Effectiveness of Solution-Focused Brief Counseling in Promoting Body Image of Adolescents Author:Yu-Shan Su, Wei-Su Hsu
Research Article
Body image is one of the crucial components of adolescents’ self-development and social interaction in a critical period of seeking self-identity. In the process of physical and mental development, the influence of negative body image cannot be underestimated. Numerous studies have explored the negative influence of adolescents’ body image; however, only a few studies have focused on positive body image and ways to improve it. Personal subjective perception affects adolescents’ body image. One of the essential research directions is identifying ways to assist adolescents in clarifying their subjective feelings and beliefs regarding their body image and promoting its positive development. Although solution-focused brief counseling (SFBC) is suitable in assisting adolescents, this approach has rarely been used in research on body image. Accordingly, the question posed is as follows: Can SFBC improve adolescents’ body image? Will the counseling effect of SFBC persist? This study aimed to (a) investigate the immediate and follow-up effect of SFBC on adolescents’ body image and (b) understand the effective factors of SFBC in enhancing adolescents’ body image. This study adopted the embedded mixed method research design, embedding the “quasi-experimental design of pretest, protest, and follow tests” into “ qualitative data on the interviews conducted immediately after the SFBC session and one month later.” The counselor was a junior high school counselor for 10 years and was trained and supervised under SFBC for almost six years. Purposive sampling was used to select adolescents with the following conditions: (1) Those who had a negative perception of their body image and used methods, such as weight loss and dieting, to improve their body image but still failed; (2) those who consciously felt bothered in interpersonal, emotional, or life adaptation due to their body image; and (3) those who were willing to participate in the research process and obtained the consent of their guardians. After screening, 10 adolescents aged 14 to 16 years were invited to participate in this study. After conducting research explanatory meeting, those clients with a high willingness to accept counseling every week and they were invited to be a part of the experimental group. Accordingly, five adolescents each were included in the experimental and control groups. Both groups had two males and three females. The experimental group received SFBC once a week for approximately 4 to 6 times according to their decisions. Since the SFBC sessions were conducted on a school campus, the structure of the interviews was changed to approximately 45 minutes for each session to match the schedule of this middle school. The three phases of the SFBC were revised to (1) “building relationship and developing a solution-talk” phase for approximately 30 minutes; (2) break phase for 5 minutes; and (3) positive feedback phase for approximately 10 minutes, providing positive feedback with compliments, bridge, and suggestions. The Multidimensional Body-Self Relations Questionnaire (MBSRQ) was the key research instrument, a well-validated self-report inventory for assessing body image. The MBSRQ included eight subscales: appearance emphasis (9 questions), appearance evaluation (9 questions), weight emphasis (2 questions), weight evaluation (3 questions), physical fitness emphasis (6 questions), physical fitness evaluation (7 questions), health emphasis (3 questions), and health evaluation (4 questions). As attitudes, these dispositions included evaluative, cognitive, and behavioral components. The reliability analysis results indicated that the Cronbach’s α value of the eight subscales was between .7 and .82. This result suggested that the internal consistency of each subscale was good. The participants were required to complete the MBSRQ before the SFBC sessions, immediately after termination, and one month later. The Wilcoxon matched-pair signed-rank test was used to analyze quantitative data as well as the descriptive statistics. Meanwhile, the experimental group underwent one 30 to 60-minute semi-structured interview before the SFBC sessions, right after the termination of SFBC sessions, and one month later. The outline of the interviews referred to the eight subscales of the MBSRQ, including the following: (1) The understanding and evaluation of their current body image as a whole and its dimensions (such as their evaluation and emphasis on appearance, physical fitness, health, and weight); (2) after accepting SFBC, their perception for their changes in body image (such as their evaluation and emphasis on appearance, physical fitness, health, and weight) and others (such as interpersonal, family, emotional, self-confidence, or future expectations); and (3) their subjective perception of the benefits from SFBC and the effective factors during the counseling process. These qualitative data were analyzed according to open-coding principles, with continuous research team discussion. The study indicated a significant immediate counseling effect in enhancing the appearance evaluation and physical fitness emphasis of the MBSRQ in the experimental group. The average scores of the MBSRQ and other dimensions did not reach statistical significance among the pretest, protest, and follow-up tests. However, the scores were slightly higher at the end of the counseling session than those before the counseling and slightly decreased one month after the counseling but continued to be higher when compared with the scores before counseling. The experimental group in the interviews shared their perception regarding the benefits after receiving SFBC: being more affirmative with regard to their efforts on body image, having increased self-confidence and self-efficacy, learning the abilities of self-motivation and self-monitoring, willing to continue to change, placing more emphasis on health and physical fitness gradually, and producing a positive feeling of “accepting their own body image.” Meanwhile, these benefits reduced the emphasis on weight and appearance, and gave the client more sense of control. The effective factors of SFBC in enhancing body image perceived by adolescents included the following: (1) counselors’ encouragement; (2) successful past experiences, willingness, and goal formation; (3) discussions for specific steps toward personal goals; (4) self-encouragement, self-efficacy, and self-motivation ability; (5) combinations of old and new effective methods; (6) explorations of specific small changes and self-monitoring; (7) acceptance of body image ; and (8) future expectations and effective strategies. The effective factors described above would influence each other in SFBC counseling process. Meanwhile, the effective factors, such as counselor’s encouragements, self-motivation ability, goal formation and planning, and past successful experience emerged in the earlier stage of SFBC process; combinations of new and old effective strategies, discussion on specific steps, self-encouragement, self-efficacy, and self-monitoring, confirmation of small changes, acceptance of body image, and expectations and confidence for the future change emerged at a later stage of SFBC process. Particularly, willingness, motivation, and confidence of clients involved throughout the counseling process were core effective factors for these clients’ changes. These effective factors were related to principles mentioned in the literature on helping adolescents improve body image and clearly echoed the therapeutic concepts of SFBC. In short, the SFBC presented its counseling effect and reflected the influence of social and cultural factors (such as the media). Based on the results and discussion of this study, future studies should consider the following: use effective factors of SFBC to help adolescents in improving their body image; expand research sample numbers and their backgrounds; analyze the process of SFBC in detail and examine how its interventions create counseling effects; and explore more about the influence of media, gender, weight, or sports on adolescents’ body images when doing their counseling work.
Effectiveness of Solution-Focused Brief Counseling in Promoting Body Image of Adolescents
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