|Anne Kruger, PhD
|Georgia State University, Center for Research on School Safety, School Climate and Classroom Management, Atlanta, Georgia
|Georgia State University, Center for Research on School Safety, School Climate and Classroom Management, Atlanta, Georgia
|Coweta County Schools, Newnan, Georgia
|Clayton County Schools, Jonesboro, Georgia
|Park Hill Schools, Kansas City, Missouri
|Joel Meyers, PhD
|Georgia State University, Center for Research on School Safety, School Climate and Classroom Management, Atlanta, Georgia
Introduction: Youth from low-income, urban backgrounds face significant challenges to maintaining a positive developmental trajectory. Dangerous neighborhoods and stressed relationships are common in these settings and threaten adaptation by weakening the natural assets that undergird resilience. African American girls in these contexts face specific, multiple risks, including gender stereotyping, violence, and sexual exploitation. The commercial sexual exploitation of children (CSEC) is a multibillion-dollar industry victimizing over 1 million children around the globe. The typical victim in 1 city in the southeastern United States is an African American girl 12–14 years old. There has been little research investigating the characteristics of girls placed at risk for CSEC and even less research on the personal perspectives of these girls.
Methods: Over 3 school terms we provided preventive intervention groups for 36 African American middle school girls who were placed at risk because they lived in neighborhoods with high rates of interpersonal violence and CSEC. Two group leaders and a process recorder took detailed notes on each group session. Our focus on group conversations over a period of weeks increased the probability of recording spontaneous, open comments by the children and is a promising method with this population. The data were analyzed qualitatively and resulted in an account of the girls’ own views of the environmental challenges and personal experiences that may influence their development.
Results: The girls’ language during the group sessions contained 4 themes: difficulty forming trusting relationships, frequent peer aggression, familiarity with adult prostitution, and sexuality as a commodity.
Conclusion: Our research shows how girls placed at risk for CSEC view their own lives. These children described violence and sexual exploitation and cited limited supports to protect them from these risks. Understanding the perspectives of these girls should generate future research and intervention strategies to support their coping and resilience.
Youth from low-income, urban backgrounds face significant challenges to maintaining a positive developmental trajectory. Dangerous neighborhoods and stressed relationships in these settings threaten adaptation by weakening the natural assets that undergird resilience. African American girls in these contexts face the specific, inter-correlated risks of sexualization, ethnic stereotyping, and violence. The project described here used a unique approach to data collection by recording discussions held by low-income African American middle school girls participating in preventive intervention groups to enhance wellbeing. The purpose of the research was to learn how the girls themselves view risks and their assets to deal with them. Taking a narrative psychology approach, we argue that an individual’s psychosocial functioning is related to, and perhaps the result of, a life narrative, that is, his or her personal construal of lived experience.2
A Focus on Low-Income African American Girls
The sexualization of girls in American culture is a significant threat to healthy development. Sexualization refers to the inappropriate imposition of sexuality on a person and/or valuing a person only as an object of sexual desire.3 A task force of the American Psychological Association3 reports on the ubiquitous messages sexualizing girls that are reinforced by others, including parents and teachers. With repeated exposure over development, many girls internalize these attitudes.3–6 The results can include shame, anxiety, body dissatisfaction, low self-esteem, depression, and sexualized expectations of the future.3 Further, African American girls are stereotyped as “hypersexual” and in low-income urban environments they are more likely to experience abuse, early sexual activity, and early pregnancy.7–14
Miller15 reports that African American girls in low-income neighborhoods are overlooked as victims of violent crime and often experience gendered aggression during routine events. These episodes range from harassment to assaults and are perpetrated by male neighbors. African American girls who have been exposed to violence are more likely than boys to report anxiety and depression.16
One of the gravest manifestations of sexualization and interpersonal violence is the commercial sexual exploitation of children (CSEC), a multibillion-dollar industry that victimizes over 1 million children around the globe.1 CSEC includes practices by which a person, usually an adult, achieves sexual gratification, financial gain or advancement through the abuse or exploitation of a child, forcing children into activities such as prostitution, pornography, nude dancing, stripping, sex tourism, and trafficking for sexual purposes.17,18 Personal predictors of CSEC victimization include poverty, unstable housing, hostile family environments, runaway/truant/dropout status, emotional/behavioral problems, sexual abuse, and early sexual behavior.19,20 The typical victim in 1 southeastern city is an African American girl 12 to 14 years old.21
Despite the serious problems associated with CSEC, there has been very little research addressing this topic. While the environments that place children at risk have been described, little is known about the characteristics, coping, and resilience of children living in those environments. Prevention of sexual exploitation must begin with research on the early identification of children who are vulnerable and on the resources available to them.22 There are barriers to conducting such research. For example, it has been suggested that at-risk girls in impoverished circumstances have difficulty establishing trusting relationships.23 Thus, research using traditional interview strategies with this population may have serious limitations. Ongoing preventive intervention groups have the potential to establish trust. Research based on girls’ discussions in such safe settings may provide a more accurate view of their perceptions and contribute knowledge to prevention science in general and the prevention of CSEC in particular.
