Working with Generation Z: Supporting Our Younger Clients and Bridging the Generational Divide

Editor's note: This text-based course is an edited transcript of the webinar Working with Generation Z: Supporting Our Younger Clients and Bridging the Generational Divide, presented by Jenny Maenpaa, MSW, EdM, LCSW.

Learning Outcomes

After this course, participants will be able to:

• Define Gen Z and their key struggles.
• Identify cultural barriers and issues of intersectionality related to Gen Z.
• Identify new therapeutic approaches to connect and combat their generation specific issues.

Introduction

I'll start by telling you a little bit about me. In addition to being a licensed clinical social worker, I am the founder of Forward in Heels, an intersectional feminist group therapy practice that empowers all women to stand tall and own their worth so they can light up the world. In my 20s, I was the classic overachiever, with multiple graduate degrees and fellowships, always looking for the next gold star to make me feel valid and wondering why I was constantly making lists and plans, only to have to rewrite them when something unexpected came up, as it always does.

I would go to a therapist, and after three sessions or so, they would say, well, there's nothing exactly wrong with you, and I'd think, oh, okay, clearly I just have to work harder, message received, which is about the worst thing you can tell to an overachiever. Finally, I realized that I suffer from high-functioning anxiety and that just because I'm often able to sublimate my anxious tendencies into achievements doesn't mean they're not still negatively impacting me. I created the practice I wish I'd had in my 20s, one that recognizes that being a badass doesn't mean you never have doubt, that being the strong one doesn't mean you never need to be checked on, and that being the one everyone always goes to for solutions doesn't mean you're never vulnerable.

Who is Generation Z?

Today we're going to focus on working with Generation Z, supporting our younger clients, and bridging the generational divide. From immigration to sexual assault, a surplus of issues is causing significant stress among members of Generation Z, primarily those between ages 15 and 25. According to the APA report, Stress in America, mass shootings top the list of stressful current events. Although specific barriers like social media and technology can get in the way of older therapists connecting with Gen Z individuals, strategic planning, continued education, and a little bravery can help establish therapeutic rapport with this population.

Let's start with definitions. Who is Generation Z? Conventional wisdom at this time defining generations says that people born between 1997 and 2012 are considered Generation Z. At this time, that makes the oldest of this generation about 25 years old. The most recent research says that adolescence is a stage of development from ages 10 to 25. The prefrontal cortex continues to develop during this time, with neurons and synapses continuing to form connections and the physical skull soft spots continuing to harden until age 25. Knowing this can reframe our previous conception of adolescents as an age that ends alongside high school graduation.

Gen Z spends an average of nine hours daily in front of phones and tablet screens. Gen Z is attracted to social media for its ability to build community, relate to others, and try on new identities to find what fits and discard the rest. Teenage and college-age clients commonly voice concerns about future careers, school shootings, financial security, climate change, and societal unrest. At best, TikTok videos have brought greater awareness of disorders like Attention Deficit Hyperactivity Disorder (ADHD), Attention Deficit Disorder (ADD), Tourettes, and autism. 

At worst, these videos have brought a proliferation of misinformation that has led many to believe that they have a condition or disorder when they may not reach their clinical criteria. As we've seen during the pandemic, anyone can pose as whoever they want to on the internet. PhDs can call themselves doctors and imply that they're medical doctors. A self-proclaimed health guru can pose as a nutritionist by changing some of that language and maybe not saying registered dietician but nutrition coach. Whatever the case or situation, younger people are quick to believe what they see and hear on the internet without always doing much questioning or further research. They tend to be raised to listen to adults, so when they find information on their own, they haven't yet developed that skill to say, who is this adult or this person, and what's the source?

Young people ages 11 to 17 are particularly susceptible to social influence. TikTok channels can create a sense of community and inclusiveness for this age group, but they can also be a slippery slope. While awareness and destigmatization of mental health issues on TikTok can be beneficial, taking advice from any armchair experts, otherwise known as those without real medical expertise, can pose problems. It's essential to consider Gen Z as a generation, what they have experienced that is different from previous generations, and where they fall developmentally, which isn't so different from previous generations.

They're still searching for connection and relatability while exploring their growing independence. As we know from Eric Erickson, adolescence is thought to be about 12 to 18 years of age. The ego development outcome is identity versus role confusion. Basic strengths include devotion, fidelity, faithfulness, or loyalty. According to Erickson, development mostly depends upon what is done to us up to this stage. Still, from here on out, at the beginning of adolescence, development depends primarily on what we do. While adolescence is a stage at which we are neither a child nor an adult, life is getting more complex as we attempt to find our own identity, struggle with social interactions, and grapple with moral issues.

