Introduction

The purpose of this paper is to describe the state of the literature on adolescents’ use of social media, specifically adolescents struggling with mental health problems. The authors will review the literature on adolescent communication patterns, social media use, and potential benefits and risks of social media use. The authors will conclude the paper with implications for school psychologists and other mental health professionals and recommendations for future research.

Communication Patterns Among Adolescents

In the past decade, communication has drastically changed through the use of social media, social networking, and computer-mediated communication (CMC). Similar to adults, adolescents are motivated in three different ways to utilize alternative tools for communication: content creation, social networking, and multi-channeling. Although distinctions exist between the three motivating factors, considerable overlap exists.

Traditional mass media is still used as a way to communicate, collect, and share information through print media (i.e., newspapers, magazines, books), broadcast media (i.e., radio, television), and digital media (i.e., the Internet, mobile phones, social media) (Supsakova 2016). Encompassed within traditional mass media is social media. Social media consists of websites, apps, and other interfaces that allow users to create and connect with virtual content, as well connect socially with other users. Some examples of social media platforms include Facebook, Twitter, Buzzfeed, Snapchat, YouTube, and Pinterest. Within traditional mass media and social media exists social networking. Social networking is based on communication with other users of the social networking websites. The most popular social networking site, among adolescents, is Facebook, followed by Instagram, Snapchat, and Twitter. Finally, within traditional mass media, social media, and social networking are CMC (Pew Research Center 2015). CMC is human communication facilitated by computer technology (Thurlow et al. 2004). Examples of CMC include email, text messaging, Facebook Messenger, WhatsApp (an instant messaging application), and online forums.

Pew Research Center (2007) found that adolescents have different motivations for choosing particular types of media platforms. Some teenagers are known as content creators because they create and share their content on social media. Typical examples of content creations are blogs, personal websites, or apps. Also, content creators may create original art and share it on Etsy for purchase or share a digital copy on Tumblr for followers to reblog. Pew Research Center (2007) explains that the motivation for this type of media is production and distribution to a widespread audience. Except for Internet famous adolescents, content creators are more likely to spread their content to small circles of individuals within their social network.

Adolescents that focus on social networking platforms are known as social networkers and are focused on communication and connectivity with friends, family, and even strangers on social networking sites (Pew Research Center 2007). However, social networkers share some commonalities with content creators. Social networkers integrate content-creating behaviors of the content users plus sharing other content created by someone other than themselves (Pew Research Center 2007). Typical examples of social networks and content sharing are Facebook or Instagram videos.

Some adolescents use a “multi-channel” approach because they are motivated by CMC; these adolescents are focused on communication through a combination of the Internet, email, instant messaging, text messaging, and social networks (Pew Research Center 2007). What sets adolescents who multi-channel apart from other adolescent users is the intensity in which they use CMC. They are more likely than the other types of adolescents, to engage with technology and social media.

Social Media Use by Adolescents

Smartphones have shifted the communication paradigm, allowing for almost constant access to communication and social media: 73% of adolescents have smartphones, 76% of those adolescents being 15–17 years old and 68% being 13–14 years old (Pew Research Center 2015). Access to smartphones has become increasingly important because the majority of adolescents now have communication and Internet access with them at all times. Furthermore, most social media and social networking apps are free to download and operate. Thus, adolescents are mostly unrestricted, unless under parental control, in daily social media use. In fact, according to Pew Research Center (2015), 92% of adolescents report daily use of social media, with 24% saying they are online “almost constantly” and African-American girls more likely than any other group in America to engage in social media use. Furthermore, adolescents are unrestricted in the number of social media platforms they can use. Pew Research Center (2015) reports that the majority of teens (71%) are using more than one social networking site. Some of the most popular social networking sites include Facebook, Instagram, Snapchat, Twitter, Google+, and Tumblr. Somewhat less often used, but still popular social networking sites also include Pinterest, Reddit, Whisper, Yik Yak, and Ask.fm.

