Counseling Adolescent Girls for Body Image Resilience_ Strategies

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					Counseling Adolescent Girls for Body Image Resilience: Strategies for School Counselors Laura Hensley Choate. Professional School Counseling. Feb 2007. Vol. 10, Iss. 3; Early adolescence presents extensive developmental challenges for girls. As they face the onset of puberty and its associated psychological and physical changes, girls also confront the emergence of dating relationships, school transitions, and contradictory gender role expectations. During early adolescence girls also become more focused on their appearance, weight, and shape as key aspects of their identities. With the considerable weight gains that accompany puberty, girls become concerned about the discrepancy between their developing bodies and the societal ideal for female thinness that is portrayed in Western cultures (Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999). In other words, at a time when a girl's physical appearance is most important to her, her body is changing in ways that are increasingly discrepant from the thin ideal. These influences leave many girls vulnerable to body image dissatisfaction (BID) and eating-related problems (Levine & Smolak, 2002; Thompson et al.) According to Levine and Smolak (2002), between 40% and 70% of adolescent girls are dissatisfied with two or more aspects of their bodies, most generally with the hips, buttocks, stomach, and thighs. One study found that over 80% of girls surveyed reported body dissatisfaction (Kostanski & Gullone, 1998), while another large-scale study revealed that 42% to 45% of 9th-to-12th-grade girls were dieting to lose weight (Thompson et al., 1999). With such large numbers of girls experiencing dissatisfaction with their bodies, it is important for school counselors to note that BID is associated with emotional distress, obsessive thinking about appearance, unnecessary elective cosmetic surgery, depression, poor self-esteem, smoking onset, and maladaptive eating practices (Stice & Shaw, 2003; Stice & Whitenton, 2002). Further, BID is the primary precursor for the development of eating disorders such as anorexia or bulimia (Polivy & Herman, 1999; Thompson et al.), particularly during the adolescent period (Kalodner 8c DeLuciaWaack, 2003). Because BID is such a pervasive problem in adolescent girls, school counselors need to develop effective prevention and intervention programs in this area. Current research indicates that successful BID prevention incorporates two primary strategies: (a) the enhancement of protective factors; and (b) the inclusion of a broad-based, holistic focus. Rather than a pathology-driven model that emphasizes treatment for the concerns of girls in clinical samples, the most promising programs incorporate protective factors that build on girls' strengths, promote resilience, and buffer them from the development of body dissatisfaction and subsequent disordered eating practices (Cash, 2002; Crago, Shisslak, & Ruble, 2001; Irving, 1999; Piran, Levine, & Steiner-Adair, 1999; StriegelMoore & Cachelin, 1999, Taylor & Altman, 1997). Promoting protective factors would include assisting all girls as they confront the multiple challenges of adolescence and also help them to define their identity and sense of worth apart from physical appearance (American Psychological Association, 1999). Researchers in this area have also called for holistic approaches that are focused on multiple dimensions of an individual's environment. Instead of an exclusive view of body image problems and eating disturbances as disorders that originate within an individual adolescent girl, programs should also target family, peers, schools, media, and other sociocultural influences (Barker & Galambos, 2003; Crago et al., 2001; Irving, 1999; Levine & Piran, 2001; Piran et al.; Smolak & Murnen, 2001).

