Group therapy for early adolescent relationship problems between girls

ABSTRACT Adolescence is a process rather than a specific period in an individual’s life. The focus in this study, however, was on early adolescence (11–14 years of age) and not on adolescence as a whole process. This study focused in particular on early adolescent girls, their psychosocial development and possible relationship problems. Early adolescent girls often display imbalances due to hormonal changes that in turn cause emotional reactions in especially relationships within the peer group. The researchers used semi-structured interviews in a qualitative study to deduce what kind of relationship problems seven early adolescents experienced within their peer group and how they handled the problems. Group therapy was used as therapeutic intervention, because it is often successful for interpersonal and intrapersonal psychological problems. The findings of the empirical study concurred with the above notion, as well as with findings from the literature review.


Introduction
indicate that the word 'adolescence' comes from the Latin word 'adolescere'. It means 'to grow in maturity'. Adolescence is a process rather than a specific period in an individual's life. It is the time between puberty and adulthood, during which young people prepare for their roles and responsibilities as adults (Arnett, 2013). According to Louw, Van Ede, and Louw (1998), adolescence is a developmental stage divided in three stages: • Early adolescence, between 11 and 14 years • Middle adolescence, between 14 and 18 years • Late adolescence, between 18 and 21 years For this study, the emphasis was on early adolescent girls, approximately between 11 and 14 years. It focussed on the psychosocial development with attention to peer-group relations. Friendships as part of social relations are complicated in early adolescence, but are of great importance for optimal development (Van Roekel, Scholte, Engels, Goossens, & Verhagen, 2015). Good peer relations have a positive influence on adolescents' psychosocial development. However, peer groups can also be a source of pain and stress resulting from rejection, negative expectations, poor communication, conflict, peer pressure and jealousy that may lead to uncertainty, doubt and loneliness.
A qualitative study was conducted by way of a literature-and empirical study on peer-group relationship problems among early adolescent girls, and the possibility of group therapy as therapeutic intervention. The research question was: Can group therapy help early adolescent girls with peer-group relationship problems? The resulting sub questions were the following: (1) What relationship problems are found amongst early adolescent girls?
(2) What are the causes of relationship problems among early adolescent girls?
(3) Can group therapy help early adolescent girls with peer-group relationship problems?

Theoretical framework
In this study, the researchers used the attachment theory and the social identity theory. John Bowlby (1969), the father of the attachment theory, believed that primary caregivers have the power to create a safe environment for the child in order to trust others in relationships. Children with secure attachments with caregivers will have confidence to explore the world, but those with insecure or disorganised attachments often are fearful, angry, and anxious in their relations with caregivers, and later with peers. In the attachment theory, it is normal that adolescents become less dependent on parents/caregivers and get more involved with the wider social world. Peers gradually become more important in fulfilling the emotional needs of adolescents (Coleman, 2011;Woolfolk, 2016).
According to Mynhardt (2009), the social identity theory of Tajfel and Turner emphasises the uniqueness of the individual, but also the individual as part of a group. The individual often compares herself to others. Group acceptance is very important, especially for adolescents. Rivers, Duncan, and Besag (2007) indicate that a person's social identity links with the conception of belonging to a particular social group. Membership of a social group can provide emotional security and meaning, thus adding value to the person's life, for instance by enhancing social self-esteem.
Coleman (2011) is of the opinion that both the discussed theories give insight into why friendships, especially within peer groups, are important in early adolescence and why problems sometimes occur.

