Social media and teens: the value of group work
Courses this spring and summer have centred around putting social work theory into action. Most of our projects and papers have been group work and thus less about my main areas of interest. It’s been fun to play in other spaces, and this paper, in particular, got me thinking about how social media impacts grief. But that’s another paper. For now, here’s a proposal we created for our course on Practice Evaluation. A special call-out, if this is your area of interest, to the work of danah boyd, and in particular her work It's Complicated: The Social Lives of Networked Teens (2014).
Examining how a social media literacy group impacts
anxiety, depression and self-image in adolescent girls:
A pilot study proposal
Social Work Research: Practice Evaluation
Summer, 2018
Introduction
Research literature abounds with information about how youth use social media, and how social media, and social network use in particular, can exacerbate or trigger mental health issues. However, the evidence is contradictory or associative in nature and offers no clear direction for social work (SW) practitioners. To date, social workers (SWs) have no evidence-based direction on how to interview when social media is implicated in presenting problems. Nor do they have indications about the kinds of support needed by teen girls struggling with identity development in the online sphere, or how to help girls deconstruct the ways in which social media may be influencing or compounding problematic identities. Could peer support through group work help validate and normalize the struggles these girls face?
Social media is evolving faster than research can keep up with it, so SWs must not wait for gold-standard evidence for the many presenting problems they see. Can SWs identify general approaches while supporting the clients already seeking help? This research proposal reviews SW theory, including psychosocial developmental theory, ecological systems (ecosystems) theory, and intersectionality as they pertain to the tasks of development common to teen girls. The authors also investigate new theories such as co-construction and the transformation framework, to understand how youth consider the role of social media in their lives.
Statement of the Problem
SWs know youth are spending a great deal of time online, but do not yet know if or how it impacts their presenting problems or how to address it clinically. Underwood & Ehrenreich (2017), among others, state that it is critical clinicians study the way in which social media affects their distressed clients’ lives, and become competent in social media use assessment and in techniques to address negative online behaviours. Given that research shows that social media is having an impact on various aspects of life for teens, there is an urgent need to “start somewhere”; research would be useful to determine where to begin.
Purpose of the Study
The purpose of this study is to determine if augmenting individual counselling with social media literacy group work can improve outcomes in girls aged 12-17 years, seeking support for the developmental challenges of adolescence. In addition, it is hoped that such group work could provide valuable information to counselling practitioners about strategies to address the role of social media in the developmental challenges of female youth.
Research Question
Can group work involving psycho-ed, social media literacy and peer support improve outcomes for young girls active on social media, while providing clinical direction for SWs?
Definition of terms
Social media (SM): Web 2.0 Internet-based applications extensively populated by user-generated content, and divided by individuals and groups on sites or apps maintained by social media services. Social media services create social networks by connecting profiles with those of other individuals and/or groups (Obar & Wildman, 2015, p. 745).
Social networking sites (SNS): SNS is a subset of social media, or “networked communication platforms,” where participants have “uniquely identifiable profiles” consisting of content generated by themselves, others in their networks, and the system itself. Connections between members are publicly visible, and the user can interact with content produced by connections within the network (Ellison & boyd, 2013, p. 1912). Examples of SNS include Facebook, Instagram and Snapchat.
Fear of Missing Out (FOMO): “Defined as an apprehension or concern of being disconnected, absent or missing an experience which others (peers, friend, family) might receive or enjoy” (Dhir, Yossatorn, Kaur & Chen, 2018, p. 143).
Theoretical Framework
Teen engagement in social media is likely driven by powerful adolescent developmental needs for peer connection and self-exploration (Michikyan & Suárez-Orozco, 2016; Nesi, Choukas-Bradley & Prinstein, 2018; Underwood & Ehrenreich, 2017). Many theories are applicable to social media, and from a SW perspective, social media likely represents an extension of ecosystems theory (as per Rothery, 2016), in that social media can be considered one of the social environments in which our clients actuate. boyd (2014) describes social media as a ‘place,’ much like school hallways or malls, where teens hang out and interact.