Rationale for Study
The goal of this research is to construct a systematic description of the students we served in a preventive intervention, African American urban middle school girls at risk of CSEC and interpersonal violence. Our goal was to enhance the scholarly literature regarding these students by listening to their narratives about personal strengths and weaknesses and about the challenges and supports in their environments.
Since 2007 our team has worked with a southeastern city’s urban schools affected by CSEC with approval by a local institutional review board. We assessed the specific needs of African American girls in middle school and designed and delivered an original prevention program to promote their healthy psychological development and reduce their risk for victimization. Using the Socioeconomic Mapping and Resource Topography (SMART) system (http://smart.gismapping.info), we confirmed that the school sites for the project, described below as Schools 1 and 2, are located in high-risk neighborhoods. Combining 3 weighted census tract measures—the percent of persons living below the federal poverty line, the percent of persons receiving public assistance, and the percent of families with minor children that are female headed—the Community Disadvantage Index (CDI) is more reliable than any single indicator and normed to reflect the distribution of community disadvantage across census tracts in the United States. According to the SMART system, both of our intervention sites have a CDI score of 10, indicating the greatest disadvantage. Furthermore, Priebe and Suhr36 identified these locations as having adult and juvenile prostitution arrests at especially high rates. Thus, young adolescent girls in these schools are placed at risk by cultural objectification, community disadvantage, community violence, and CSEC–related arrests in their neighborhood.
To begin with, we visited these neighborhoods and talked with administrators, teachers, and afterschool staff about life in the local schools. We also researched culturally specific curricula for African American girls. Greater adherence to Afrocentric values is predictive of higher self-esteem and perceived social support, and higher ethnic identity has been shown to have a direct relationship with higher sexual refusal efficacy in African American girls. 24,25 Although this review was informative, there are very few evidence-based prevention programs for African American girls, even fewer that focus on building strengths in resistance to the prevailing culture, and none that are specific to CSEC. 26 Therefore, we created a curriculum responsive to the community’s needs. By including content to enhance physical and emotional safety, both in and out of school, we addressed community threats while working to promote the social-emotional development of girls. Our curriculum included sessions on trust, relationships, decision-making, and coping with negative stereotypes and emotions. We did not directly address sexualization, but, as discussed below, participants raised the issue.
The present study focuses on middle school girls who participated in our prevention curriculum during 3 school terms (Spring, Summer, and Fall of 2009). The setting for Spring 2009 was Middle School #1, a public school in an urban district. The setting for Summer 2009 and Fall 2009 was Middle School #2, another school in the same district. Both schools were located in high-risk neighborhoods, as described above. In both schools, 92% of the students were considered economically disadvantaged and 94% of the students were African American. The participants in our curriculum sessions each term were sixth, seventh and eighth grade African American girls (age in years M=11.04, SD =1.21) enrolled in a voluntary afterschool program at their school. The intervention sessions took place as part of the afterschool programming. Over the 3 terms, there were 36 participants (10 girls meeting as 1 group during Spring 2009, 14 girls meeting as 2 groups in Summer 2009, and 12 girls meeting as 1 group in Fall 2009). Sessions met for 1.5–2 hours on a weekly basis for 8 weeks.
Procedures and Instrumentation
Two graduate students facilitated each group and recorded their observations after the sessions using field notes. Two other graduate students served as process recorders (one recorder per group) and wrote their observations of the interactions, discussions and the curriculum throughout each session. These graduate students were either in training to become, or already were, certified school psychologists. Their training included advanced study in providing mental health services in schools, as well as qualitative and quantitative research methods. The written descriptions of each session (8 sessions per group X 4 groups = 32 sessions) consisted of transcribed spontaneous participant comments and observations of participant behaviors. We reviewed these notes weekly to make the intervention continuously responsive to the girls’ interests and needs. At the same time these notes were research data, and we were mindful of the contrast and synergy of the 2 purposes. The topics of the sessions and our interest in coping with risks affected the content of the discussions and thus the data collected.