The profession of counseling in general and school counseling in particular is based upon a comprehensive, developmental model that emphasizes students' positive resources and strengths (American School Counselor Association, 2004; Gale & Austin, 2003, McAuliffe & Eriksen, 1999; Myers, Sweeney, & White, 2002). School counselors are therefore poised to take the lead in designing and implementing holistic approaches that strengthen protective factors in adolescent girls. Specifically, school counselors need a prevention approach that identifies protective factors at the individual, family, peer, and school level, as well as teaches girls how to challenge broader sociocultural influences. Elsewhere I have identified a five-factor theoretical model of body image resilience that addresses these concerns (Choate, 2005) and in this article I will apply the model specifically to school counselors' work with adolescent girls. In the paragraphs that follow, I first provide an overview of sociocultural theories that describe the process of body image development in adolescence. I then explore the five protective factors included in the body image resilience model and provide specific prevention and counseling strategies that school counselors can use to promote positive body image in adolescent girls. SOCIOCULTURAL CONTEXT AND THE MASSMEDIA Sociocultural theories have strong empirical and theoretical support to explain the impact of social and cultural influences on the development of BID in Western societies (Heinberg, 1996; Stice & Whitenton, 2002). These theories assert that contemporary Western societies emphasize thinness as a central aspect of beauty for women (Mussell, Binford, & Fulkerson, 2000) and that pervasive social pressures to achieve extreme thinness result in women's "normative discontent" (Rodin, Silberstein, & Striegel-Moore, 1985) with their bodies. Even as women have made great educational and vocational advances during the past several decades, there has emerged increasing pressures for women to refocus their energies on achieving a largely unattainable ideal of beauty and thinness (Bordo, 1995; Thompson et al., 1999; Wolf, 1991). For example, in recent years the thin ideal has become progressively thinner while the average woman has become larger (Heinberg). Further, the beauty ideal also encompasses often unattainable and frequently contradictory attributes including extreme thinness, White and flawless skin, thin waist, long legs, tall, young, physically fit, muscular, and angular while also espousing a curvaceous and full-breasted body type (Barber, 1998; Groesz, Levine, & Murnen, 2002; Heinberg; Levine & Smolak, 2002). The pervasiveness of these messages leads researchers and practitioners to conclude that BID and even eating disorders are natural outcomes of extreme social pressures to achieve thinness (Attic & Brooks-Gunn, 1989; Thompson et al.). One of the strongest and most effective conveyors of these socioculturel messages is the mass media. In early adolescence, girls are especially likely to make social comparisons in forming a self-identity and media images serve most often as their comparison standard. Research in social comparison theory demonstrates a consistent relationship between adolescent girls' BID and the viewing of media images promoting the thin ideal (Botta, 2000; Cusumano & Thompson, 2000; Groesz et al., 2002; Hargreaves & Tiggemann, 2003; Jones, 2001; Thompson et al., 1999). In one study by Dunkley, Wertheim, and Paxton (2001), girls most often cited magazine advertisements as the source they turned to for information regarding how to achieve their ideal body size and shape. Even though these standards are largely impossible to achieve, the media also transmits the message that the body is infinitely mutable (Heinberg, 1996)

and that with enough hard work any individual can achieve the ideal. Rather than questioning these unrealistic standards, girls and women learn to blame themselves for not being able to reach the prescribed norm; this selfideal discrepancy results in BID. Some sociocultural theorists have also examined race and ethnicity as influences on adolescents' body image development. Because all girls in the United States are inundated with messages regarding the importance of thinness for women's success in Western culture, no racial or ethnic group is immune to these influences. While eating concerns were formerly regarded as a "White woman's issue," research currently indicates no significant differences in Hispanic, Asian, American, and Caucasian girls in terms of BID (Levine & Smolak, 2002). On the other hand, African American girls are also vulnerable to maladaptive eating practices, yet as a group they are less likely to possess negative body image than are other girls. This is due in part to cultural messages within the African American community that de-emphasize thinness as an essential component of beauty (Levine & Smolak; Mussell et al., 2000; Striegel-Moore & Cachelin, 1999). Drawing on these and other components of body image resilience, I now describe the five protective factors and strategies designed specifically for school counselors' work with adolescent girls. BODY IMAGE RESILIENCE MODEL Protective Factor 1: Family and Peer Support Adolescent girls are confronted with cultural pressures regarding how they should look and act, and for many girls these messages are strongly reinforced by family and peers. Research indicates that a girl's perception of her family's approval of her overall appearance is positively related to her body esteem (McKinley, 1999). Conversely, those girls who perceive parental pressures to be thin and who receive criticism about their weight and shape are the most likely to experience BID and to diet (Green & Pritchard, 2003; Haworth-Hoeppner, 2000; Smolak & Murnen, 2001; Stice & Whitenton, 2002; Striegel-Moore & Cachelin, 1999). Girls' sense of body satisfaction is also strongly related to their mothers' personal attitudes toward their own bodies (McKinley; Usmiani & Daniluk, 1997). Daughters observe the ways in which their mothers cope with cultural pressures and are highly influenced by such maternal modeling. To develop positive body image, therefore, girls need family members who provide them with affirming messages about their bodies and who possess positive attitudes toward their own appearance, weight and shape. Several authors have noted that in comparison with Caucasian girls, African American girls receive maternal messages to be strong and selfreliant and are therefore less vulnerable to body image problems because these qualities lead to an enhanced sense of competence and independence (Celio, Zabinski, & Wilfley, 2002; Pedcrsen, 2000). Further, general family qualities such as supportive parental relationships, open communication and expressiveness, and low family stress can also protect against adolescent BID (Barker & Galambos, 2003; Graber, Archibald, & Brooks-Gunn, 1999; Haworth-Hoeppner, 2000; Kearney-Cooke, 2002; Striegel-Moore & Cachelin, 1999). Peers also have a significant impact on adolescent girls' body image development and serve as relevant sources of information regarding the culture of thinness. Paxton, Schutz, Wertheim, and Muir (1999) found that girls share the attitudes and behaviors of