Many researchers hope to understand why social media has become so popular among adolescents. However, to discover why adolescents use social media, researchers must first understand how adolescents use social media. One of the most prominent theories of media use is from Steele and Brown’s (1995) Adolescents’ Media Practice Model. The model is based on the uses and gratifications theory; instead of believing adolescents are passive consumers of media, it is founded on the notion that adolescents are active users and consumers of media (Arnett 2013). The theory focuses on the use or purpose of the media that has become so motivating and the type of gratification or satisfaction the adolescents receive from the media (Arnett 2013). Steele and Brown (1995) call this a practice model because it emphasizes that adolescent practice (i.e., moment-to-moment use) of the media contributes to its integration, construction, and modifications into the adolescent culture and identity.

According to Steele and Brown (1995), four components encompass the cyclical Adolescents’ Media Practice Model: identity, selection, interaction, and application. The first element of the Adolescents’ Media Practice Model is identity. Adolescents encounter media with a current identity, which motivates the selection and attention focused on a particular type of media. The meaning gained from the media content is evaluated and interpreted, appropriated, and incorporated. Adolescents appropriate or actively use media when they decorate their rooms with posters, participate in media-related activities, or create accounts on social media platforms. Adolescents incorporate media when it becomes part of themselves. Although the model contends that adolescents are active users and consumers of media, the process of incorporation is often automatic and not consciously intended. As the media is incorporated into their identity, the selection process begins again, except influenced by their slightly adapted identity. Arnett (2013) explains this process as the Adolescent Media Practice Model. One example is when a girl responds to the depiction of a thin model by following supermodels on Instagram as a part of her interest in becoming thin like the model. However, other adolescents may choose to resist content on social media and reject them as false ideals. Regardless, the motivation and selection of social media content is a result of their developing identities.

How Adolescents Struggling with Mental Health Use Social Media

Adolescent choices in social media platforms are a window into understanding how they identify with the media they are following, how they are forming their identities, and equally as important, how they are coping, relieving, and reacting to negative emotions. For example, Facebook features that focus on depression tips and facts are more likely to be engaged with by a user suffering from depression or experiencing depressive symptoms. Often, adolescents choose media based on specific coping purposes (Arnett 2013). Much research has been conducted on the links between Facebook and depression, but two newer and less researched platforms, Tumblr and Pinterest, are known as havens for individuals suffering from self-injurious behavior and depression.

Tumblr is a microblogging platform that allows users to create their content (i.e., blog) and share (i.e., reblog) their content with other Tumblr users. Specifically, users can choose among seven reblogging types of posts: text, photo, link, audio, video, chat, or quote (Bourlai and Herring 2014). A Tumblr feature known as a hashtag is a fast and easy way to search content related to the hashtag. For example, anyone can search tags like #self-harm, #depression, or #sadness, and will find thousands of blogs related to depression. Therefore, at the touch of their fingertips, they can search and find members they can relate to, as well as share content that attracts other members that relate to their suffering (Bine 2013). Tumblr has become an avenue for adolescents to talk to one another about personal struggles and experiences in a way they may not be able to or feel comfortable with offline (Delvin 2014).

To further study depression and its relation to Tumblr, Cavazos-Rehg et al. (2016) searched and coded 2739 Tumblr posts relating to depression, suicide, self-mutilation, and cutting. Among the posts studied, the most common themes are related to self-hatred, loneliness, and suicide/death. Cavazos-Rehg et al. (2016) also noted that posts about self-harm, including graphic pictures of cutting, were also readily shared on Tumblr. Although the dissemination of depression and self-harm related content is evident on Tumblr, the researchers also found that 8% of the posts were focused on providing comfort, support, and preventative advice. Tumblr is known for their strong community interactions among users, which is reflected in 9% the posts involving direct communication between Tumblr users, and among which 47% provided emotional support or reassuring messages to each other. Although providing support and communication may create resiliency among those users, the researchers wanted to delve further into the type of advice that was given; if it was potentially helpful or dangerous. Cavazos-Rehg et al. (2016) found that 25% of the posts provided potentially harmful advice (e.g., advising how to engage in self-harm or maladaptive behaviors secretly). However, 13% of the posts suggested seeking professional help or therapy to cope with their mental health struggles. Dr. Mark Reinecke (as cited in Bine 2013) describes Tumblr’s lack of encouragement for healthy coping strategies or seeking therapy for their mental health issues as an environment that can create a reverberating, echo chamber of adolescents sharing their experiences and thoughts that potentiate the negative feelings and depression.

