is Chairperson for Action for XP and Trainee Representative for Psychoderm UK. P.B. reported personal fees from AbbVie, Pfizer, Novartis and L’Oreal outside the submitted work. A.B. reported grants and personal fees from AbbVie, Almirall, Bayer, Bristol Myers Squibb, Galderma, Janssen, LEO Pharma, Lilly, Novartis, Pfizer, Sanofi and UCB outside the submitted work and was Editor of Practical Psychodermatology (Wiley, 2014) and Psychodermatology in Clinical Practice (Springer), and was Chairman of Psychodermatology UK (2008–2020). T.B. is Clinical Director of NHSE for outpatient transformation and past President of British Association of Dermatologists (2020–2022). S.C. reported personal fees from Galderma, LEO and Incyte UK outside the submitted work, and is the Chair of Dermatology Council for England and of Derma and is Trustee for the British Dermatological Nursing Group (2018–current). T.C. is Executive Chair and author of the Primary Care Dermatology Society website and has undertaken work with the MHRA on isotretinoin. E.H. is Trustee of Changing Faces Charity. A.L. is Head of Services of the National Eczema Society. P.M. is Committee Member of Psychodermatology UK. C.M. is on the medical advisory board for National Eczema Society and Ichthyosis Support Group. G.N. is cofounder of Anathem and reported no conflicts of interest related to this work. A.P. is Chief Executive of the National Eczema Society. C.R. is past Chief Executive Officer of Eczema Outreach Support. S.S. reported personal fees from Pfizer outside the submitted work. J.S. is Expert Advisor to NICE on matters relating to paediatric dermatology and Medical Advisor to Nottingham Eczema Support Group. S.B. reported personal fees from AbbVie, Sanofi and Pfizer outside the submitted work and is Expert Advisor to MHRA on Dermatology matters and Co-Chair of Psychodermatology UK. No other disclosures were reported., (© The Author(s) 2023. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: People with chronic pain may seek rehabilitation to reduce pain and restore productivity and valued roles. Theoretically, a biopsychosocial approach makes rehabilitation more meaningful, however, the limited research on meaningful rehabilitation predominantly describes the perspective of therapists and researchers. The client's perspective of meaningfulness in rehabilitation is lacking., Objective: To investigate the experience of meaningfulness in rehabilitation from the perspective of people with chronic pain., Methods: Qualitative, semi-structured interviews were conducted with Australian adults who had chronic pain and recent experience of occupational therapy or physiotherapy. Sampling continued until thematic saturation occurred. Transcripts were coded and analyzed using theory-driven and data-driven thematic analysis., Results: Ten participants (four males; six females) were interviewed. Pain histories ranged from nine months to 20+ years, with conditions such as fibromyalgia or trauma. Three themes from a prior concept analysis were upheld, and a further three data-driven themes emerged. Results indicate that people with chronic pain seek a "genuine connection"; from a therapist who is "credible"; and can become a "guiding partner", and they find rehabilitation meaningful when it holds "personal value"; is "self-defined"; and relevant to their sense of "self-identity"., Conclusions: The genuine connection and guiding partnership with a credible therapist, that is sought by people with chronic pain, may be at odds with aspects of contemporary rehabilitation. Client-defined meaningfulness is an important construct to engage clients in treatment and improve work and other occupational outcomes for people with chronic pain.