The research team (2 university faculty members and the 4 students described above) met on a weekly basis while running the groups to process the collected data, implementing both open coding and selective coding using the constant comparative method.27,28 Open coding resulted in 8 codes with high inter-rater agreement (92% when creating codes and 96% when checking for coder drift). This report is focused on the subsequent analyses conducted using selective coding and pattern analysis procedures to examine the relationships among the codes.27,28 Selective coding was accomplished by having the team read through transcripts to seek integrating themes and by using the constant comparison method to identify a set of themes that occurred repeatedly throughout the transcripts. The entire research team provided feedback and reached consensus on the themes.29,30 Then the themes were applied to each transcript by 3 research assistants who reached 100% consensus about these coding decisions.29,30 This resulted in 4 integrative themes that are presented in the results section.
We identified 4 risk-related themes in the group discussions: (1) difficulty forming trusting relationships, (2) physical aggression in peer relationships, (3) familiarity with adult prostitution, and(4) girls’ sexuality as a commodity.
Difficulty Forming Trusting Relationships
We defined trust as the ability to rely on others to maintain confidentiality and alliances. The girls participating in this research described difficulty establishing trusting relationships with peers, teachers, and other adults in the community. For instance, at the beginning of the group process, the girls developed their own group rules. One participant indicated concern with the group rule that the girls trust the other group members; this student indicated that this was the most difficult rule to follow. Another girl could not name a single person she trusted. Further, some of the group members indicated that they could not trust the police. One girl related her experience in which a police officer failed to stop a man from masturbating in front of her. Some of the following illustrative quotes resulted when the girls were asked directly whom they trust: “Nobody.” “I don’t know.” “I don’t trust nobody because people is fake.” “We ain’t no family.” “I don’t have friends; I have associates.” “… I don’t trust nobody.” One girl said: “You can’t trust all your Church members.”
The participants’ discussion about trust had particular implications for their relationships with other girls. Interestingly, the mistrust of other girls was often discussed with respect to their boyfriends. “Friends keep your secrets to themselves…they don’t try to sneak and talk to a guy you like.” [Friends] “don’t tell secrets, lie, talk behind your back, fake.” “Your friend will not go behind your back and talk to your boyfriend.” “Friends don’t instigate or try to sabotage your relationship with another person.”
Girls also mentioned difficulty with adults. This was especially clear during a discussion about fathers. “My daddy broke a promise to me.” “ My daddy broke a promise to me. He say he gone give us money, then he say he gone be down here and he doesn’t come.” “Daddies are never there…My daddy’s … in jail. He said he was going to send me some money and he didn’t.”
Despite concerns about trust, the facilitators reported that over time some students formed positive relationships with them. Also, some girls stated that the trust-building exercises in the curriculum were a favorite. For example, one girl said: “I liked when we had to be in the circle and trust each other.” Another stated: “I would want to do more and different trust building games.”
Physical Aggression in Peer Relationships
We defined physical aggression as hostile behavior, or threats of hostile behavior, intended to cause physical harm. Physical aggression could be witnessed by, initiated by, or directed against the girls. This theme reflected the participants’ perception that physical aggression was a common and significant feature of peer interaction. For example, one girl claimed to protect herself from peers at school by carrying a razor blade under her tongue. Students’ statements about aggression were supported by facilitator and process recorder observations of the girls and their environment. Some girls laughed at other girls in the sessions. Although they were reminded of the rules of group behavior, some occasionally struck each other. On one occasion during the afterschool hours, facilitators observed a boy openly carrying a gun on the school grounds.
The following statements by the participants illustrate this theme. “You have to fight to get respect.” “If you are going to roll your eyes at someone, you should be ready to fight.” “If you talk about somebody behind their back you need to be ready to fight.” The discussion of physical aggression also included some recognition of the roles played by gangs. For example, one girl said: “I was bad. When I got here this girl tried me and I was about to fight her. This girl tried to get me to be in ‘Young Killer’s Clique’ because she said I can fight. I was like I ain’t no killer. I ain’t joining that.”