Pinterest is a social media platform where users can pin (i.e., save) images, links, and quotes then share their pins with other users of the site. Pinterest is predominantly used to share crafts, recipes, pictures, or beauty advice. However, the site is also used to share moving quotes and self-help pins. Although quotes and self-help pins are prevalent on Pinterest, most of the pins are not created by professional organizations, rather by individual Pinterest users. Also, few health professionals and professional organization have been found to address depression related issues on Pinterest (Guidry et al. 2015). A study by Guidry et al. (2015) found that high engagement with depression-related pins focuses on coping mechanisms. Similar to Tumblr, the researchers found that coping mechanisms are the focus of depression-related pins, but they emphasize maladaptive coping strategies, such as behavioral disengagement, self-blame, and denial. Guidry et al. (2015) also found that 10% of pins refer to suicidal ideation or intent.

Pinterest has become a haven for individuals in need of expressing themselves and connecting with other users coping with depression or other mental health issues. However, Pinterest lacks the encouragement of healthy coping skills and advice to seek professional help. Instead, pins are repinned and liked and repinned again, validating and almost celebrating these dysfunctional coping methods (Jacoby 2015).

Adolescents are drawn to social media platforms because they can express themselves, engage in a media community and gain a sense of connectivity, as well as anonymously discover health information. Social media platforms, such as Facebook, Twitter, Snapchat, and the sites as mentioned above (i.e., Tumblr, Pinterest, and Instagram), allow adolescents, especially those who have a mental illness, to express themselves in ways they may not be able to in other environments. Two lesser known social media platforms, Thought Catalog and Whisper, allow users to practice and exchange their dialog online. Thought Catalog lets users pen articles and stories through submission for publication on the site. Many users struggling with mental illness harness their ability to express themselves and their stories by writing articles relating to mental health, personal mental health stories, and advocating for mental health awareness. For example, if you were to search “mental health” on Thought Catalog, you would find issues similar to these titles: “For Those Who Wonder What Depression Feels Like” (Huggins 2016), or “My Anxiety is a Part of Me and that is Okay” (Berger 2016).

Unlike Thought Catalog, Whisper allows for self-expression anonymously. Users anonymously post a short sentence about anything on their mind. If you were to search Whisper, you might find text images that say: “I use humor to hide my depression from everyone” (Whisper n.d.) or “Whenever I get panic attacks, it feels like my head is screaming at me to be a better me because being me isn’t good enough” (Whisper n.d.). Collectively, social media allows users to share their emotions through multiple platforms. Quinn (as cited in Delvin 2014), a user of social media that suffered from depression, felt that these platforms were a way to express her anger, sadness, and disappointment and any other pent up emotions through imagery or messages that other users that empathized with those feelings.

As adolescents express themselves, communities start to form through empathetic reblogging, retweeting, liking posts, pinning, commenting, and private messaging. This virtual empathy becomes related to feelings of social support (Carrier et al. 2015). In fact, Carrier et al. (2015) found that virtual empathy is associated with feelings of social support, although weaker than feelings of social support in a real-world setting. However, the community allows users to share their experiences, empathize, and help one another that may have shared the same struggles. To adolescents, the community becomes more important than the content being shared (Delvin 2014). By advertising their suffering, adolescents can find avenues for support, understanding, and acceptance that they may not be able to find elsewhere (Bine 2013).

A third motivation for an adolescent to use social media platforms is the ability to access health information anonymously. The stigma associated with mental illness may influence adolescents to find health information anonymously. Although stigma surrounding mental health can be harmful, social media sites do provide outlets for advocacy groups to reach out to those who are suffering. For example, adolescents that may not be ready to receive treatment can just type in “mental health” into the Twitter search bar and find many advocacy groups, agencies, and communities that provide mental health information.

