Principle Researchers: Dr. Patricia W. De Barbieri, LPC & Erica Fancher, MS

Dr. Patricia W. De Barbieri, LPC – is a licensed professional counselor with thirty-eight years of experience in education. She began her career as a teacher in both pre-school and kindergarten settings, a high school vocational education teacher and a school counselor. Dr. De Barbieri has experience in urban, sub-urban and rural environments working in public and private education, not for profit social service agencies, private practice and institutions of higher education. She has earned a Bachelor of Science degree from the State University of New York at Oneonta in Child Development and Family Relations and a Master of Science degree in Counselor Education from Southern Connecticut State University. Her Doctorate in Education is from Teachers College, Columbia University in the field of Adult Learning. Her dissertation research is on The Role of Learning in Recovery from Bulimia.

Erica Fancher, MS – received a Master of Science degree and a 6th Year Certificate in School Psychology from Southern Connecticut State University. Her interests include encouraging positive emotional, social, mental, spiritual and physical development in children, building healthy relationships, and strengthening resiliency. Erica has worked with infants, toddlers, and preschool age children for the past six years. In addition to attending to the children’s basic needs, she has organized activities that stimulate their physical, emotional, intellectual, and social growth. She has also helped these children explore their interests, develop their talents and independence, build self-esteem, and learn how to interact positively with others.


Eating disorders are the third leading chronic illness among adolescent females in the United States (Fisher et al., 1995). Girls this age tend to lose confidence in themselves as individuals, and look to their environment and their peers for guidance and a sense of self-worth. Primary prevention among pre-adolescent girls is an important treatment option to reverse this trend. This poster focuses on a Pilot Study of the North Star Program, an eating disorder primary prevention program designed to build self-esteem and resiliency in school age girls. Seven components of self-esteem serve as the theoretical framework of the North Star Program. This study is a quantitative, comparison of a group of middle school girls using pre and post survey data from the Piers Harris II – Childhood Self-Esteem Inventory. The findings challenge us to begin to rethink primary prevention as treatment in school-based programming for pre-adolescent girls.


This research study is designed to:

  1. Identify methods for measuring the effectiveness of school-based programming around self-esteem, resiliency, and body image issues.
  2. Pinpoint seven components of self-esteem around which to develop successful social/emotional and resiliency skill building programs for school age girls.
  3. Recognize and clarify how to incorporate aspects of the North Star program into school-based programming for pre-adolescent girls to enhance skills in self-appreciation, self- acceptance, self-advocacy and self-expression in a respectful, non-judgmental format to appropriately communicate and resolve conflicts.

A Review of the Literature:

The idea that self-esteem has an effect on wellness, learning, school and social success is not new (Birndorf, D.O., Ryan, M.D., Auinger, P. & Aten, M., 2005). There is much evidence in the literature that high self-esteem has been associated with better mental health outcomes, such as a better ability to cope, better personal relationships, and a lower incidence of depression in both adolescents and adults ( Birndorf, D.O., Ryan, M.D., Auinger, P. & Aten, M., 2005; Harvard Mental Health Letter, 2007). Additional studies have found “that girls with high self-esteem are less likely to develop bulimia” (Harvard Mental Health Letter, 2007). Clinicians who believe in promoting self-esteem say that long term studies provide sufficient evidence that “increasing self-esteem can raise test scores, improve school discipline, and reduce use of drugs and alcohol, and the risk of eating disorders and depression in children and adolescents” (Harvard Mental Health Letter, 2007).