Our task is to discover who we are as individuals separate from our families of origin and as members of broader society. Unfortunately, for those around us, in this process, many of us go into a period of withdrawing from responsibilities, which Erickson calls a moratorium. If we are unsuccessful in navigating this stage, we will experience role confusion and upheaval. A significant task for us during this stage is to establish a philosophy of life, and in this process, we tend to think in terms of ideals, which are conflict-free, rather than reality, which is not. The problem is that we don't have much experience at this age and find it easy to substitute ideals for experience. However, we can also develop intense devotion to friends and causes. Unsurprisingly, adolescents' most significant relationships are with peer groups.

The next part of this age group is young adulthood, 18 to 35. The ego development outcome here is intimacy and solidarity versus isolation. The basic strengths are affiliation and love. In the initial stage of being an adult, we seek one or more companions and love. If negotiating this stage is successful, we can experience intimacy on a deep level. If we're not successful, isolation and distance from others may occur. When we don't find it easy to create satisfying relationships, our world can begin to shrink as, in defense, we can feel superior to others as a way of navigating that. Our significant relationships at this age are with romantic partners and friends. Gen Z is considered those born between 1997 and 2012.

Going backward, we have Generation Y, known as Millennials, born from 1981 to 1996; Generation X, born from 1965 to 1980; the Baby Boomer Generation, born from 1946 to 1964; and the Silent Generation, born from 1925 to 1945. It makes me laugh that whoever decided to name these generations started with X, not thinking they were three letters from the end of the alphabet. I have heard some dark humor from Generation Z that says we're named Generation Z because we're going to be the last one. Adding to many of these definitions is also a darker sense of humor from Gen Z, seeing the world around them and their feelings of helplessness.

I am considered an elder Millennial, born at the maximum age of that Generation Y, Millennial group, and that comes with its own identifiers. We killed avocado toast, the housing market, and marriage. Millennials killed all the things that previous generations held dear. I am part of a generation that has a lot of assumptions, stereotypes, and stigmas around it, just like Generation Z. However, I am also afraid of TikTok, so in that sense, in my mind, maybe I'm a Silent Generation or Boomer instead of a Millennial because I don't really understand social media or technology either, which makes me feel very far from Generation Z sometimes.

How Generation Z Is Interacting Online

How is Generation Z interacting online, and what is different about what they do than what my generation of Millennials did? I can remember getting our first computer in our home office. It was big and unwieldy, it had that dial-up sound on the modem, and everybody in the house knew when I was logging on. None of that is true for Gen Z. They carry around computers in their pockets, and they're incredibly technologically literate. Gen Z is commonly attracted to social media for its ability to build community, relate to others, and try on new identities to find what fits and discard the rest.

When I talked about why I started my practice, so many of those things that I said, being a 20-something who was searching, isn't that different from what Gen Z is experiencing right now, although it looks different in terms of how they're approaching it. As an older Millennial, I can confirm that 20 years ago, I cared very much about the environment, what companies were doing, and what they said regarding ecological impact versus what they were showing me. I went through a preppy Abercrombie and Fitch phase, an all-black New York city chic phase, and hair of every length possible from my chin to my waist. I chose a half dozen college majors before landing on psychology and created some friendships and adolescents that I still have today. In contrast, other friendships ended over the years in ways that sometimes felt more impactful than a romantic breakup.

We have to remember that while the medium may be different, the developmental journey remains essentially the same for Gen Z. Finding common ground is about going beneath the surface and not expecting us to be experts in the latest technology. I don't know about you, but I am never going to be a TikTok influencer, but if a client comes to me and says, I just saw this thing on TikTok where couples sit and hold each other's hands to build intimacy, I could panic that I don't have TikTok and don't have any idea what they're talking about, or I can remember that I have had many years of working with clients who seek to build intimacy in my practice.

I can refer back to Gottman Institute trainings and say, yes, prolonged physical touch is a great way to build a connection with your partner. What drew you to try to practice this over others? What did you experience when you did it together? How was that for you today? The goal today is to empower therapists of any age to feel confident with younger generations, even if we don't understand their technology. Generation Z, also known as Gen Z or Zoomers, are extremely online because of how much of their last two and a half years on Zoom. Most of these digital natives have had social media presence for more than half their lives, which is wild to think about, given that most social media platforms ask you to be anywhere from 13 to 18 to sign up.