Adults often fail to recognize the validity of this digital space as a forum for the work of adolescent identity development. Two theories point to new ways to consider both what youth are doing online, and how they perceive the centrality of their online lives. Underwood & Ehrenreich’s coconstruction theory draws attention to the fact that, unlike in previous generations, online social media consumption is not a passive undertaking. In SNS, adolescents are co-creating their online environment through social interactions. Researchers examined adolescent communications in chatrooms and determined that the developmental tasks online and offline are in fact “psychologically continuous” (Underwood & Ehrenreich, 2017, p. 146). Next, a theory of SNS as a “transformational framework” moves away from the idea that activities and experiences on social media mirror those in real life (Nesi, Choukas-Bradley & Prinstein, 2018, p. 2). With empirical support, this theory considers how SNS shifts the way in which adolescents communicate, relate, and experience friendship and interpersonal challenges. In particular, it draws attention to how online changes the nature, frequency and immediacy of interpersonal exchanges. Because of the size of the prospective audience for posts, SNS amplifies experiences, and the nature and quality of interactions changes. The theory describes in neutral terms the way in which online creates “compensatory behaviours,” e.g., the way in which one can maintain friendships over distance, while creating entirely new ways to demonstrate the value of friendships to others, such as “top friends” and public displays of relationship statuses (Nesi, Choukas-Bradley & Prinstein, 2018, p. 17). Such a theory is helpful to SWs in that it begins to both de-stigmatize and increase understanding of teens’ experiences of SNS.
Literature Review
The use of SNS by adolescent girls is now so pervasive it can be considered the norm (Griffiths & Kuss, 2017). As of 2018, 92% of girls between the ages of 13 and 17 report being online daily. 45% say they are online constantly; 44% say they go online several times a day; meanwhile 96% of kids have access to a smartphone (Anderson & Jiang, 2018). While this is American data, it best represents the population we are currently investigating; there is no reason to believe Canadian girls are any different (Gruzd, Jacobson, Mai, & Dubois, 2018). Alarmingly for the ability to research the effects of SNS on youth, their online habits change faster than researchers can design, execute and publish studies. Whereas in 2015 Facebook was the dominant app, by 2018 it was Youtube, Instagram and Snapchat, with Snapchat garnering kids’ most frequent attention over the day (Anderson & Jiang, 2018; Lenhart et al., 2015). This varies greatly from how adults use SNS, with Facebook continuing to be the preferred application for adults (Anderson & Jiang, 2018; Gruzd, Jacobson, Mai, & Dubois, 2018. While the literature is thin on how to address the use of social media by teen clientele, the authors will describe several themes from the research that are relevant for a clinical SW practice.
Identity development
Identity development is a central developmental task of youth (Michikyan & Suárez-Orozco, 2016) moving away from childhood and toward adulthood. Separating from parents and family, to sexual and interpersonal selfhood, to identifying career goals and building the skills necessary to achieve them, to exploring identities (Noller & Callan, 2015) are some of the major shifts young people are undergoing as they develop personhood. Some of those developmental tasks now take place online, where young people can explore not only their real, but “ideal, and false selves” (Michikyan & Suárez-Orozco, 2016, p. 412).
Barker (2012) describes social identity gratification as the notion that individuals seek out information and experiences that validate preferred social identities. Charmaraman, Gladstone & Richer (2018) summarize research showing that through social media, girls have easy access to tools that allow them to develop, maintain, or highlight social. They demonstrate that social media can be a place for youth to explore intersectional social identities, such as LGBTQ identities, ADHD and mental illness identities. While the authors cite positive examples, they also note going online does not change everything in identity development, as teens with poor friendship quality in real life experience increased feelings of loneliness, isolation and anxiety online as well. In addition, Zywica & Danowski (2008) show that teens use SNS to try to compensate for poor real-world friendship quality, and they found that those with high popularity use SNS as a popularity enhancer.
Interpersonal conflict
boyd (2014) used a qualitative approach to unpack interpersonal conflict among youth online. She found that while adults were concerned with cyber-bullying, and had a wide definition of what that entailed, the youth themselves characterized much of what goes on online as “drama” (2014, p. 137). Subsequent research by Marwick and boyd (2014) resulted in a definition of drama as “performative, interpersonal conflict that takes place in front of an active, engaged audience, often on social media” (p. 1191)., Nesi, Widman, Choukas-Bradley and Prinstein (2016) break down interpersonal conflict further into negative assertion (standing up for oneself), and conflict management, and one can see elements of these in boyd’s and Marwick’s research. Additionally, youth perceive drama as a gendered phenomenon and particularly associated with girls in middle school, where having an audience is key (boyd, 2014). Girls can differentiate many different types of online drama, from joking around to significant relational aggression, and have less concern about it than adults, who are more likely than not to label these issues as cyber-bullying, suggesting to youth that adults do not understand their world (boyd, 2014). Youth interviewed by Marwick and boyd (2014) use the label of drama to help distance themselves from the hurt these activities cause. Within romantic relationships, those who spend more time relating online had lower levels of interpersonal competencies than those who engaged in more relating offline, and predicted more deficits in conflict management for boys (Nesi, Widman, Choukas-Bradley & Prinstein, 2018). All the literature surveyed pointed to the need for more research to help teens navigate interpersonal conflict and drama online to understand correlations between technology use and interpersonal competencies.