Potential Harms of Social Media

Although potential benefits to social media use among adolescents coping with mental illness, potential harms also exist: social filters, triggers, cyber bullying and trolling, and negative psychological impacts. Social filters (i.e., social bubbles) are created when a user searches for information via social media. Social media sites, such as Twitter and Instagram, create filters in which there are more restrictive rules that limit the information that is presented to the user. In February 2016, Twitter announced a new algorithm that will filter tweets and show users tweets they are most likely to care about (Jar 2016). In March 2016, Instagram followed suit by testing an algorithm similar to Twitters. They announced that the order of photos and videos in Instagram feeds would be based on the likelihood users will be interested in the content, the relationship with the person posting, and the timeliness of the post (Instagram 2016). Nikolov et al., (2015) found that searching for information via social media creates narrower search results and sets of information than a search engine would. Therefore, these new changes can make it difficult for insiders to find information beyond what is presented to them through the platform. Furthermore, social media users may accept the confirmation of the ideas and not want to reach out beyond their filtered information.

Triggers are another potential issue and can create harmful repercussions on adolescents. Social media users can search for specific topics within the platform that may produce triggering effects. For example, users can search “cutting” into the search bar on Instagram and view public pictures of self-harm acts. A concern Dyson et al. (2016) expressed was that the content could create a normalizing effect; by viewing the content, they may adopt the maladaptive coping mechanisms. A powerful example of this is the pro-anorexia (pro-ana) community on Tumblr. Tumblr has an active community of pro-ana users that share graphic and triggering content focusing on thin body ideals and for maintaining anorexic behaviors (Choudhury 2015).

The popular book and Netflix series, 13 Reasons Why, highlights the potential trigger effect that media and social media can have on vulnerable youth. 13 Reasons Why tells the story of a young adult struggling with untreated mental health issues (i.e., depression, anxiety) and suicidal ideation. In the series, the protagonist, Hannah, leaves 13 recording for everyone that she felt contributed to her suicide. Jay Asher, author of 13 Reasons Why, explained that he wrote this story because “suicide is uncomfortable, but it happens, and so we have to talk about it, and it is dangerous not to talk about it because there is always room for hope” (Yorkey et al. 2017). However, the writers, directors, and producers did not shy away from showing the method in which she committed suicide. Brian Yorkey, executive producer of the Netflix series, stated that they did this because “we wanted it to be painful to watch because we wanted to be very clear that there is nothing in any way worthwhile about suicide” (Yorkey et al. 2017). Dr. Helen Hsu, licensed clinical psychologist, reiterated Brian’s position that “as hard as it was to see the final decision that Hannah made when she died of suicide I think It was important to show that it’s not a pretty death, it’s not an easy one, and then the pain that never ends for her parent immediately thereafter, who are left with this horrible burden” (Yorkey et al. 2017).

However, the National Association of School Psychologists cautions vulnerable youth from watching the series because it may be hard for some adolescents to discern reality from a TV show. In fact, in their referendum, NASP explicitly states that “research shows that exposure to another person’s suicide, or to graphic or sensationalized accounts of death, can be one of the many risk factors that youth struggling with mental health conditions cite as a reason they contemplate or attempt suicide” (NASP 2017). It is important to understand that, although the triggering content is starting to gain public awareness, some teens may not know the gravity and scope of the graphic and triggering content on the TV show.

In fact, Ayers et al. (2017) studied Internet search trends on Google relating to the term “suicide” following the release of 13 Reasons Why and before the American football player Aaron Hernandez committed suicide on April 18th, 2017. The researchers found that the search queries related to suicide rose by 19%; specifically, “how to commit suicide increased by 26%, “commit suicide” increased 18%, and “how to kill yourself” increased 9%. However, search queries for “suicide hotline number” also grew by 21%, “suicide hotline” increased by 12%, “teen suicide” increased by 34%, and “suicide prevention” increased 23%. According to NASP (2017), it is important for educators, school psychologists, and mental health professions to be aware of the TV show and support engaging conversations with students on the potential harms posed by media and social media, as well as disseminating resources and expertise in preventing harmful behaviors.

Cyber bullying (i.e., trolling) is a prominent and dangerous issue on social media. The term “trolling” originated when users were finding victims through fishing methods; preying on them through pranks, harassment, or even violent threats (Stein 2016). Cyber bullying and trolling takes place on every aforementioned social media platform and can have dangerous and even fatal consequences. In fact, cyber bullying is strongly related to suicidal ideation in comparison with traditional bullying (van Geel et al. 2014). Although there is a strong relationship between cyber bullying and social media, the relationship is often mediated by other factors, including depression and delinquency (Hertz et al. 2013). However, youth victimized by their peers were 2.4 times more likely to report suicidal ideation and 3.3 times more likely to report a suicide attempt than young people who reported not being bullied (Espilage and Holt 2013).