their peer group regarding dieting, drive for thinness, and overall body image concerns. A girl's peer group negatively influences body image when her friends frequently discuss dieting and other weight loss behaviors, or tease peers regarding their appearance (Smolak, 1999). Being the target of peer teasing is also strongly related to BID (Paxton et al.; Smolak). Negative body image is exacerbated as peer group discussions center around heightened interest in boys; research indicates that increases in girls' weight consciousness and dieting occur with the onset of dating (Graber et al.,1999). School counselors should note, however, that friends can serve as a protective factor in a girl's body image development when they arc less invested in the achievement of appearance-oriented goals and are less competitive with one another regarding weight and shape (Paxton ct al.). Overall, the presence of a strong social support network comprised of both friends and family serves as a protective factor in body image development (Striegel-Moore & Cachelin, 1999). Here are some strategies for school counselors: 1. Educate parents regarding the impact of their weight, food, and appearance-related attitudes and behaviors on their children. Mothers in particular should be aware of the strong effects of modeling on their daughter's developing body image. Parents can change family discourse around the importance of weight and shape, and can discourage daughters from evaluating themselves based on how they appear to others (McKinlcy, 1999). Graber et al. (1999) suggested that school counselors create an informative newsletter regarding these issues for students to share with their parents. To aid in this initiative, counselors can draw from the specific prevention strategies and guidelines for parents available from the National Eating Disorders Association (NEDA, 2004a). 2. Inform students, parents, teachers, and school staff of the negative effects of dieting (e.g., slowed metabolism, increased likelihood of binge eating, and eventual weight gain), how to discourage diet talk at school and home, and ways to take a nondieting approach to healthful eating. Programs should not focus on educating girls regarding the signs and symptoms of eating disorders, as this approach can often result in girls' adoption of these behaviors. 3. Encourage parents and all members of the school community to display a low tolerance for peer teasing, particularly regarding weight and shape. Serve as a model by refusing to engage in "fat jokes" among faculty and staff. Further, teach students how to intervene to assist a teased peer, and provide strategies for coping when a student is the victim of peer teasing. 4. Facilitate girls' development of friendship groups that provide support and help them to feel good about themselves (versus friends that are competitive or make them feel judged). Intervene with friendship groups to encourage them to adopt more positive attitudes toward body image (Paxton et al., 1999; Smolak, 1999). Protective Factor 2: Gender Role Satisfaction In early adolescence, girls become increasingly more dissatisfied with their bodies and overall physical appearance than boys (Feingold & Mazzella, 1998). This discrepancy may be explained in part by two gender role socialization processes that occur during