Sixty-six percent of Gen Z state that social media is essential to their lives, but their reasoning can vary. The most common reason Gen Z uses social media is to kill time, making them the only generation to rank that above connecting with family and friends. Gen Z's social media usage continues to climb as the years pass. Sixty-five percent of Gen Z consumers have increased their use of social media in the last year, and 45% is expected to continue to grow over the next three years. This is and will continue to be a huge trend driver across the social media landscape. So what does Gen Z expect from social media? They're eager to interact with other accounts, many of them brands. Seventy-six percent of Gen Z say that social media enables them to interact with brands and companies, and 78% report using social media to learn about new brands.

Raised amid countless data privacy discussions over the last couple of years, these informed consumers deeply understand what businesses can do with their personal information. Rather than shying away from sharing their data, Gen Z leans into it. They want companies to make smarter decisions using the information they already have available. Sixty-four percent of Gen Z consumers expect a more personalized experience on social media based on previous interactions. I'm always joking when a new ad pops up on my Instagram that I was talking about a week before. I wasn't texting about it or posting anything, just talking about it in real life and saying, oh, my phone's listening to me again. Instead of saying, oh my gosh, I need to turn my phone off, or putting it on airplane mode and leaving it in another room, Gen Z is saying, yes, you're listening to me, and I am looking for a new harness for my dog, show me the best options.

They expect a more personalized experience and use that data sharing rather than hiding or fearing it. Sixty-one percent of Gen Z consumers want companies to know them better based on their social media activity. They want that to be public to get a better experience. Fifty-two percent of Gen Z consumers expect companies to read and analyze their social media posts. When we think that Gen Z has a spending power of up to 143 billion dollars, Gen Z accounted for an estimated 40% of global customers in 2020. They grew up around the internet and knew how to fact-check everything they needed. In recent years, cancel culture has been gaining popularity with people, particularly Millennials and Gen Z'ers, which involves canceling brands or celebrities whose practices don't align with their views.

According to research, a smartphone remains the device of choice for most Zoomers. They're carrying this computer in their pockets to have meaningful interactions. Gen Z is tired of interacting with accounts posing as individual people that are actually companies that only want their money. They want more and more in return and expect you to communicate with them in a personal and relatable way that speaks directly to them, not some imaginary focus group of customers as a whole. Loyalty is a strong trait that Gen Z values. If you want them to be loyal to you, whether your company or yourself as a therapist, you must first show loyalty to them. In a way, they expect you to give before you take or give before you ask. Thinking about how we interact with them, we don't have to be experts in social media. We just have to be the reciprocal therapist for them, which we are for all of our clients, and this is no different. 

Zoomers, or Gen Z, are looking for purpose. They're not just looking for something flashy or cool. Yes, sometimes that draws them in, but 69% of Gen Z'ers believe that brands should help them achieve their goals. This study claims that more than half have stopped using a brand because of its ethical practices. Zoomers are extremely passionate community builders and are great at connecting with like-minded people who want to build something great together. Gen Z'ers actively participate in communities built around common interests on platforms such as Reddit and Discord, which remain among community builders' most popular tools. I might say Reddit and Discord, and you might say, I don't know what that is. Don't panic; it's not about where they are. They are not expecting us to be on those platforms. They expect us to look at their desires for transparency, identity building, purpose, and community building. This is where we can align with them. It doesn't have to be where they are online; it's what they're looking for.

When we don't know many people in Gen Z, it's easy to listen to what media or other people tell us and not understand who they are as individuals. Think about Gen Z members that you regularly spend time with outside clients, whether they are family, friends, or colleagues. Think about how you might use them as sounding boards and listen to what they say. This can be useful for learning more about Gen Z, which can then be transferred to your practice with clients.

Cultural Signifiers Specific to Generation Z

We discussed how Generation Z have commonalities with previous generations, but what makes them different? What are some of the cultural signifiers that are specific to Gen Z? One main thing is that they tend to think of themselves as brands. Adolescents often go to great lengths to get social media likes. To promote their brands, which is themselves, some Gen Z'ers engage in what researchers call deceptive like-seeking practices. This means they might look into the research of when the highest traffic time people are on social media is and post at that time to get the most eyes on their account. They may use filters to make themselves look more attractive or even buy likes, which means purchasing a bot follower that will like your post or buying hundreds or thousands of them to boost your numbers so that more people see you. Part of this is cultivating a specific look online to represent their ideal self.