Cyber bullying has manifested on many different social media platforms including Youtube, Twitter, and Ask.fm. Scheff (2015) expressed that when you hear the names Amanda Todd, Tyler Clemente, Rebecca Sedwick, Hanna Smith, and the many others that have committed suicide due to cyber bullying, there becomes a realization that a keyboard can be used as a lethal weapon. Cyber bullying has created an atmosphere where people are humiliated and bullied at a rate that may not be possible by traditional bullying. Thousands of people can view one post by a social media user at once. This creates an atmosphere where the bullied feel as if they are getting bullied by the world. Alexandersen (2016) reported that as recently as June 2016, a 15-year-old York, Pennsylvania, resident had committed suicide following months of cyber bullying. Pantic (2014) explains that although cyber bullying may not influence adolescents to commit suicide, adolescents that have a predisposition to depression or other mental health issues, cyber bullying may negatively impact mental health even further.

Also, the American Academy of Pediatrics coined the term “Facebook depression” that postulates that internalizing symptoms, such as depression, may occur as a result of adolescents viewing social media content that may make them feel inferior or negative about their self (Ehrenreich and Underwood 2016). A study in 2013 by Kross et al. found that the more time spent on Facebook, the larger the decline in overall affect and life satisfaction. Also, Weinstein (2017) found that adolescents, that viewed simulated Instagram feeds and reported negative social comparison responses, reported an immediate reduction in emotional well-being. Therefore, it was concluded that teens who engage in negative comparisons online may be at greater threat to immediate emotional well-being than teens that acknowledge that social media portrayals are not always representative and may be skewed to seem more positive.

However, other studies are linking the possibility that internalizing symptoms may predict adolescents’ social media use. Specifically, Ehrenreich and Underwood (2016) indicate that social media sites, such as Facebook, provide an avenue for adolescents to discuss their internalizing symptoms, such as depressed mood, anxieties, or somatic complaints. Sharing content related to depressive features may encourage “co-rumination” by which adolescents ruminate on their symptoms together. Thus, adolescents may create a contagion effect, which may result in an increase of internalizing symptoms over time (Schwartz-Mette and Rose 2012).

Similarly, Ehrenreich and Underwood (2016) studied the relationship between internalizing symptoms and how these symptoms may relate to Facebook communication and responses from their peers. The study found that for girls on Facebook, internalizing symptoms predicted expression of a negative affect, somatic complaints, and more offers of support. However, for boys, internalizing symptoms did not predict negative affect, somatic complaints, and requests for peer support. The authors suggested that lack of peer response to depressive posts may be a reason for the lack of predictors. These results may support the notion that adolescents struggling with mental health may use social media for self-expression and comfort, and thus reinforce posting about internalizing symptoms on social media sites.

Potential Benefits of Social Media

Although potential harms exist within the social media world, a silver lining may exist. Many social media platforms have created warnings and links to suicide lifelines, chats, or crisis intervention websites when certain topics are searched. Also, they have made strides to block certain content from being searched altogether. Specifically, if a Tumblr user searches “suicide” on the platform, they are brought to a message giving links to lifelines, crisis interventions websites, and other positive Tumblr dashboards. Also, they have instituted trigger and content warnings, which warn users of emotionally triggering or harmful content. Users of Tumblr have created the Tumblr Suicide Watch in which users can support one another if they are coping with suicidal thoughts, depression, or any other mental or emotional disorder (tswatch, n.d.). Delvin (2014) explains that the site’s reputation for being a venue for depression and suicidal ideation is one that Tumblr is trying to shake. In their community guidelines, they have explicitly stated that Tumblr is not to be used for promotion or glorification of self-harm (Tumblr 2016). Instead, Tumblr (2016) hopes to create a community built on awareness, support, and recovery.

