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of their friends to shape their own sense of identity (Degges-White & Borzumato-Gainey, 2011). Girls tend to seek more connection, support, and understanding in relationships they develop and maintain (Gilligan, 1982; Jordan, Kaplan, Miller, Stiver, & Surrey, 1991), and these are selected from available peers (e.g., classmates, block friends). In groups or cliques, girls will operate according to the principles of group dynamics, such as norms, roles, selections, and expectations (Cohen & Prinstein, 2006); therefore, they are easily influenced by others, even if it is in a negative way. Adolescent girls can also be a source of stress rather than support to each other. They can perpetrate aggression by spreading rumors, gossiping about others, attempting to ruin relationships, and manipulating and excluding others (Centifanti & Modecki, 2013). Clinicians should help adolescents assess their support networks and friendships groups to determine whether or not the relationships are providing the support she would prefer.

      Romantic Relationships

      As mentioned earlier, the adolescent years are full of exploration and trial-and-error learning and this includes romantic relationships, as well. Today’s “hook-up culture” opens up many adolescents to engagement in low/no-attachment sexual intimacy but at a potentially high cost. In fact, most sexual encounters occur within non-dating relationships (e.g., with friends or ex-partners) (Centers for Disease Control and Prevention, 2019). Young women who engage in “friends with benefits” relationships have noted that these types of alliances actually give them a sense of empowerment, control, and safety in that both partners are cognizant of the purpose and the limits of their relationships (Jovanovic & Williams, 2017). More serious romantic relationships, however, become increasingly preferable in late adolescence into the emerging adult years as the desire for a deeper connection and commitment from a partner grow in significance.

      Relationship with Self and Media

      Adolescent girls may experience many more stressors growing up compared to their male counterparts. For example, body image, double standards in sexuality, female gender roles being valued less than male roles, lower expectations of success for girls, earlier onset of puberty, and rumination tendencies are only some of the factors influencing girls’ self-esteem and self-perceptions, which tend to decline in adolescent years. As young girls are trying to figure out who they are, they are constantly bombarded with messages about who they need to become. Their relationship to self is rather fragile and often unacknowledged due to frequent peer and media pressure of expected norms for looks and behaviors. There is little room for introspection on their own strengths, talents, and values.

      Social media plays a significant role in the world of adolescent girls and it can have a significant impact on their sense of self. Nowadays, the majority of adolescents are connected to social media through technology (e.g., computers, smart phones). What they see and hear on social media platforms shapes their views, perspectives, and experiences significantly. Research indicates that 71 percent of adolescents use more than one social media platform, and the average time spent on social media is about nine hours a day (Department of Health and Human Services, 2016). The most common platforms are Facebook, Instagram, and Snapchat. Girls were found more likely than boys to use visually oriented platforms such as Instagram, Pinterest, and Tumblr. Social media use is consistently and positively associated with negative body image, and longitudinal studies suggest that this association may strengthen over time; young women who spend a significant amount of time viewing music videos are especially at risk for increased perceived importance of appearance and increased weight concerns (Fardouly & Vartanian, 2016). The majority of social media platforms expose adolescents to violent, sexual, and materialistic images, which often serve as a social comparison; this creates expectations for normative behaviors and values that might be incongruent with those of most families (Comstock & Scharrer, 2006). In the last few years, text messaging and chat rooms have become a norm for communicating not only with friends but also with the larger society, often anonymously. This presents another opportunity for risk taking and aggressive behaviors, such as cyberbullying. To navigate such a complex and challenging environment while establishing an identity, adolescent girls require support and guidance primarily from their immediate family circle but also from school personnel and the larger community. It is through constant negotiations between all factors mentioned above (e.g., risk factors and protective factors) that young girls will develop a clear sense of self and continue with healthy biopsychosocial development. It is a team effort to raise a child and support a growing adolescent. No school or family can do it alone. Parents, professionals, and nonprofessionals have a huge obligation to create environments that promote healthy growth opportunities for all adolescents.

      Best Practices

      Referrals for adolescent counseling are frequent and there are seldom enough practitioners who specialize in this area. According to the Department of Health and Human Services (2016), most adolescent girls struggle at some point with symptoms of depression, anxiety, attention deficit and hyperactivity disorder, or eating disorders. The National Survey on Drug Use and Health (Center for Behavioral Health Statistics and Quality, 2018) found that 13.3 percent of all youth have experienced a major depressive episode. Overall, almost 35 percent of youth at some point struggle with mood disorders, and two-thirds who do are girls. Findings from a meta-analysis of psychological treatment outcomes for depressed youth indicated that cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) were the two most efficacious treatments (David-Ferdon & Kaslow, 2008). It is imperative to note that many adolescent girls might not present with typical symptoms of depression (e.g., hopelessness, isolation, weight gain, weight loss). On the contrary, children and adolescents may have symptoms of depression that manifest with a great deal of anger, arguing, physical fighting, and outrageous behaviors. As behaviors are purposeful, adolescent behaviors can often be expressions of unmet needs closely related to adolescents’ developmental stage. See chapter 16 for additional information on counseling women with mood disorders.

      To be as effective as possible in counseling adolescent girls, it is necessary to keep in mind their emotional, cognitive, and psychosocial development and the developmental tasks (e.g., competence, autonomy, intimacy, formation of identity) they are managing. These developmental tasks are linked to specific behaviors that are easily detectable. For example, arguing with and disobeying teachers and parents may stem from frustration related to an inability to succeed in school. Other young women may opt for “sensation seeking” activities in order to avoid boredom, avoid being put down, and overcome feelings of being ignored and unimportant. These behavioral functions are linked to the developmental task of achieving competency. Acting out behaviors, such as causing trouble in school, making threats, choosing outrageous clothing, or using profanity, are potentially related to an adolescent’s need to make a personal statement and to be recognized as a capable and worthy individual. In such instances, counselors should focus on validating needs and the developmental tasks at hand while helping the client to develop more appropriate and healthier alternatives. For example, allowing girls to participate in rule and decision making, exploring ways they can contribute to society, teaching them to identify and express anger and other feelings more appropriately, and teaching them negotiations skills are ways to validate and redirect their efforts at identity development and competence achievement. Lastly, clinicians should bear in mind that the expression of needs and the actions taken to fulfill them are determined to a large extent by a client’s cultural background.

      Cultural Considerations

      No matter a young woman’s age, an individual’s culture plays a significant role in shaping her values, perceptions, and experiences. Racial, ethnic, and religious background and socioeconomic status can greatly influence development and counselors should be careful to consider intersectionality and its effects on development. While many practitioners may have completed a course in cultural diversity, it is important for clinicians to think beyond broad brush strokes when considering the influence of cultural identity on clients. Every client is the product of a unique set of circumstances, influences, and background.

      Ethical Considerations

      Despite the exercised independence

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