Counseling Techniques for Adolescent Females with Polycystic Ovary Syndrome
Froeschle, Janet G., Castillo, Yvette, Mayorga, Mary G., Hargrave, Terry, Journal of Professional Counseling, Practice, Theory, & Research
Polycystic ovary syndrome affects up to 10% of adolescent girls and is accompanied by devastating physical symptoms and mental health issues (Ehrmann, 2005). This article reviews current literature on the nature of polycystic ovary syndrome including the physical symptoms and risk factors, mental health risks, and counseling programs targeting the special needs of affected adolescent girls. Benefits of the program's components (walk/talk, Adlerian social interest, and solution-focused brief therapy) are discussed along with specific techniques involved.
Living in a society that highly values beauty can be devastating to teen girls with medical conditions that affect appearance. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting up to 10% of young women (Ehrmann, 2005) and is accompanied by obesity, growth of male pattern facial and body hair known as hirsutism, unintentional hair loss termed alopecia, acne, acanthosis nigricans or dark skin markings on the neck, underarms, or groin, cutaneous manifestations such as skin tags (Lowenstein, 2006), as well as mood disorders, bipolar disorders (Klipstein & Goldberg, 2007), and depression (Himelein & Thatcher, 2006; Rasgon & Kenna, 2005). Though previous research has focused on the significant medical problems associated with PCOS such as infertility, diabetes, and cardiovascular implications, the psychosocial consequences are no longer being ignored (Jones, Hall, Balen & Ledger, 2008). As a result, counselors are challenged to find approaches to help adolescent girls cope with the medical and mental health issues accompanying PCOS (Carmina & Azziz, 2006; Ehrmann, 2005; Goodarzi & Azziz, 2006; Wright, Zborowski, Talbott, McHugh-Pemu, & Youk, 2004).
In order for counselors to have a complete understanding of the complications involved in treating clients, a review of the literature including the prevalence of the syndrome, ethnic considerations, issues related to heredity and diagnosis, and an examination of the four major risks of the syndrome including physical (reproductive, metabolic, cardiovascular) and mental health concerns follows (Ehrmann, 2005; Himelein & Thatcher, 2006; Klipstein & Goldberg, 2007; Rasgon & Kenna, 2005). A discussion concerning medical risks, often the catalyst for mental health issues, precedes an overview of mental health risks. These discussions are intended to offer a holistic understanding of client stressors (Coulam, 1974; Jones et al., 2008). Finally, the article provides a rationale to persuade counselors to incorporate a program utilizing walk/talk therapy, Adlerian theory, and solution-focused techniques when counseling adolescent females diagnosed with PCOS.
Overview of Polycystic Ovary Syndrome
PCOS was first diagnosed by Stein and Leventhal in 1935 (Ehrmann, 2005; Goodarzi & Azziz, 2006). The seven women in this first study exhibited many cysts within their ovaries accompanied by amenorrhea (lack of menstruation), hirsutism (growth of male pattern facial and body hair), and obesity. Despite the lack of a uniform definition of the disorder and controversy concerning appropriate treatments (Carmina & Azziz, 2006; Ehrmann, 2005; Goodarzi & Azziz, 2006; Wright, et al., 2004), physicians recognize the condition as having detrimental effects on the reproductive, metabolic, and cardiovascular health of women (Ehrmann, 2005). PCOS affects between 5 and 10% of women (Carmina & Azziz, 2006; Ehrmann, 2005; Essah & Nestler, 2006; Goodarzi & Azziz, 2006; Lowenstein, 2006; Wright, et al., 2004) and onset generally occurs around menarche (Ehrmann, 2005). In the United States, this means between four and five million women of reproductive age are affected (Goodarzi & Azziz, 2006), many of whom are adolescents.
Distinctions exist between Mexican-American women and other races with regard to prevalence of the syndrome (Ehrmann, 2005; Goodarzi & Azziz, 2006). …