Although warnings and censoring can have positive effects that may not always be the case. In 2012, Instagram attempted to combat pro-eating disorder (pro-ED) hashtags, such as #anorexia, #ana, and #eatingdisorder. However, Instagram users showed to be more tenacious than expected. A study by Chancellor et al. (2016) found that there was a clear and explicit strategy by the pro-ED community to circumvent the censor by creating variant hashtags. They found that users would just change hashtags, such as #ana to #annaa or #eatingdisorder to #eatingdisorderrr. Instagram went from having a few pro-ED root hashtags to thousands of variant pro-ED hashtags. In fact, the #anorexia went from one hashtag to splitting into 99 variants including #anoretic, #anorexi, and #anorexique. Also, the #eatingdisorder spurred 97 variants including #eatingdissorder, #eatingdis, and #eatingdisorde. Chancellor et al. (2016) explain that the message became apparent among the pro-ED community; they were going to continue to reinforce their belief systems, share information encouraging adoption and maintenance of their behaviors, and sharing triggering content regardless of the sensor.

However, strides continue to be made to advocate for mental health awareness and reduce stigmatization. Specifically, Buzzfeed has dedicated a week to mental health and stigmatization. Smith and Frank (2015) explain that our society needs to see mental health issues as illnesses, rather than personality flaws. Also, they explain that Buzzfeed Mental Health Week is intended to fight shame and isolation of mental illness. Buzzfeed advocated for the courage to talk openly about mental health, struggles with mental health, and create connectedness among readers (Smith and Frank 2015). Buzzfeed recently launched an initiative they are calling “Outside Your Bubble,” which highlights different perspectives on topics consumer is reading. Also, the National Alliance on Mental Illness (2016) has created specific tools for users to upload Facebook profile covers, hashtags, and logos to their social media profiles to share information during their Mental Health Month in October.

Furthermore, a study by Pittman and Reich (2016) found that image-based sites, such as Instagram and Snapchat, provide users with a sense of intimacy can increase feelings of happiness, life-satisfaction, and connectedness. The researchers believe that the creation of a social presence can transmit happiness and connectedness across social media. However, text-based technology, such as texting or Twitter, does not create the same feelings of intimacy and face-to-face interactions that photos and videos produce.

It has been reported that social media use can increase adolescents’ self of belonging and self-disclosure (Davis 2012), as well as their sense of identity and self-concept (Davis 2013). However, these factors tend to depend on the quality of the friendships in which they are communicating and interacting. Thus, adolescents with high friendship quality tend to use online communication to contact their peers, whereas those with low friendship quality tend to experience motivation to go online in order to explore their identities. Similarly, Khan et al. (2016) found that adolescent self-concept was highest when those adolescents had greater amounts of online socialization in combination with face-to-face peer support.

Implications for School Psychologists

Overall, adolescents may encounter negative and positive uses of social media. Specifically, social filters may skew an adolescent’s experiences and content on social media sites and further influence a confirmatory mindset of negative feelings and experiences. Also, adolescents may be exposed to triggering content and cyber bullying. Furthermore, use of social media may influence or predict internalizing symptoms of teens. The literature has not conclusively sided one way or another; rather both may be true. However, social media use can positively impact adolescents with mental health issues. Specifically, adolescents have access to suicide lifelines and crisis hotlines issued through warning signs on social media sites. Also, advocacy groups and professional resources are being disseminated by organizations to offer assistance to adolescents and reduce the stigma associated with mental health issues. Finally, social media in combination with supporting friendships can enhance happiness, life-satisfaction, connectedness, and self-concept.

Although research in the field of psychology on social media is in its infancy, (Guadagno et al. 2016), it is imperative that school psychologists use the information that is being gathered and integrate it into practice. Guadagno et al. (2016) acknowledge that mental health and education are starting to accept and use various forms of communication in the delivery of services to enhance well-being and knowledge to patients and students. Therefore, school psychologists will likely be critical in the development of the influences of social media on adolescent lives.