Psychosocial development
When children make the transition from childhood to adulthood, they display the need to be more independent from their families (e.g. the attachment theory) (Arnett, 2013;Gallardo, Barrasa, & Guevaria-Viejo, 2016;van Roekel et al., 2015). Good peer relations create autonomy within the parent-child relationship with a positive influence on 'self-esteem, social competence [and] social acceptance' (Collibee, Le Tard, & Aikins, 2016, p. 252). It is in line with the most important psychosocial developmental tasks of adolescents namely to socialise, to find their place in society, to develop interpersonal relations, to cultivate tolerance for personal and cultural differences and to develop self-confidence as well as autonomous functioning (Collibee et al., 2016;Gouws, 2016).
The result of the mentioned developmental tasks is that the acceptance of the peer group becomes more important. Groups consisting of three to six friends (mostly the same gender) become a source of security for the young adolescent (Lebelle, 2012). Berk (2009) is of the opinion that the early adolescent mostly looks for a friend who resembles her, in terms of age, gender, culture and interests. Reciprocal give-and-take, as well as mutual understanding build the strongest friendships.
Close peer-group relationships play a fundamental role in the psychosocial development of the early adolescent and vary in quality and stability (Arnett, 2013;Croft & Zimmer-Gembeck, 2014;Underwood & Rosen, 2011). According to Underwood and Rosen (2011), research has shown that positive peer-group relations contribute to positive outcomes, for example, adolescents who spend time with others, who have good emotional and social skills, acquire the same skills. Papalia et al. (2008, Arnett, 2013, however, maintain that peer groups can also be negative. Friends can cause negative reactions such as 'anger, frustration, sadness and anxiety' (Arnett,p. 214), because of emotional vulnerability and reliance on peers. For instance, conflict followed by aggression can influence relationship stability (Croft & Zimmer-Gembeck, 2014).
Early adolescent girl peer-group relationship problems Girls have less stable relations than boys and they experience more stress when under peer pressure and in conflict situations (Thomas & Bowker, 2012). Girls often engage in relational or social aggression using insults, gossip, exclusion and taunts in their peer relations (Woolfolk, 2016) with a negative influence on their friendships. Gouws (2016) is of the opinion that negative relationships between adolescent girls can cause much pain and stress. Some of the problems experienced are mentioned below:

Popularity
According to Pickhardt (2010) popularity can be defined as a well-established social position among peers. Popularity in the adolescent peer group may mean somebody who values appearance, has self-confidence, is outspoken, has up to date digital equipment, wears the 'right' clothes and has knowledge of the latest fashions.
Clarke-Stewart and Parke (2014) identified two kinds of popular adolescents. Ordinary popular adolescents are friendly towards their peer groups. They are assertive, but not disrupting or aggressive. The popular aggressive adolescents, on the other hand, are arrogant and aggressive, but supported by the group. To be a member of a popular group with an amount of popular members is a route to power and influence.
Adolescents follow popular members within groups, but they often also denounce them, concentrate on their flaws and failures, and start gossiping about them. Unpopular members within peer groups often have a poor self-image and they cling to popular members to be part of the group. Popularity and friendship are not, however, identical. Popularity emphasises the rank of people, whilst friendship emphasises the relationship (Pickhardt, 2010). Woolfolk (2016) is of the opinion that early adolescents are not always tolerant towards others who are different from themwhether it is physical, intellectual, racial, economical or linguistic differencesand they often reject them. Adolescents also reject peers who are aggressive, withdrawn or hyperactive.

Rejection
Adolescents react negatively if they are sensitive to rejection. However, if their self-image is strong enough and they have the ability to handle most social situations, they will manage rejection easier. Adolescents with a good sense of humour treat rejection more positively and chances are good they can process the peer group's attitude easier. However, should the adolescent's self-image not be good enough, it can be the cause of much suffering and pain. Rejection is more difficult to accept if it comes from somebody close and significant (Clarke-Stewart & Parke, 2014).
truth and that of others as less important. In early adolescence, the members of the peer group often blames one another for problems in the group and conflict takes place without proper communication.

Causes of peer-group relationship problems
Two of the most important causes for relationship problems of early adolescent girls are the following: Low self esteem Gouws (2016) is of the opinion that adolescents with low self-esteem are more prone to feelings of isolation and loneliness. In social situations, they are tense and uncomfortable which impedes communication with other. Factors determining self-esteem are relations with the peer group, close friendships and romantic liaisons. The ego and self-image develop positively through praise, achievements and success.
Adolescents try to overcome feelings of worthlessness by holding up a false front, because they are so vulnerable to rejection and criticism (Gouws, 2016). Laursen, Hafen, Rubin, Booth-LaForce, and Rose-Krasnor (2010) confirm that low self-esteem influences adolescents' relationships with their peers. It can lead to aggressive behaviour and feelings of rejection.