adolescence. First, girls are taught the importance of attracting a dating partner and gaining popularity as a measure of their self-worth. They are also socialized to take responsibility for the establishment of relationships and to sacrifice their own needs in order to maintain their social connections (Miller, 1990). This interpersonal orientation leaves girls vulnerable to others' opinions and motivates them to go to great lengths to achieve the approval of peers and potential dating partners. Girls receive the message that the best way to gain such approval is through conformity to the beauty ideal. Unfortunately, early adolescence is also a time in which the onset of puberty brings an average weight gain of 50 pounds in girls, with 20-30 pounds of fat deposited in the hips, waist, thighs, and buttocks; weight gains in these areas are in direct contradiction with the beauty ideal espoused in Western cultures (Levine & Smolak, 2002). Girls are better protected from BID when they begin to question the discrepancy between their changing bodies and how girls are represented in the media, and when they understand that achieving the beauty ideal is not the only avenue for achieving peer acceptance or popularity. A second socialization process for girls occurs as they are also confronted with societal messages for what it means to be successful as a woman: She is expected to fulfill the traditional female gender role by being nurturing, family- and relationship-oriented, and passive. At the same time she is expected to be independent, self-reliant, assertive, and high achieving in academic and career pursuits, while also achieving the cultural standard for thinness and attractiveness (Denmark, 1999; Hart & Kenny, 1997; Thompson et al., 1999). The message that "you can have it all" (termed the super woman myth by Steiner-Adair, 1986) results in a sense of inadequacy, confusion, and frustration for all girls. For many adolescents this gender role discrepancy is manifested somatically as BID (Thompson et al.). Smolak and Murnen (2001) suggested that contradictory expectations are related to eating problems because thinness is valued in many of the roles to which girls aspire (e.g., both in the workplace and in maintaining relationships). Further, girls who strive to be "superwomen" often do so at the expense of meaningful relationships, leaving them feeling disconnected and isolated. In order to regain a sense of control, many girls learn to avoid facing contradictory pressures by refocusing their energies on trying to perfect their bodies (Friedman, 1999; Hensley, 2003). To manage feelings of confusion, they learn to define themselves solely in terms of their appearance and in controlling their weight. School counselors can help girls to acknowledge contradictory cultural expectations and, rather than internalizing their feelings, to begin to address and understand these conflicts (Choate, 2005). Here are some strategies for school counselors: 1. Provide girls in early adolescence with information regarding the physical and psychological changes that occur with the onset of puberty. Girls can learn of the normative nature of their weight gains and begin to challenge the inconsistencies between the thin ideal and their maturing bodies. 2. Because girls are being socialized to suppress their feelings in order to maintain relationships, assist girls in developing the skills to assertively express anger, conflict, and power in their relationships (Compitello, 2003).

3. Girls can be assisted in recognizing the effects of gender stereotyping and the harmful nature of the super woman myth. Instead of avoiding their confusion and frustration, girls can begin to acknowledge and question the diverse roles they are expected to fulfill. 4. Rather than comparing their appearances to others in striving to achieve interpersonal success, counselors should reinforce girls' acceptance of each individual's unique body type. Expose girls to female role models representing a diversity of shapes and sizes who are praised for both their accomplishments and their appearances. 5. Because boys also are exposed to pervasive images regarding how women should look, they also need assistance in developing an appreciation for attractiveness that includes an array of body types (Halpern, Udry, Campbell, & Suchindran, 1999). Protective Factor 3: Global and Physical Self-Esteem In adolescence, body image becomes the most salient aspect of girls' global selfesteem, which may partially explain the significant decrease in girls' selfesteem during this period (Basow & Rubin, 1999). It is interesting to note that African American girls have higher levels of self-esteem than White girls do, in part because their self-esteem is not based on narrow definitions regarding what is considered attractive (Compitello, 2003). Even when they weigh more, Black girls are more likely than White girls to be satisfied with their bodies and with their overall appearance (Jaflfee & Lutter, 1995). For all girls there is a strong relationship among high self-esteem, strong identity, and positive body image, suggesting that self-esteem and identity can play a role in the development of body satisfaction (Crago et al., 2001; Smolak & Murnen, 2001; StriegelMoore & Cachelin, 1999). One important aspect of global self-esteem that has direct implications for body image development is physical self-esteem, defined as one's attitudes toward physical activity, endurance, strength, coordination, flexibility, sports competence, body fat, appearance, and general health (Dunton, Jamner, & Cooper, 2003; James, Phelps, & Bross, 2001). Participation in physical activity is a central feature of physical self-esteem. When girls exercise to improve their overall fitness or health (versus working out to burn excess calories) they are more likely to possess positive body image. Further, physical activity leads to body satisfaction when girls develop an appreciation for what their bodies can do, rather than how they appear to others (McKinley, 1999). While encouraging girls to engage in exercise is important, school counselors should be aware of the potential inadvertent negative effects of physical activity promotion. Zabinski, Calfas, Gehrman, Wilfley, and Sallis (2001) found that a university program designed to teach students skills for enhancing their physical fitness actually increased women participants' drive for thinness and had no effect on changing their BID or body mass index. The authors noted that when girls are encouraged to become more engaged in physical activity, they also need assistance in setting realistic expectations for the effects of exercise on changing body shape or for improving other aspects of their lives. Positive self-esteem and body image are also associated with girls' and women's participation in organized athletic activities (Jaffee & Lutter, 1995; Mussell et al., 2000). While previous research indicated that girls' sports participation was a risk factor for the development of BID, such participation is a risk factor only for girls who participate in sports that emphasize leanness, who display high levels of perfectionism, and who