Depression and SNS
The evidence is mixed as to the impact of SNS on adolescent mood and wellbeing, and much of the research has been done with young adults, not teens. Such studies link SNS use to compromised well-being, measured as depressive symptoms (Feinstein et al, 2013; Pantic et al, 2012; Twenge, Joiner, Rogers & Martin, 2018), subjective well-being (Kross et al, 2013), or life satisfaction (Shakya & Christakis, 2017). Other studies show no effect of SNS use on well-being or depressive symptoms (Banjanin, 2015; Jelenick, Eickhoff, & Morena, 2013). Still others link positive well-being to SNS use, when the independent variable in question was positive and supportive online feedback (Oh, Ozkaya & LaRose, 2014; Valkenberg, 2006). These studies lack directionality indicating SNS as a causal factor per se (Radovik et al, 2018).
Looking beyond the time spent on social media to the how (patterns of use) and why (motivations behind) of SNS use has produced interesting but narrow findings. Shensa et al (2017) found that frequency of use was associated with depressive symptoms, while overall time spent was not. Lup, Trub & Rosenthal (2015) did not find an association between frequency of use and depressive symptoms for Instagram use: they found a negative association with well-being for users who follow many strangers, and positive associations with well-being for those who follow mostly known individuals and few strangers. Krasnova, Wenninger, Widjaja and Buxmann (2013) identified differences in passive (browsing) activities verses active (posting) activities: active use was associated with positive wellbeing, while passive use reduced life satisfaction, perhaps from increased upward social comparison. Finally, a few studies examined pre-existing personality traits and interpersonal factors related to depressive symptoms with SNS. Weinstein (2017) concluded that teens prone to negative self-appraisals in social comparison had a greater likelihood of compromised well-being. Nesi & Prinstein (2015) found that a tendency toward social comparison increased depressive symptoms in girls who considered themselves less popular. Gerson, Plagnol and Corr (2016) found experience-seeking girls reported higher subjective well-being with SNS use, while girls high in impulsivity or behavioural inhibition (who ruminate about the future) reported lower well-being with SNS use.
Underwood & Ehrenreich (2017) propose the application of the classic hypothesis (Kraut et al, 1998) that “the rich get richer and the poor get poorer” (Kraut et al, 2002 p. 49): adolescents with positive real-world relationships benefit from additional online affirmation, whereas adolescents who are introverted, socially isolated, have more real-world peer difficulty, or have depressive symptoms suffer more negative impacts from SNS use. With respect to depressive symptoms and SNS, the research to date suggests this is an interesting hypothesis to consider, as many SW clients may be at risk of getting “poorer”. Further research is required to explain the relationship between SNS use and mood symptoms in youth.
Body Image
Whether SNS use increases risk for body image problems with teen girls remains contested. Rousseau, Eggermont & Frison (2017) studied passive browsing and found that girls’ passive Facebook use was not associated with appearance comparison or body dissatisfaction. However, SNS may be much like traditional media (Homan et al, 2012; Rothwell & Desmond, 2018) in that repeated exposure to idealized images is associated with body dissatisfaction. A study of young women’s Instagram use (Fardouly, Willburger & Varanian, 2018) revealed that greater use was associated with higher ‘self-objectification’ and viewing ‘fit’ idealized images was associated with more body image problems. This is in keeping with Meier & Gray’s (2014) finding that it is not the total time spent on SNS, but the amount of time allocated to photo activity, a highly visual activity, that is associated with greater ‘thin ideal’ attitudes, self-objectification, and weight dissatisfaction. Walker et al. (2015) found that intensity of Facebook use predicted disordered eating behaviour, but only when online physical appearance comparison was factored in. Little research has been done with an adolescent population, as opposed to young adults. In one study with teens, parental involvement and school environment (the school’s ‘messaging’ of self-acceptance and appearance diversity) mitigated some of the media exposure and appearance concerns (Burnette, Kwitowskia, & Mazzeo, 2017).