The literature is consistent that fewer girls than boys report high self esteem across all grade levels (Birndorf,, 2005). In addition, research has shown that pre-adolescent girls tend to lose confidence in themselves as individuals, and look to their environment and their peers for guidance and a sense of self worth. A 1992 study commissioned by the American Association of University Women, “How Schools Shortchange Girls”, indicated that sixty percent of elementary school girls feel positive about themselves; by high school that number falls to twenty-nine percent. A group of New Zeland researchers found that “young adolescents with low self-esteem were at increased risk of poor mental and physical health, poverty, and criminal activity by their mid-20’s” (Harvard Mental Health Letter, 2007). “Low self esteem is among the most consistently reported correlates of both peer victimization and peer rejection (Hawker & Boulton, 2000; Parker, et. al, 1995)” (Lopez & DuBois, 2005). Lopez and DuBois report that “in a study of 279 sixth grade youth, (Grills & Olendick, 2002), global self-esteem was found to mediate the relationship between girls’ experience of peer victimization and reported levels of anxiety” (2005). “Because self-esteem usually has begun to change by the age of 12, the context within which the adolescent is developing already may have promoted (or discouraged) the development of high self-esteem by the age of 14” (Birndorf,, 2005).

“School counselors are in a unique position in schools to assume leadership roles in reducing academic disparity” (Bemak, F., Chi-Ying, R., & Siroskey-Sabdo, L., 2005). They also can play a major role in the overall growth and development of students by working to improve self- esteem, social emotional learning, interpersonal communication, and overall school climate. Long recognized as an indispensable component of effective school counseling programs, group counseling is one means of accomplishing these goals while coping with growing student loads and increasing duties (Borders & Drury, 1992; Corey, 1995; Praport, 1993; Shechtman, 1993). In schools, group counseling offers excellent potential for increasing the number of students served in counseling (Sells & Hays, 1997). Done well, group counseling can make planned, purposeful, and effective counseling available to greater numbers of emotionally needy students (Becky & Farren, 1997; May & Housley, 1996; Phillips & Phillips, 1992). In their analysis of school-based studies of counseling, Prout and Prout (1998) found strong support for the effectiveness of group intervention. They suggested that given a common limitation on resources, school counselors should make greater use of group counseling. In particular, thematic groups bring together students experiencing similar problems and allow counselors to make effective use of their time and skills. Group counseling has proven to be especially effective in schools, addressing adolescent problems such as school attrition (Praport, 1993), abusive and violent dating relationships (Becky & Farren, 1997; Rosen & Bezold, 1996), and sexual abuse (May & Housley, 1996). Phillips and Phillips (1992) developed a successful school-wide group counseling program to help students improve communication skills and cope with alcohol abuse, learning disabilities, and developmental concerns. In a study of students manifesting social and academic maladjustment, Shechtman (1993) demonstrated that short-term group counseling correlated with significant improvement of achievement scores and interpersonal relationships. In an analysis of school counseling outcome research, Whiston and Sexton (1998) concluded that group counseling is effective in assisting young people to adjust to changes in family structure and to manage aggression and stress. (Zinck, K., & Littrell, J., 2000)

While there is much information on self-esteem in psychological and educational journals, most of this information is “assoicated with the problems of low self-esteem, there are only a few psychologists and teachers proposing solutions to the problems” (Emerson, 1994). In their longitudinal study of high self esteem in adolescents, Birndorf,, include among their findings the suggestion “that clinicians and community leaders may promote self-esteem in their adolescents by encouraging families, schools, and community organizations to engage teenages in positive communication and to provide safe and nurturing environments” (2005) both attributes which are included in the North Star Program. Director of Research at the University of Minnesota Adolescent Health Program, Dr. Michel Resnick, “emphasizes the need to move to research on resiliency and resistance” (Emerson, 1994) as well.

The North Star Program:

North Star is focused on helping students learn about ways to investigate self-esteem and develop resiliency through the medium of visual art. The project was developed with middle school girls in mind as a psycho-educational support group aimed at building social emotional skills, self-esteem and resiliency in school age girls, to prevent future interpersonal and academic performance problems. Each of the group sessions in the North Star Curriculum Manual as well as the program format has been successfully pilot tested over a 5 year period as an after school program at the Foote School in New Haven, Connecticut. Anecdotal data from those pilot tests suggest that the North Star Program is a highly beneficial program. The North Star program consists of twenty-two art based activities all focused around a conceptual framework of seven components of self esteem. Each activity session corresponds with a specific component of self esteem and questions and quotes for discussion correspond to re-enforce that component as well as the art activity. Native American culture relates strongly to animals in the wild. Animal cards figure prominently in North Star. Girls explore their own personalities and how they, as individuals, might relate to a particular animal. The Native American theme also forms the ritual of the program.