Familiarity with Adult Prostitution
We defined prostitution as the practice of soliciting customers to pay for sexual acts. The students demonstrated familiarity with prostitution and the practices of prostitutes in their neighborhood, calling one neighborhood prostitute by name. One participant described an episode in which she accompanied her grandfather in the car to buy gas. While they were both inside the car, a prostitute knocked on the grandfather’s window to solicit him. The student described the conversation that ensued as the grandfather dismissed the prostitute, and she concluded by observing, “These girls offer something strange for a piece of change.” Other girls reported: “It’s a whole bunch of girls [prostitutes] at Metropolitan [Avenue]. I will be at the Chevron on Metropolitan, and they will knock on people’s windows.” “They will walk up to the prettiest cars. They will think, ‘if they can afford them, they can afford me.’ Sometimes the car will take them away. The security guards don’t say nothing. They young. Like twenties.” “If some of these girls don’t change the way they are right now then they are going to be like that.” “Me and my mom talk about some stuff like this. It might not be their intention to degrade themselves, but they might need quick money. They might start off doing something that’s legal then it turns illegal.”
The participants also discussed their view of how girls can be lured into prostitution, referring to the techniques that men use in what they called the “boyfriend-to-pimp transition.” “Some guys you date will try to get you to do things and say they will never do this and that to you and before you know it you’re in the back of a car.” The students made it clear that they were aware of CSEC risks and of how pimps provide clothes, food, shelter, jewelry, and drugs to control girls. In some cases this knowledge came from their exposure to popular media.
Girls’ Sexuality as a Commodity
We defined sexuality as values, ideas, or constructs about one’s sexual feelings, identity or behavior. During the sessions the participants described their own and others’ sexual behavior with boys in language suggesting that sexual involvement is expected and that girls see their sexuality as a commodity. The girls described their preference for wearing short skirts and tight clothing when going to peer gatherings outside of school; one stated, “I don’t want to look like no lil baby.” They also described the presence of older men lurking on the perimeter of the schoolyard and outside peer gathering spots. One girl stated that a strange man approached her on the street and said, “If I were your pimp, I’d let you wear lots of makeup.”
The girls reported heavy use of popular media, e.g., videos with sexualized depictions of females or with implied violence against females. Consistent with this exposure, when discussing news reports describing the severe beating of a popular female musician by her equally famous boyfriend, the girls argued that the beating was justified. “She was going through his phone. She should go to jail, too.” “His career is ruined and she has a CD coming out.” Their statements echo popular cultural values that devalue and objectify females.
This theme was especially clear when the girls described the activities at their local skating rink, where there is little to no adult supervision, low lighting, and the principal activity is sexual behavior. To describe the skating rink activities the girls used language derived from the adult entertainment industry. For example, one girl noted that the main purpose of going to Metro (the skating rink) is to give boys lap dances (as is done in adult strip clubs), and she said if girls miss a week they might lose their “regular customer.” Another girl described how a boy will lie on his back and a girl will “do a split” on him. In one session the girls discussed the merits of stripping as a career. The general assessment of their activities regarding sexuality was summed up this way: “Whatever y’all do in the adult clubs is innocent compared to what happens at Metro.”
This research makes an important contribution to the literature, in part because there has been so little prior research about children at risk for CSEC. This investigation explored the perceptions of African American middle school girls who may be at risk of exploitation (rather than already victimized). Our findings add a unique perspective by using qualitative methods that highlight the voices of the girls participating in preventive intervention groups. One finding that seems particularly significant is that children who live in communities that place them at risk for sexual exploitation face the dual problems of chronic exposure to physical violence in relationships and routine exposure to sexualization and prostitution.
Difficulty forming trusting relationships has been found in previous research to be a predictor of maladjustment.31–33 Diminished trust is implicated in both physical aggression and sexualization. It seems likely that these variables influence each other recursively whereby aggression and sexualization reduce trust, and this in turn exacerbates those problems. Future research is needed to learn more about the level of trust experienced by girls, the factors that contribute to and inhibit the development of trusting relationships, and how the degree of trust experienced influences the physical aggression and sexual behaviors exhibited by girls. Over the course of their group meetings, the participants became more interested in trust exercises and developed a level of trust with the adult facilitators. We acknowledge that this change in their attitude may represent their desire to please the facilitators more than a change in their lives outside the group. However, it is possible that attempts to please adults in authority may be first steps toward more lasting behavioral change with others. We also note that we did not see similar shifts suggesting a social desirability bias in the other problem areas outlined.
The fact that trust emerged as a key variable in this investigation reinforces the use of a novel methodology to learn about the perceptions of these girls. Rather than conduct formal interviews where problems with trust may be exacerbated, we listened to their conversations in groups where they felt comfortable over a period of weeks. This is a unique methodology, clearly useful with this population, and it is recommended for future research.