Anxiety and The Fear of Missing Out
The extent to which SNS use correlates to increased emotional disruption among adolescent girls shows potential for understanding the effects of SNS use on young girls. Van Schalkwyk, Klingensmith, McLaughlin & Qayyum (2015) quote teen participants as saying that SNSs provide an opportunity to broadcast personal struggles without forcing anyone into a supportive conversation -- a less stressful way to talk about personal problems, with time to formulate responses and to store supportive messages for future reference. Anxious individuals may find that while SNS is a way to communicate without being face-to-face (hence, lessening anxiety), due to the 24/7 nature of social media and the stresses of being exposed to pictures or posts involving former romantic partners, it may in fact increase their anxiety (van Schalkwyk et al., 2015). In addition, van Schalkwyk et al. (2015) describe a phenomenon called “distorted perception,” (p. 109) whereby adolescents on SNS view curated photos of the happiest or most fun moments of people’s lives, only to compare themselves to the unrealistic happiness they see others enjoying. Being bombarded with messages, posts and pictures of their social group taking part in activities that the young person has not been involved in or been invited to leaves young people feeling left out (van Schalkwyk et al., 2015).
FOMO may result in the overuse of SNS to the exclusion of other activities, further exacerbating anxiety (Dhir, Yassatorn, Kaur & Chen, 2018; Oberst, Wegmann, Stodt, Brand & Chamarro, 2017). Teens with chronic psychological deficits may constantly seek out updates and possibilities to engage with social media, even in dangerous circumstances, e.g. while driving (Oberst et al., 2017). Adolescents with anxiety and depression could also develop higher FOMO because of their perceived social deficits. Most studies on the negative consequences of SNSs investigate these factors in the general population or with young adults -- despite the fact that adolescents are the most vulnerable population in this regard and more information on the effects on adolescents is needed (Oberst et al., 2017). In Asia, Internet use among adolescents has already been recognized as a serious public health issue (Oberst et al., 2017).
While FOMO may be a socially constructed term, and evidence of a shift in communication standards among the young generation, it is argued that FOMO is directly implicated in SNS addiction (Tomczyk & Selmanagic-Lizde, 2018). Internet use is first in the hierarchy of activities preferred by young people (83.5%) and the majority of young people stay online longer than they had intended (73.1%). In addition, Tomczyk & Selmanagic-Lizde (2018) found that more than half of adolescents use SNSs to avoid thinking about their problems, and that FOMO is correlated with problematic smartphone use and fear of peer judgment.
Methodology
Research Design: Mixed methods
This study is designed to yield two kinds of information valuable to the SW practitioner. The first is quantitative: does the face-to-face, social nature of group work, combined with social media literacy and awareness education and content, improve therapeutic outcomes for girls already seeking therapeutic support? Outcomes will be measured using three different scales pre- and post-test, designed to measure anxiety, depression and body and self-esteem. The second type of information is more qualitative, derived from recording, transcribing and analyzing the content of group discussions in a classic content analysis (Hsieh & Shannon, 2005). Through this analysis, the authors hope to identify protective and risk factors that may influence the test group’s degree of vulnerability to SNS concerns such as increased depressive/anxious symptoms, FOMO, body-image and overall self-esteem among others, and to begin to inform clinical SWs about best practices for including SNS interviewing and discussion in SW interventions.
Study design. Pre- and post-test. Qualitative content analysis of group discussions.
Sampling. A convenience sample will be taken from an outpatient adolescent counselling service in Toronto, suspected to have mood and anxiety problems, randomized into three groups.
Test group. The experimental group, Group C, will consist of 8-12 girls, aged 12-17 years, who will receive both manualized individual counselling at a Toronto youth clinic, and participate in a facilitated peer support group with a social media literacy component. This study design allows the researchers to control for the impact of social media literacy on outcomes, independent of the impact of group work alone.
Control groups. The two control groups will consist of demographically matched 8-12 girls receiving regular, manualized individual counselling (Group A), and manualized individual counselling plus general peer-support group work (Group B).
Group interventions. The format of the social literacy group that the test Group C will receive will be four one-hour sessions, semi-structured around content and process. Content will be manualized to include: cohesion building, media literacy, internet/social media safety, psychoeducation re: coping and compensatory strategies to mitigate social media impacts, and termination themes. Control Group B will consist of an unstructured support group for four sessions, facilitated by a SW to ensure adherence to group norms.
Assessment tools. The following 3 instruments will be administered pretest and posttest to both test and control group participants.
1) Revised Children's Anxiety and Depression Scales (RCADS).