Peer pressure
Adolescents use 'social comparison' to compare themselves to others (e.g. social identity theory). Social comparison helps adolescents to determine who they are and how they compare with the group. Social comparison greatly determines the adolescent's self-esteem, whether positive or negative (Clarke-Stewart & Parke, 2014; Gouws, 2016). (Arnett, 2013, p. 218) prefers the term 'friends' influence' above 'peer pressure', because friends are emotionally and socially of more importance than the whole peer group. Clarke-Stewart and Parke (2014) use the term 'peer pressure' when referring to behaviour that is approved or disapproved by the peer group determining whether the individual is accepted or not (e.g. social identity theory). Adolescents influence each other by setting standards to which the group must adhere and according to which they measure themselves. Positive behaviour develops through praise or encouragement from friends in a peer group; however, unacceptable behaviour is punished by criticism and negative reactions.

Definition
According to Kendra (2013) group therapy is a type of psychotherapy where one or more therapists work simultaneously with a group of people. The therapist/s can combine it with individual therapy. Group therapy is successful for a group of people with similar problems. The therapist/s is only the facilitator, because group members help each other to overcome or understand their problems (Kendra, 2013). Cherry (2013) indicates that group therapy sessions can have as little as three members, but in general most groups have seven to twelve members. Groups get together once or twice a week for an hour or two for more or less six sessions. Therapists can either adopt a freestyle session where everybody contributes or can structure the session according to a specific theme or topic. Paone, Malott & Maldonado (2008) sees group therapy as intervention in problems with selfexpression, self-exploration, and self-knowledge, as well as in problems of loss, aggression, empowerment, relationships, the development of empathy and the teaching of social and communication skills.
The Place of Group Therapy in Building positive Peer-Group Relations Group therapy can assist with people feeling that they belong to a group where everybody is equal, because of sharing the same problem and trusting each other. It is an environment where some clients for the first time learn to share their feelings in a spontaneous way (Kendra, 2013). (Weiten, 2004)is of the opinion that group members act as therapists for each other. They describe their problems, share experiences and possible solutions. The most important aspect of this kind of therapy is that members support each other emotionally and they accept and trust each other.
Group therapy is especially a good way of dealing with relationship problems (Sue & Sue, 2006) as can be seen in the following remarks: • In group therapy, the therapist can observe how the client will react in a real life social and interactive situation. • Members of a group learn new communication and social skills in group therapy through imitation and practical experience • Members of a group are more open to discussing their problems once they realise that there are other people with the same problems. • Members of a group give each other social and emotional support. They learn about trust, intimacy, belonging to a group and they often become motivated to solve their issues together.
A qualitative study was done to determine how early adolescents experienced their relationship problems and in which ways they tried to solve their own problems. Group therapy was done when solutions did not seem to be sustainable.

Research design and approach
The researchers used an exploratory, case study research design for insight into early adolescent girl peer-group relationship problems and possible solutions to these problems. McMillan andSchumacher (2001, Arnett, 2013) explain that a case study encapsulates one case that can be researched in depth through various sources in a specific context. A case study can be a rich source of information, but cannot be generalised. This study examined a specific group of seven adolescent girls with peer-group relationship problems within their friendship circle.
The researchers used a qualitative approach. According to de Vos, Strydom, Fouche, and Delport (2011), qualitative research is used to gather information about the lived experiences of peoplein this case experiences of early adolescent girls with relationship problems within their peer group.

Sampling
Purposeful selection was done to identify a specific case, namely an early adolescent group with relationship problems. The case study consisted of seven early adolescent girls in a rural school in the Limpopo province in South Africa. The guidance teacher helped to identify a specific group of early adolescent girls with peer-group relationship problems for attention of an educational psychologist. Two educational psychologists conducted the research. The Department of Education and the headmaster of the school gave permission for the research. Parents gave their consent and the girls gave assent to participate in the study.

Semi-structured interviews
The researchers conducted individual semi-structured interviews with the selected participants to deduce what kind of relationship problems they experienced and what they saw as possible solutions. Group therapy was done when their own solutions did not work to alleviate the problems. A focus group interview was conducted after the group therapy to find out whether it worked as technique in addressing interactive problems.
The researchers had probing questions at hand on an interview schedule to guide the semi-structured interviews namely: Your group has been friends for a long time. Let us talk about your friendship.
• How will you describe the friendship in your group? • Why do you think there are problems between individuals in your group of friends? • What kind of problems do you experience between your friends? • How do you handle problems in your group?