Another major theme was familiarity with adult prostitution. That these students knew a local prostitute by name suggests their proximity to criminal activity and thus their vulnerability to exploitation. Priebe and Suhr21 reported that areas with high levels of adult prostitution also have high levels of juvenile prostitution. Reinforcing this vulnerability was the girls’ discussion of their relationships with boys. The language they used frequently borrowed from both the legal and illegal adult sex industry, referring to boys as “customers” and to the boyfriend-to-pimp transition.
Miller15 indicates that African American adolescent girls need outlets to discuss environmental threats as an aid to coping. However, discussion with family members is often not an option in stressed situations, and institutions are often distrusted. One of our intervention goals was to provide a safe context for girls to express concerns. Another was to arm girls against cultural assumptions about gender and ethnicity that contribute to their potential victimization. We wanted our participants to recognize their common interests in the face of shared community threats and to find support and trust in each other. It is important to underscore that this was accomplished in an afterschool program located in the participants’ schools, even though schools are among the areas of the environment that these girls distrust.
Despite the important contributions of this investigation there were limitations that must be considered. First, a relatively small number of children participated in this research (N = 36). While this provided the opportunity to construct a richly detailed description, caution must be exercised regarding any generalization of these findings. Further, all the children participated in an afterschool program with their parents’ permission. Since parent involvement is widely considered a protective factor, these participants probably do not represent the most disadvantaged children in these neighborhoods. Second, although collecting data through an intervention group may have the advantage of overcoming distrust and may result in more open responses, this is an assumption that requires further investigation. It must be recognized that even with enhanced trust, the group format may influence the statements made by the participants based on their social awareness that they are in a group or based on their desire to please or appease the adult facilitators. Third, it should be noted that our curriculum directly addressed relationships, decision-making, and safety. Thus, the themes that emerged from the girls’ discussions were prompted by that content and should be interpreted in that light. Our curriculum did not directly address sexuality or prostitution, since these topics are off limits in many schools. Nonetheless, the girls chose to raise these issues in the group sessions. Further research is required to learn more about the contexts in which these students spontaneously discuss such issues.
Our study demonstrates how research and practice can be used to strengthen each other. In this case the content and procedures used in this intervention combined with our use of field notes and process recording allowed us to collect systematic information from middle school girls about their experiences in relationships. Our findings have implications for enhancing our understanding of young African American girls who may be at risk for commercial sexual exploitation and for developing prevention interventions to support their healthy development.
Supervising Section Editor. Abigail Hankin, MD, MPH
Submission history: Submitted December 13, 2012; Accepted February 22, 2013
Full text available through open access at http://escholarship.org/uc/uciem_westjem
Address for Correspondence: Anne Cale Kruger, PhD. Center for Research on School Safety, School Climate and Classroom Management, Georgia State University, P.O. Box 3979, Atlanta, GA 30302-3979. Email: firstname.lastname@example.org.
Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources, and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.
1. Swecker C. Statement before the Committee on Security and Cooperation in Europe, U.S. Helsinki Commission: Exploiting Americans on American Soil: Domestic Trafficking Exposed. 2005. Available at: http://www.fbi.gov/congress/congress05/swecker060705.htm.
2. Thorne A, McLean KC, Lawrence AM. When remembering is not enough: Reflecting on self-defining memories in late adolescence. J Pers. 2004;72:513–542. [PubMed]
3. American Psychological Association. Report of the APA task force on the sexualization of girls.Washington, DC: American Psychological Association; 2007.
4. Banarjee R, Dittmar H. Individual differences in children’s materialism: The role of peer relations.Pers Soc Psychol B. 2008;34:17–31. [PubMed]
5. Mead GH. Mind, self, and society. Chicago: University of Chicago Press; 1934.
6. Vygotsky LS. Mind in society: Development of higher psychological processes. Cambridge, MA: Harvard University Press; 1978.
7. Bryant Y. Relationships between exposure to rap music videos and attitudes toward relationships among African American youth. J Black Psychol. 2008;34:356–380.
8. Johnson JD, Adams MS, Ashburn L. et al. Differential gender effects of exposure to rap music on African American adolescents’ acceptance of teen dating violence. Sex Roles. 1995;33:597–605.
9. Ward LM. Understanding the role of entertainment media in the sexual socialization of American youth: A review of empirical research. Dev Rev. 2003;23:347–388.
10. Ward LM, Hansbrough E, Walker E. Contributions of music video exposure to black adolescents’ gender and sexual schemas. J Adolesc Res. 2005;20:143–166.