possess beliefs that having a lower weight will enhance their athletic performance (Mussell et al.). Another study indicated that girls' participation in refereed sports (e.g., basketball, tennis, volleyball, track) versus judged sports (e.g., diving, cheerleading, gymnastics) can serve as a protective factor against developing excessive concern with body size and shape (Zucker, Womble, Williamson, & Perrin, 1999). Therefore it is not sports participation per se that influences body satisfaction or dissatisfaction, but certain aspects of an athletic environment that can contribute to its protective effects; these include the presence of supportive peer groups, emphasis on the body's physical competence rather than how it looks, and promotion of flexible gender role attributes (Richman & Shaffer, 2000; Zucker et al.). Here are some strategies for school counselors: 1. To help build girls' self-esteem in adolescence, encourage girls to become involved in a variety of school, volunteer, or work activities that are not focused on physical appearance or achievement of the thin ideal (Smolak & Murnen, 2001). 2. Develop mentoring programs between older and younger girls as a means to discourage girls from overreliance upon attractiveness as the only indicator of their selfworth (Crago et al., 2001; Smolak, 1999). 3. Play an active role in promoting a broader, more fluid definition of beauty on your school campus. This comprehensive view of beauty would include non-appearance qualities such as selfrespect, assertiveness, caring about others, wisdom, selfawareness, individuality, confidence, and motivation (NEDA, 2004b; Smolak, 1999). 4. Encourage girls to participate in a variety of physical activities that they enjoy; however, monitor girls' motivations so they learn to exercise for the purposes of health and improved fitness rather than for weight control or body shape change. 5. Work with girls to focus on their positive physical attributes. For example, ask girls to list all aspects of their bodies that they appreciate and then help girls create a list of positive body affirmations to practice daily. An excellent resource for conducting this exercise can be obtained from the NEDA Web site (2004c). Protective Factor 4: Coping Strategies and Critical Thinking Skills As outlined previously, girls face many developmental transitions and challenges during the adolescent period. They need the internal resources to cope successfully with life demands. It is unfortunate that many girls focus on their weight and shape as a way of avoiding these complex issues. Steiner-Adair and Vorenberg noted, "Clearly dieting, eating, and shopping are not adequate skills for coping with life's ups and downs . . . yet it is not surprising that girls turn to these self-limiting behaviors in times of need" (1999, p. 109). In response, prevention in the area of BID and eating disorders has increasingly emphasized life skills training (e.g., promoting problem-solving abilities, interpersonal competence, assertive communication, stress management strategies, and internal locus of control) as an effective program component (Crago et al., 2001; Irving, 1999; McVey & Davis, 2002).