Ethical considerations
Before the girls answered any questions, they were reassured of anonymity and confidentiality of the contents of their conversations. They could opt out when they did not want to participate any longer. Should the person feel that she needed individual therapy, it would be organised, but no harm was foreseen during the research process.

Analysis of data
The researchers used the data analysis spiral of de Vos et al. (2011) to analyse the data. They recorded the interviews on a digital recorder, whilst making notes. They transcribed all interviews and then deducted broad categories and themes by repeatedly reading the transcripts of the interviews concentrating on the main meaningful units. Data was analysed by reading through it, reflecting on it, coding and distilling it into themes, formatting it into a coherent story and writing the narrative.

Individual semi-structured interviews
Several relevant themes under broad categories came to the forth during the semi-structured interviews about friendship, problems and possible solutions: Category 1: friendship Theme 1: the value of friendship It was clear that friendship was very important to all participants. Caring, love, happy times together and loyalty were elements that often came to the fore. According to Underwood and Rosen (2011), the peer group plays a fundamental role in the life of an adolescent. It was also evident in this peer group. Participants 1 and 2 experienced that the group shared the same interests. Participant 2 mentioned that they love each other and that it was enjoyable to be together.
Participant 1 described participants 3 and 4 as real trustworthy friends. Participant 2 was of the opinion that participants 1 and 5 were like sisters to her because they were friends for yearsthey could discuss problems with each other and look for possible solutions together. Participant 3 acknowledged that the group members knew each other very well, because they had been friends for a long time. Participant 5 said the following about friendship: 'It means you have to care for each other and not fight and support each other'.

Theme 2: loyalty and trust
Participant 1 felt that it was important to be loyal towards each other. She remarked: 'For me, it is when friends support each other and help each other even if we make mistakes . . . tell if there is something that bothers them. Rather say it directly . . . than gossiping behind their backs'. According to Baron et al. (2009) adolescents devote a lot of time to their friends, communicate with each other and offer emotional support to each other. (Rathus, 2006) is of the opinion that adolescents value loyalty and reliability. Loyalty between friends was also very important for participant 3. She mentioned that the group often argued, because they changed 'best friends' and was thus not 'loyal to one friend'.

Category 2: possible problems in friendship
Theme 1: jealousy Participants of the researched group became jealous of each other when members of the group decided to do something on their own. It often happened in the group that two members decided to form a special friendship apart from the groupthey changed 'best friends' and acquired new 'best friends'. According to participant 4 one of the biggest problems within the group was jealousy and gossip. It created conflict. (Gouws, 2016) is of the opinion that early adolescents often want to do things togetherthey go to school together, participate together in sport, spend free time together, use each other as soundboard to share ideas, thoughts and fears that cannot be shared with parents (for example, difficulties with parents, teachers, clothes, hairstyles, the future, sex, drugs and alcohol). The early adolescent girls of this study were very involved with each other's lives; it was on that point that friction, and jealousy occurred.
Participant 1 was of the opinion that jealousy definitely existed in their group. One of the reasons why they envied each other was that some did better in schoolwork and dancing. As far as appearance was concerned, they were also jealous of each other. Participant 2 declared that 'Sometimes participant 5 feels she is not beautiful enough'.
According to Parker et al. (2005) many adolescent girls experiencing friendship jealousy, have a low self-esteem. Participant 2 used this example: 'If participant 3 does modelling, then we feel we are not as good and that causes a feeling of inferiority'. Participant 1 realised that each member of the group excelled in her own way, but they struggled to give credit to and praise to each other.
Participant 1 also felt that the group had trouble when boys were involved. When one of them had a boyfriend, or only spent some time with a boyfriend, the group did not accept it.

Theme 2: gossip
The girls in this study gossiped about each other more than about other children in the school. According to participant 3 they were inclined to share each other's secrets, especially after holidays. 'Secrets must be kept secret, but when they are best friends again, secrets become known'. This caused friction in the group. Problems that arose, according to participant 1, was that 'gossip and stories are amplified and twisted'. Participant 2 felt that the kind of problems that they experienced, originated when one of the group realised that somebody had gossiped about her and then they argued.