School Psychologist’s Role with Social Media

School psychologists are encouraged to reflect on their individual competencies to examine where they are with social media. For example, while some school psychologists may need to continue focusing on knowledge of social media, others may be ready to implement and/or apply their knowledge via mental health screeners, semi-structured interview, and/or examining how the information may influence an assessment. For example, in terms of knowledge about social media, school psychologists may improve their efficacy in providing services by becoming more familiar with the influence of social media on adolescent culture. For example, Lewis et al. (2012) recommended school psychologists familiarize themselves with the colloquiums of social media because engagement with users of social media use may be difficult without the repertoire of social media. Furthermore, Duggan et al. (2012) recommended school-based mental health practitioners familiarize themselves with the culture and themes of social media. They should understand the online support groups, which may range from educational and supportive to normalizing and reinforcing (Duggan et al. 2012). Another example is further substantiated by Duggan et al. (2012) work in which they recommend becoming familiar with the content on social media platforms to guide assessments of students. In terms of the role of the school psychologist, assessment is a key aspect and information gathered from an adolescent about social media use may directly influence the selection of social and emotional rating scales or even academic screening tools.

As aforementioned, the popular Netflix series 13 Reasons Why highlights the need for school psychologists, educators, and mental health providers to be aware of the content, and especially trending content, that adolescents are utilizing. NASP (2017) recommends that when adolescents are engaging in media, it is important to help students understand and cope with their perceptions of the media content, remind students that school-employed mental health professionals are available to assist them, recognize warning signs and take immediate action to keep adolescents safe, reinforce resiliency factors (i.e., peer support and adaptive coping skills), and provide professional resources and supports.

Specifically for assessment purposes, Lewis et al. (2012) recommended school psychologists log their social media use, highlighting their thoughts, feelings, and actions before, during, and after using social media. Next, a semi-structured interview can be used to assess the way adolescents are engaging in social media content. Also, the clinician may determine the frequency, duration, and time of day of online activities. Thus, clinicians may be able to evaluate the function of their social media use, potential antecedents to using social media, and possible harms and benefits of the activities.

Thompson et al. (2018) created a social media semi-structured interview for professionals to use to guide their assessment of adolescents struggling with mental health. The semi-structured interview focuses on targeting “red flags” during the interview to prompt further investigation into how they are using social media to cope with mental health issues. Specifically, the semi-structured interview is designed to target the pattern of use by adolescents; the content created, “followed” or “shared” and its influences on their personality and identity. This type of work has the potential to assist professionals in obtaining critical information about their functioning in an effort to connect them with resources. Similar interviews, counseling interventions, and preventative resources can continue to highlight the need for resources related to social media.

For intervention purposes, Lewis et al. (2012) recommended starting with a motivational interview to assess adolescent readiness to change. Encouraging healthier substitutes to their online activities can follow this. However, Lewis et al. (2012) caution against promoting abstinence from social media. As seen in the example mentioned above of the hashtag variants on Instagram among adolescents struggling with eating disorder, social media use embedded into the adolescent culture, readily available, and often a motivating and satisfying activity, thus making the interactions very pervasive (Lewis et al. 2012). Rather, reinforcing the use of other positive activities can help reduce the use of harmful online activities. Finally, Lewis et al. (2012) recommended disseminating and supporting credible professionally driven resources of adolescents and their families. Duggan et al. (2012) explain that suggesting reliable resources may divert adolescents from relying on peer-driven resources which may provide misinformation, maladaptive coping mechanisms, and trigger content.

Recommendations for Future Research

More research is needed to understand more regarding how adolescents, especially those struggling with mental health problems, use social media—both in ways that may help them and in ways that may contribute to maladjustment. Particular consideration should be given to the theoretical foundations of this literature, which include potential motivating factors such as content creation, social networking, and multi-channeling. Given the way technology has advanced within social media, researchers also need to investigate how interventions that target adolescents struggling with mental health problems may be used with social media. Very little has been done in the literature to explore the use of social media as a means to identify individuals in need and disseminate information and interventions.

Conclusion

Romer and Rich astutely stated, “adolescents today have greater access to information about their bodies, their selves, and the world in which they are living, all of which may lead to effects not seen in their predecessors” (2016). Social media is a dominant form of communication in our culture. School psychologists are encouraged to consider how this impacts the profession given the potential influence and implications that are emerging related to adolescent functioning. Moreover, the field is at a critical place in that more research is needed broadly across psychology and social media. Therefore, researchers are encouraged to continue to develop methods related to studying social media use. As this topic continues to grow in the literature, professionals must constantly reflect on how to incorporate and apply it into practice.