A life skills training approach can play an important role in facilitating a girl's developmental capacity to understand her environment in a qualitatively different way. While she previously defined herself only in terms of the beliefs and values of others, in adolescence a girl slowly develops the ability to become a self-authoring knower (Kegan, 1994; McAuliffe & Eriksen, 1999). Self-authoring knowers learn to step outside of the values of their culture/peers/family, evaluate these norms, and make decisions for themselves. At this more cognitively complex stage of knowing, they can consider the opinions of others as important, yet also realize that their suggestions are but one option from among an array of alternatives. They begin to recognize that ultimately they are the authors of their life scripts. A girl must possess this ability in order make informed decisions about how she will allow sociocultural pressures from media, family, and peers to influence her sense of self worth. This is a difficult transition for girls, as adolescents are also highly concerned with external approval and acceptance and are not socialized to express their own voices (Gilligan, 1982). School counselors have to demonstrate an understanding of how important the approval of others can be during this time, while also encouraging girls to formulate their own beliefs and values. School counselors can facilitate girls' cognitive development by teaching them the critical thinking skills needed to question sociocultural norms, including the beauty ideal. One important prevention initiative in this area is to foster media literacy: the ability to identify, evaluate, and resist media messages (Levine, Piran, & Stoddard, 1999). These promising approaches teach students how to become active consumers rather than passive victims of media influence (Levine & Piran, 2001; Levine et al.). Media literacy can be conceptualized as a fourstep process: (a) identifying harmful cultural images, (b) exploring and deconstructing their underlying messages, (c) resisting the message being sent, and (d) actively working to change these messages. In the paragraphs that follow, I describe these four components. As part of identifying and exploring harmful media messages, school counselors can highlight the social construction of beauty in Western culture and the unrealistic, unattainable nature of the images girls see. For example, they can learn how the majority of images that represent the beauty ideal are created through intricate strategies used to enhance models' appearances, including airbrushing, softfocus cameras, digital editing, or cosmetic surgery (Botta, 2000; Groesz et al., 2002; Heinberg, 1996). It is powerful for adolescent girls to discover that even the models and celebrities that portray the beauty ideal don't meet these standards. Once girls have identified the ways in which images are constructed, they must then begin to question the values embedded in these images. The Media Education Foundation (2004) suggests that girls can explore such questions as "Do real women look like these models?" "What is the real purpose of this advertisement?" "Will buying this product help me look like this?" "IfI did look like this, would my life really become like the life portrayed in this ad?" "Does this model really use this product to help her look like this?" and "What are the consequences of these messages for girls?" Girls also must possess the skills to actively resist, challenge, and generate positive alternatives to the messages conveyed through the mass media. Rather than conforming to cultural norms, girls can learn to make informed choices regarding how they allow media messages to influence their personal lifestyles, beliefs, and values. They can use cognitive behavioral strategies to dispute any maladaptive beliefs

regarding media portrayal of the thin ideal (Strachan & Cash, 2002). For example, they can replace the thought, "I must look like the model in this swimsuit ad in order to be popular," with the more rational belief, "This image is airbrushed. I don't have to look like this in order to feel good about myself. Others will be attracted to my positive attitude when I accept myself as I am." Finally, girls can learn media activism skills as they work to challenge the social status quo and shape healthier cultural norms. To this end, they can actively protest media products they identify as transmitting harmful messages to girls, and praise advertisers when they portray women of varying ethnicities, ages, sizes, and shapes (Crago et al., 2001; Levine et al., 1999). Girls become empowered as they recognize themselves as citizens in a democracy who have the power to take collective action for change (Levine & Piran, 2001). Here are some strategies for school counselors: 1. Reinforce girls' skills in developing an internally-derived value system and internal locus of control so they can begin to rely less on others' opinions about the importance of appearance. Girls can begin to explore what it would be like to trust their own values regarding how they should look and act. 2. To incorporate media literacy into prevention programs for girls, consult the Center for Media Literacy (2004) and Media Education Foundation (2004) Web sites. Both Web sites contain excellent critical media viewing activities and resources, including downloadable handouts and study guides for students. Encourage the infusion of media literacy throughout the curriculum, as students benefit from repeated exposure to positive messages about self-esteem that are not based on achievement of the thin ideal (Steiner-Adair & Vorenberg, 1999). 3. Include education about the nature of the thin ideal and how it changes historically. Girls should learn to recognize the unrealistic images presented in the media, the methods used for altering and perfecting these images, and how these do not represent the average woman. Excellent films by Kilbourne (1995, 2000) are helpful resources in this area. 4. As reviewed previously, teach girls critical thinking skills for deconstructing harmful media images. As an example, they can review popular magazines and collaboratively create a "wall of shame" and "rave wall" collage based on images that represent both negative and helpful messages to girls and women (Levine et al., 1999). 5. As suggested by prevention specialists, school counselors can involve girls in a media activism project. For example, encouraging a girl to write a letter of support or protest to an advertiser can empower her to believe that she can make a difference in changing sociocultural norms. Examples of ongoing media activism campaigns in which girls may participate can be found through the Media Watchdog Program on the NEDA Web site. Protective Factor 5: Holistic Wellness and Balance A review of the previous four factors of the resilience model-family and peer support, gender role satisfaction, physical self-concept, and coping skills-demonstrates that