Theme 3: peer pressure
The participants in the group interpreted peer pressure in different ways. Some participants experienced group pressure with regard to appearance; and others with regard to academic or sports achievements, as well as the positions they played on the hockey field. According to participants 1, 4 and 5 though, peer pressure was not so important in their group of friends. Rathus (2006) confirms it by mentioning that peer pressure is not such an important factor in the life of the early adolescent, but more so in older adolescents.
As already mentioned, adolescents use a process named 'social comparison' to compare themselves to each other. Baron et al. (2009) mention that uniformity refers to behaviour in accordance to the specific group's norms. This determines acceptance or rejection in the group. Participant 2 experienced group pressure when she wanted to share a secret with only one person, but the group pressurised her into sharing it with them all. Appearance was also important for the group, for example, when the school celebrated spring day; the girls competed against each other to dress according to the group's expectations.
Theme 4: popularity Gouws (2016) is of the opinion that for the early adolescent, acceptance by the peer group, as well as popularity, is important. Participants 6 and 7 felt that popularity was not so important to them, but that it certainly played a role in the group. Participant 1 believed that everybody in the group was to a certain extent popular, because the children in the school knew the group. She considered participant 2 to be the most popular. Everybody liked her, especially the boys. She deemed the reason to be 'because she is beautiful'. Clarke-Stewart and Parke (2014) confirm this statement by mentioning that physical appearance plays an important role in peer group ranking.

Theme 6: poor communication
The most relevant problem for this group was communication. The participants experienced that members of the group sometimes fell silent when they were upset about something. There was a great need for them to talk to each other and openly expressed their reasons for anger or sadness. Participant 1 felt that the way in which problems in their group were handled, was not very effective -'[T]hey take sides, even though they do not know what it is all about'. Participant 1 was of the opinion that communication was the solution to problems. They could solve problems by asking questions like: 'Did you say it?' or 'What did you mean?' Baron et al. (2009) is of the opinion that conflict occurs when a person communicates in such a way that it angers the next person because of misunderstanding.
Participant 4 said that when they argued, they would not speak to each other for days. Participant 1, however, would always try to solve problems through communication. Participant 4 felt that everybody should follow participant 1's example. Sometimes the group decided to ignore the instigator of conflict in the group. The participant was consequently rejected for a set period. (Woolfolk, 2016) is of the opinion that rejection or exclusion can be very traumatising for an early adolescent.

Theme 6: competition
There mostly was healthy competition between the girls, but jealousy brought about some negative competition. (Gouws, 2016) explains that healthy competition in the peer group serves as preparation for the adult life, which is highly competitive in many aspects, especially in the professional world.
Participant 1 mentioned that she realised that everyone excelled in her own way, but they still struggled to give credit to each other. 'Some of us succeed, but not everyone'there existed, especially with sport and academic achievement, negative competition among the group members.
Category 3: possible solutions for friendship problems Theme 1: divide in smaller groups Participant 2 gave the following solution to friendship problems: 'We usually . . . divide into groups, then we cool down and then we come together and we apologise and say we love each other and then we are together again'. According to participant 6 they would still accept each other and stand together in the mornings, irrespective of the conflict.
Theme 2: discuss the problem Participant 3 felt that the only way to solve their problems would be to talk about it. Sometimes they succeeded, but not always. According to participant 4, there was an improvement in communication; however, they should learn to express their feelings by indicating what made them happy and to make their peace when necessary. She affirmed: 'Sometimes it is so serious, that we don't talk to each other for a day or two. But if participant 1 had an argument with me she will return the same day to apologise, she will honestly tell you where you faulted, she will apologise for where she blundered'. (Gouws, 2016).contends that the peer group serves as a 'socializing agent' and satisfies the adolescent's need for comradeship and friendship. It creates an opportunity to practice social skills and to establish firm friendships; therefore, communication about problems was imperative.