A pilot study of the North Star Program was conducted in spring 07 at the Westwoods Elementary School in Hamden, Connecticut to begin to quantify the changes in self-esteem as a result of the intervention of the North Star Program. The Piers-Harris Children’s Self-Concept Scale was used in pre and post data collection. In a general measure of the groups’ overall total self-concept and in all six sub-scales [Intellectual and School Status (INT), Behavioral Adjustment (BEH), Physical Appearance and Attributes (PHY), Freedom from Anxiety (FRE), Popularity (POP), and Happiness and Satisfaction (HAP)] the increase in the number of scores in the higher ranges from the start to the end of the program, suggests that students’ perception improved in all domains.


Six 5th Grade girls between the ages of 10(n=4) and 11(n=2), from Westwoods Elementary School in Hamden Connecticut participated in this study. The participants were referred by their 5th Grade teachers because they might benefit from the North Star program. Permission from Teachers, the building Principal, and Parents were received as well as accent from the student participants. Eight weeks of 1 hour sessions, once a week were held in multiple locations within the school building during lunch, recess, and sustained silence reading period. Five of the twenty-two Noth Star Activity Sessions were uses in this Pilot Study; The Friendship Journal, Lisa’s Heroine Project, Keeping a Personal Journal, Design and Advertisement, and, Personal Pillow. All six students completed the eleven –item North Star Student Information Form. Collectively this group identified themselves as having ten sisters; seven brothers; one step-brother and one step-sister. Four of the six students had a pet, with the most popular pet being a dog, followed by cat and multiple pet owner. To the question, ‘Do you like school?’ four of the students responded ‘yes’, and two of the students responded ‘no’. The majority of students in this group also felt that they did well in school: four students responded ‘yes’to the question ‘Do you do well in school?,’ while two students responded ‘no’.

Data Collection Instruments:

The following data collection instruments were used as Pre and Post measures in this study: The Piers-Harris 2 Childhood Self Esteem Inventory, and a Demographic Survey. An engagement survey was also completed by the North Star facilitator for each girl during each acivity session. The Piers-Harris 2 Total (TOT) score provides a general measure of the respondent’s overall self-concept. For the purposes of this study all TOT scores were grouped into interpretive ranges with labels to provide an overall strategy for interpreting and comparing results. The interpretive ranges provided by Piers-Harris 2 scales are (seven categories) Very Low (≤ 29T); Low (30T – 39T); Low Average (40 – 44T); Average (45T – 55T); High Average (56T – 59T); High (60T-69T) & Very High (≥ 70T).

Findings and Implications: The findings challenge us to rethink primary prevention as treatment in school-based programming for pre-adolescent girls. The frequency table and bar charts below depict the distribution of the interpretive labels at the start (pre-test) and at the end (post-test) of the program. The increase in the number of scores in the higher ranges suggests that students’ perception of self-concept improved.

Table 1 Pre-Test Scores: Table 1 shows the frequency of scores that range in the Low, Low Average, Average, and High Average range on the Piers-Harris 2 Childhood Self –Esteem Inventory in the Pre-test prior to the North Star Program Intervention.


Table 2 Post-Test Scores: Table 2 shows the frequency of scores that range in the Low Average, Average, High Average, and Very High Average range on the Piers-Harris 2 Childhood Self –Esteem Inventory in the Post-test after the North Star Program Intervention to the North Star Program intervention.



Table 3 Comparison of TOT T-score Distributions by ‘Interpretive Label’ – Shows bar graphs of the Pre-testy (start) and Post-test (end) findings of the North Star Intervention Pilot Study.


Limitations of the Study: The primary limitations of this study were the size as well as the lack of randomization of the sample poplulation.


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