You see this a lot with the Kardashian family. They're very transparent about using filters and face tune, which makes their bodies smaller on social media, showing their workout routines, waist cinchers, and plastic surgery. They're adults and are allowed to make those choices. Still, when you have adolescents watching these accounts, they don't always know the difference between these filters or angles or how the representation of the ideal self is not someone's perfect self online. Then they try to replicate that themselves. Understandably, these behaviors might seem extreme to parents, but likes tap into critical adolescent needs that have always been there. All humans have an evolutionarily driven desire to belong.

During adolescence, we are incredibly motivated to gain social status among our peers. Teens are highly attuned to social norms, and many youths will engage in risky or illegal behaviors to gain peer approval. One study found that when teens were playing a driving game, the mere presence of their friends, without any direct peer pressure, led to riskier driving within the game, along with heightened activation of the brain's reward center. Conversely, adults did not show these behavioral or brain patterns in the same study. Adolescents now have 24/7 access to a broad audience of peers. Those likes provide a clear, compelling, quantifiable, public, and ever-present indicator of peer approval. Imagine your high school experience, having a ticker online that someone could look at your popularity at any given time.

Adolescents are highly attuned to like counts, their peers, and their own, and they use them to compare and contrast. For every adolescent whose like count is increasing, another adolescent is engaging in social comparison with those likes. This can generate stress and may increase the risk of mental health problems for some adolescents. The phrase "compare and despair" has become popular in recent years. It goes back to comparing yourself to a Kardashian, for example, or someone whose online presence is very cultivated and perfect and makes you feel less than others. Social media thrives on the attention economy, meaning the more time a user spends on an app, the more money the tech company makes from ads, so likes equals money.

We keep posting and checking, hoping for that next dopamine hit from getting another like. Recent studies found that teens who received fewer likes than their peers reported more negative emotions and thoughts about themselves. Youth who showed stronger adverse reactions to low like counts were more likely to develop depressive symptoms over time. Many people, especially teens and adolescents, don't know that apps all have rules. The number one goal of those rules is to keep you on the app. If you go on LinkedIn, Twitter, or Facebook and want to share a link to an external source, that app or platform will deprioritize your post, even if it's getting thousands of likes, because it asks people to click off of their site.

Similarly, on Instagram and TikTok, there's a For You Page, an explore page with tons of accounts that you don't follow and don't necessarily have anything to do with you. Still, Instagram and TikTok have said, well, you like these types of things, so instead of showing you something where you then click off to do something, we're going to show you more stuff like that to hold your attention. It might be worth explaining and exploring with Gen Z precisely what these apps are designed to do because they often have a misconception about an app's purpose. It isn't to connect you with your friends or information; it is to keep you on the app.

Let's zoom back out to that big picture where some of these things are not so unique. From an evolutionary perspective, a significant function of adolescence is attaining reproductive status and developing the physical and social competencies needed to access a new and highly contested biological resource, sex and reproduction. Being liked, in the real world or online, is often conflated with the perceived future success of finding a mate who will value you. The central focus of the evolutionary model on "what's in it for the kids" who engage in high-risk behavior has important implications for our intervention. Risk-taking behaviors among adolescents have an important signaling function. Successful risk-taking, where the real danger is involved, is often admired and confers status, especially for males. Accordingly, drinking games, social drug use, being a Daredevil, fighting, and other risky behaviors play an important role in adolescent life.

Interventions that just ask them to stop doing those things, like don't use TikTok, are unlikely to be successful because they ignore motivation and function. We can't ask adolescents to give up successful social strategies without anything in return. That's why a lot of zero-tolerance policies just don't work. Instead, we need to use interventions that work within the goal structures of adolescents to substitute effective evolutionarily informed pro-social strategies that yield outcomes and incentives comparable to those achieved through risk-taking. In other words, what does social media give them? Where can we mimic that reward system rather than just saying, don't do that?

After the Facebook leak by Frances Haugen in 2018, many of us know that Facebook and Instagram are well aware of their impact on teen girls. Adolescent girls' depression, anxiety, and self-injuries rates surged in the early 2010s as social media platforms increased and expanded. In accounting for other correlatives, not causative factors, the study showed that the only thing in the early 2010s through the early 2020s that could account for this change and the different gender applications is the social media platforms expanding and exploding. More than for boys, adolescence typically heightens girls' self-consciousness about their changing bodies and amplifies insecurities about where they fit in their social network.