Focus group interviews
The solutions the adolescents tried out did not always work for all their problems, therefore the researchers did group therapy to see whether the identified problems can be solved in another way. Some of the issues identified in the individual interviews were thus addressed through six group therapy sessions. The group apparently had some coping skills of their own, but it did not really seem to work long-term, therefore the group therapy sessions. In the focus group interviews participants had to indicate what they learned through the group therapy sessions and why they thought it was worthwhile.
The first and fourth group sessions were about friendship. The emphasis was on the definition and value of friendship, as well as the expectations from good friendships. The participants emphasised loyalty and trust as key to good friendships as also indicated in the individual interviews. All participants needed real trustworthy friendships, but most of them realised that they do not always succeeded in being loyal friends. Participant 1 felt that real friendship was a rare commodity and they needed to treasure it. She indicated that the therapy session taught her the following: 'Friendship is not merely about being friends. It is not about only being friendly with each other. Friendship means to be loyal to a person and that the other person be loyal to you, and that you can trust each other. Real friendships are rare.' Loyalty and trust came to the fore again and they could see that most of them value the same qualities in friendship. Participant 4 realised that they connected as group members, because of the same expectations, but they did not always realise that. Participant 5 was of the opinion that they connected in unique ways, because they were different individuals. Participant 1 felt that they did not appreciate each other enough: 'Only when you lose your friend, do you realise what you had in her . . . Therefore one needs to enjoy life and your friends whilst you can'.
The second session was about anger, mostly because of jealousy, snobbishness, peer pressure and gossip, indicated in the individual interviews as causes of peer-group relationship problems. Group members realised that they needed each other to overcome anger, but they also realised that individuals get angry over different issues and they reacted differently when angry. Participant 1 indicated that even though they reacted differently as individuals, they remained loyal to the group. The members of the group learned how to identify special qualities in each other and how to express their gratitude towards each other. Participant 3 indicated that she also learned something about herself: 'Participant 1 gives me a compliment about my blue eyes and Participant 7 values my smile. The other participants also add positive remarks in a sincere, believable way and that makes me feel good!' They learned to talk about what made them angry in the group and how to appreciate the members' individual strengths.
The third session was about individuality and appreciation for the special value individual members added to the group to encourage group members to accept each other without getting agitated. Participant 2 was amazed at what she learned about her friends: 'I learned things that I did not know, so I thought really is that what you do and also wow I did not know this about you and we have been friends for such a long time'. Participant 2 remembered qualities of her friends that she has forgotten about. The participants felt that they got to know each other better during this session.
Participant 5 said that she learned to think about herself and her role in the group. She felt that they should accept each other and not become unnecessarily jealous or angry with others. Participant 4 suggested that group members should change their attitudes and not who they were.
The fifth and sixth sessions were about working as a team. They experienced the sessions as very therapeutic and Participant 7 felt that 'it changed me to be a better person'.
In general, the group members felt that they learned more about their friends and themselves through the group therapy sessions. They learned to accept each other and to function as a team. They learned to communicate and to listen to each other.

Recommendations
The following recommendations to alleviate peer group conflict and to enhance good social skills, with group therapy in mind, are made: • Adolescence is a period of major changes and the adolescent has to decide with whom she fits in with her unique personality traits. Group therapy is a good way of doing introspection with the input from peers. • Identity formation and acquiring self-knowledge is very important in this developmental stageit becomes possible by getting to know others in the same age group; therefore, group therapy assists in getting to know oneself in relation with peers. • Conflict management skills are important in early adolescence. The early adolescent gets to know herself within a group context and learns how to deal with conflict, jealousy and anger, as well as how to affirm herself through communication and social skills training in a safe environment. • If the adolescent girl gets to know herself as unique individual within a group, she will learn to be more self-sufficient and that will most probably curb jealousy. • Early adolescents are often very emotional because of hormonal changes, but their emotional reactions can cause relational problems. Group therapy as well as individual therapy could teach early adolescents emotional vocabulary to express their feelings in an appropriate manner. • Group therapy is a place where the early adolescent can feel safe, because of the acceptance of the group and the trust they put in each other when trying to solve the common challenge that they have.

Conclusion
In this study, the emphasis was on the early adolescent girl and her psychosocial development. Early adolescent girls spend much time with friends; they communicate with each other, and render emotional support to each other. The peer group, thus, plays a fundamental role in the life of the early adolescent. There often are relationship peer-group problems due to the level of psychosocial development. Problems develop because of peer pressure, management of popularity, communication problems, jealousy and a low self-image. Group therapy is an invaluable way in dealing with peer relation problems of the early adolescent girls. According to Paone et al. (2008) group therapy assists in self-exploration, self-knowledge, the solving of relationship problems and the development of social and communication skills. This study confirmed this notion by observing growth in the early adolescent group especially in their peer relations. The group learned to trust each other more, to stand together as a group, and to communicate when problems arose.