adolescent girls need a broad foundation of internal resources and external support to develop body image resilience. The resilience model indicates that when girls place an excessive emphasis on physical appearance, they may neglect the development of those supportive relationships and essential life skills needed for managing the challenges of adolescence (Striegel-Moore & Cachelin, 1999). Therefore, the fifth protective factor, a sense of holistic wellness and balance, suggests the importance of enhancing and balancing all life areas in order to foster body image resilience. When girls are encouraged to develop and value their strengths in multiple life dimensions, including spiritual, intellectual, social, emotional, and physical competence, they learn to view their identities as extending beyond their appearances. Unfortunately an exclusive focus on only one life area-physical appearance-is culturally reinforced for women. As is strongly emphasized in the mass media, girls are socialized to believe that being highly invested in achievement of the thin ideal is the only way to achieve social approval and success. It is easy to see how a girl learns to perceive her body as a reflection of her total self; she believes that "who I am" is equated with how she appears to others. To challenge these beliefs, school counselors can introduce girls to the concept of holistic wellness. One effective framework to help girls conceptualize life balance is the Wheel of Wellness model (Myers, Sweeney, & Witmer, 2000). The model defines wellness as "a way of life oriented toward optimal health and well-being in which body, mind, and spirit are integrated by the individual to live more fully within the human and natural community" (Myers et al., p. 252). The Wheel of Wellness comprises five interrelated life tasks, indicating that changes in one area of wellness affect all other areas. At the center of the wheel is spirituality, surrounded by the life tasks of selfdirection, work and leisure, love, and friendship. School counselors can use the wheel as an evaluation tool to help girls conduct an assessment of their strengths and areas for improvement in each life dimension (for suggestions, see Myers et al.). As girls decrease their emphasis on appearance and bolster their sense of self-worth not contingent on unattainable standards, they can dedicate their time and energy to the pursuit of goals in all areas of wellness. School counselors can provide girls with some of the specific strategies drawn from Myers, Sweeney, and Witmer (1998) and NEDA (2004b) to develop all dimensions of wellness: 1. To develop their sense of spirituality, girls can spend more time with individuals whose spiritual lives they admire and relate to, and talk with their parents about their spiritual development. 2. Girls can practice keeping a gratitude journal, focusing on what is working well in their lives rather than focusing on their complaints. 3. Girls can learn to nurture their bodies, incorporating proper nutrition and sleep habits. They can create opportunities to move their bodies, exercising for pleasure rather than as a means to purge excess calories. 4. Through activities such as mentoring programs, girls can learn to view academics and work as activities that provide a sense of accomplishment, purpose, and competence.

5. To encourage the development of leisure as an important component of wellness, girls can find things that they like to do for fun that are congruent with their beliefs and values. They can engage in these activities on a regular basis as an expression of their creativity. 6. To develop social competence, girls can seek out a stable, supportive network of peers and adults who help them to feel good about themselves and their accomplishments. CONCLUSIONS In adolescence, girls struggle to formulate an answer to the question "Who am I?" Girls are currently socialized to view their appearance as the most salient aspect of their identities, and their self-evaluation in this area becomes increasingly determined by comparisons with others. When girls base their identities on comparisons with the current standard for women's beauty as portrayed in the mass media, it is not surprising that BID and low self-esteem are pervasive. When school counselors work to prevent BID, they must recognize difficulties inherent in asking a girl to challenge developmental gender norms and cultural standards at a time that she might not yet possess the skills to do so (Oliver, 2001). School counselors' goal in building girls' body image resilience, therefore, should be twofold: First, they must provide girls with the skills and support necessary to resist sociocultural pressures; and second, they must work tirelessly to reduce negative messages regarding the importance of the thin ideal that are present in school communities (Levine et al., 1999). The body image resilience model gives school counselors a framework within which they can begin to address these two objectives. The model provides conceptual and practical strategies for enhancing protective factors in multiple life dimensions and for working with students, families, school staff, and the media in changing the status quo. While progress in creating this type of cultural shift might be slow, this work is important for school counselors to undertake because girls need help in recognizing the many ways in which they have value beyond their physical appearances. By reclaiming their strengths, girls can cultivate the resilience to navigate the complex sociocultural and developmental challenges of adolescence. [Sidebar] With the considerable weight gains that accompany puberty, girls become concerned about the discrepancy between their developing bodies and the societal ideal for female thinness that is portrayed in Western cultures.

[Sidebar] Body image dissatisfaction is the primary precursor for the development of eating disorders such as anorexia or bulimia, particularly during the adolescent period. School counselors need a prevention approach that identifies protective factors at the individual, family, peer, and school level, as well as teaches girls how to challenge broader socioculturel influences. [Sidebar]

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