The Revised Children's Anxiety and Depression Scales (Chorpita et al, 2000; Chorpita, Moffitt & Gray, 2005) is keyed to specific clinical syndromes (as opposed to personality trait dimensions). It includes 47 items of which 37 relate to anxiety and 10 to depression, with anxiety subscales screening for obsessive compulsive disorder, generalized anxiety disorder, panic disorder, social phobia, and separation anxiety disorder. A recent meta‐analysis (Piqueras et al, 2017) concluded “that the RCADS is a reliable instrument for evaluating the symptoms of anxiety and depression in children and adolescents in different cultural settings” (p. 160).
2) Rosenberg self-esteem scale (RSES).
The RSES (Rosenberg, 1965) is a 10 item 4-point Likert scale that has been widely used for decades as a measure of global self-esteem, and has been more recently divided equally to measure two facets of self-esteem, self-competence and self-liking. (Tafarodi & Milne, 2002). It has been normed with good reliability to samples of Canadian high school students (Bagley, 1997; Byrne, 1990), including a French-language version (Vallieres & Vallerand, 1990).
3) The Body Esteem Scale for Adolescents and Adults (BESAA).
The BESAA (Mendelson, Mendelson & White, 2001) is a 23-item, 5-point Likert scale with three subscales of “appearance satisfaction”, “weight satisfaction” and “attribution” (which examines other’s appraisals of one’s appearance, e.g. “People my own age like my looks”). It that has been validated on both adolescent and adult samples (Bowker, Gadbois & Cornock, 2004; Cragun, DeBate, Ata & Thompson, 2013).
Data Collection and Analysis. These researchers anticipate any statistical analyses will not be internally valid due to the small sample size (as well as the potential attrition of members), therefore the study will be primarily descriptive in nature. However, outcome measures will be administered pre-test and post-test to determine suitability for future inquiry. Outcome measures will be plotted on graphs, for descriptive rather than explanatory purposes. Meanwhile, audio recordings of the group sessions will be transcribed verbatim. Two researchers will independently read the transcripts and note in the margins key concepts relating to SNS use, using the youths’ language. These concept words will be used as preliminary codes, to be combined, sorted and subcategorized into a hierarchical structure, with counts as to the frequency indicating the relative level of importance. Should this pilot lead to an expansion of the research initiative to other cohorts or other clinics/clusters, this data could be valuable for future research.
Ethical Issues
A primary ethical concern for this study is the guarantee of anonymity throughout the process, analysis and publication of findings. In addition, consent will be needed from the parents of each participant; given that the participants are underage, assent will be obtained from the participants themselves. Ensuring that participants and their guardians are fully aware of the research questions and uses of the data collected will be key from an ethical standpoint. Group norms regarding confidentiality within the group context will be reinforced at the start of every session.
Discussion & Conclusion
The proposed study would be significant for the field of SW due to the limited attention the field has paid to SNS to date. It would provide preliminary data about a potential adjunct treatment, namely group work with a social media literacy component, for clients presenting with issues that may be exacerbated by SNS interactions. It would give SWs an overview of how to interview around SNS, and to understand how SNS might play into presenting problems, thanks to a content analysis of group interactions. As a pilot, the study does not aim to be comprehensive, definitive or evidentiary, but rather a first step to encourage further collaboration and research by academic and practicing SWs.
Study limitations include the fact that convenience sampling is not representative of the general population and compromises external validity, and the results will pertain only to female teens. The study will not screen for conditions such as psychosis/schizophrenia, ADHD, ASD, conduct disorder -- only mood, anxiety, and body image. Further, the current study does not screen for clinical eating disorders, but rather body esteem and satisfaction, to minimize the screening demand on participants. The small sample size may be further impacted by drop-outs and missed group sessions which would also impact internal validity. Finally, there will be no follow up for maintenance effects over time (e.g. 6 months or 1 year after group), due to limited time and the logistical issues associated with ensuring follow-up.
In conclusion, SWs need to recognize the role SNS plays in the development of adolescent clients. From an ecosystems perspective, ignoring the significance of social media in adolescent development and day-to-day functioning would be akin to neglecting a whole realm of challenges, strengths, and potential resources useful in holistically understanding clients’ person-in-environment context. The current study will likely contribute to both the knowledge base of an emerging area of interest, but also provide practical clinical strategies for SWs to implement in their practice. As a mixed methods design, it promises to reveal both quantitative and qualitative findings that will inform future research initiatives in the arena of youth, SNS and mental health.
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