11. Stephens DP, Few AL. The effects of images of African American women in hip hop on early adolescents’ attitudes toward physical attractiveness and interpersonal relationships. Sex Roles.2007;56:251–264.
12. Stephens DP, Phillips L. Integrating Black feminist thought into conceptual frameworks of African American adolescent women’s sexual scripting processes. Sexualities, Evolution & Gender. 2005;1:37–55.
13. Belgrave FZ, Marin BV, Chambers D. Cultural, contextual and interpersonal predictors of risky sexual attitudes among urban African American girls in early adolescence. Cultur Divers Ethnic Minor Psychol. 2000;6:309–322. [PubMed]
14. Limbert WM, Bullock HE. “Playing the fool:” U.S. welfare policy from a critical race perspective.Fem Psychol. 2005;15:253–274.
15. Miller J. Getting played: African American girls, urban inequality, and gendered violence. New York, NY: NYU Press; 2008.
16. Foster JD, Kuperminc GP, Price AW. Gender differences in posttraumatic stress and related symptoms among inner-city minority youth exposed to community violence. J Youth Adolesc.2004;33:59–70.
17. Estes RJ, Weiner NA. The commercial sexual exploitation of children in the United Stated. In: Cooper SW, Estes RJ, Giardio AP, Kellogg ND, Vieth VI, editors. Medical, legal and social science aspects of child sexual exploitation. St. Louis, MO: GW Medical Publishing; 2005. pp. 95–128.
18. Flores RJ. Protecting our children: Working together to end child prostitution. Washington, DC: 2002. Paper presented at: Protecting Our Children: Working Together to End Child Prostitution.
19. Azaola E. The sexual exploitation of children in Mexico. Police Pract Res. 2006;7:97–110.
20. Brannigan A, Gibbs Van Brunschot E. Youthful prostitution and child sexual trauma. Int J Law Psychiatry. 1997;20:337–354. [PubMed]
21. Priebe AS, Suhr C. Hidden in plain view: The commercial sexual exploitation of girls in Atlanta.Atlanta, GA: The Atlanta Women’s Agenda; 2005.
22. Todres J. Taking prevention seriously: Developing a comprehensive response to child trafficking and sexual exploitation. Vanderbilt Journal of Transnational Law. 2010;43:1–56.
23. Murray C, Avoch K. Teacher-student relationships among behaviorally at-risk African American youth from low-income backgrounds: Student perceptions, teacher perceptions, and socioemotional adjustment correlates. J Emot Behav Disord. 2011;19:41–54.
24. Constantine MG, Alleyne VL, Wallace BC. et al. Africentric cultural values: Their relation to positive mental health in African American adolescent girls. J Black Psychol. 2006;34:281–308.
25. Corneille MA, Belgrave FZ. Ethnic identity, neighborhood risk, and adolescent drug and sex attitudes and refusal efficacy: The urban African American girls’ experience. J Drug Educ. 2007;37:177–190.[PubMed]
26. Robinson T, Ward JV. A belief in self far greater than anyone’s disbelief: Cultivating resistance among African American female adolescents. In: Gilligan C, Rogers AG, Tolman DL, editors. Women, girls, and psychotherapy: Reframing resistance. Binghamton, NY: Hawthorn Press; 1991. pp. 87–103.
27. Strauss A, Corbin J. Basics of qualitative research: Techniques and procedures for developing grounded theory. 2nd ed. Thousand Oaks, CA: Sage Publications; 1998.
28. LeCompte MD, Schensul JJ. Ethnographer’s toolkit, book 5: Analyzing and interpreting ethnographic data. Walnut Creek, CA: Altamira Press; 1999.
29. Hill CE, Thompson BJ, Hess SA. et al. Consensual qualitative research: An update. J Couns Psychol.2005;52:196–205.
30. Hill CE, Thompson BJ, Nutt Williams E. A guide to conducting consensual qualitative research.Couns Psychol. 1997;25:517–572.
31. Henrich CC, Kuperminc GP, Sack A. et al. Characteristics and homogeneity of early adolescent friendship groups: A comparison of male and female clique and nonclique members. Appl Dev Sci.2000;4:15–26.
32. Kuperminc GP, Blatt SJ, Shahar G. et al. Cultural equivalence and cultural variance in longitudinal associations of young adolescent self-definition, interpersonal relatedness to psychological and school adjustment. J Youth Adolesc. 2004;33:13–31.
33. Parker JG, Asher SR. Peer relations and later personal adjustment: Are low-accepted children at risk? Psychol Bull. 1987;102:357–438. [PubMed]