From 2010 to 2014, hospital admission rates for self-harm did not increase for women in their early 20s or boys or young men, but they doubled for girls ages 10 to 14. National surveys of American high school students show that only about 63% reported using a social networking site daily in 2010. But as smartphone ownership increased, access became more accessible, and visits became more frequent. Only four years later, by 2014, the 63% of high school students who said they used a social media platform daily went up to 80%. Twenty-four percent said that they were online almost constantly. Girls who use social media heavily are about two to three times more likely to say that they are depressed than girls who use it lightly or not at all.

For boys, the same is true, but the relationship is smaller. Public performance is risky. Private conversation is far more playful. A bad joke or poorly chosen word among friends can elicit groans or maybe a correction or a chance to apologize. Getting repeated feedback in a low-stakes environment is one of the main ways play builds social skills, physical skills, and the ability to judge risk properly. Play also strengthens friendships, but this is not reciprocal when talking about our clients posting things online in a vacuum. This isn't feedback. The wrong photo can lead to schoolwide or even national infamy, cyberbullying from strangers, and a permanent Scarlet letter. Performative social media also puts girls in a trap as those who opt not to play the game are cut off from their classmates, so there isn't even an option to say, I'm just not going to do this.

Finally, since the pandemic started, American workers across various ages, industries, and income brackets have experienced heightened fatigue, burnout, and general dissatisfaction with their jobs. The difference is more young people are airing these indignations and jaded attitudes on the internet, often to viral fame. Today's young people are not the first to experience economic hardship, but they are the first to broadcast their struggles on social media in a way that even a decade ago, people would say, oh, you're going to alienate a potential employer, you're going to be too radical.

Something happening right now is the great resignation, inspiring a generation of workers to speak critically and cynically about the role of labor in their lives. As a result, Zoomers are now being painted as beacons of anti-capitalism and pivotal figures in this national quitting spree, but that's not exactly what's happening. Essentially, these Gen Z'ers are saying, I just don't think I should be crushed to have a job, pay rent, and get ahead. It's not that I don't believe in work; this kind of work exploitative of my labor is not one I'm willing to sign up for. Younger Millennials and Gen Z, in general, have witnessed two recessions back to back. This is a very different labor market than what their parents and grandparents encountered. Many Zoomers entered the workforce during the pandemic-affected economy amid years of stagnant wages and rising inflation.

People say things like, my dad got a job straight out of college, saved up, and bought a house in his 20s. I don't even think that's a possibility for me. I don't even see a horizon where that could happen. What sets these Zoomers apart is their determination to be fulfilled and defined by other aspects of life outside of work. They expect employers to recognize that and promote policies and benefits that encourage work-life balance. Work has been a significant aspect of the American capitalist identity.

Most people, immediately upon talking to them, will identify what they do for a job. It's an identity that adults willingly take on in this country. The pandemic changed much of that, not just for the youngest workers. In addition to reassessing their relationship to work, many reflect upon their greater life purpose. People are taking stock of what they want from a job, and many find that they're not content with what they have. Gen Z is not shy about detailing these expectations to employers and on social media. They realize they want better for themselves and are unwilling to accept the status quo. They don't want to be stressed, depressed, and always waiting to clock out.

I remember when I was first entering the workforce almost 20 years ago. My mom made an offhanded comment and said, why do you think there are songs called working for the weekend? That's what you're signing up for. I remember even then thinking, well, I don't want that, I reject that, but we have to create different systems. While Millennials might have been beginning those conversations, Gen Z is really leapfrogging and saying, nope, absolutely not, I have the skills to be highly online, that means that I can carve out a niche for myself that I don't have to live in a major city or live near an office, and they're changing the game. They want to work with companies who understand that they're human beings and don't think that's too much to ask.

Gen Z's heightened awareness of mental health has both pitfalls and benefits. Some pitfalls include coming into therapy with preconceived notions of their own diagnoses. This can be because they want to be a part of a community online that all experience similar things, like ADD, ADHD, or depression. Developmentally, clients in Gen Z may understand the logic and language of diagnoses without having a similar depth of understanding of their emotions, triggers, and boundaries. This can present challenges for the therapist in wanting to validate clients while also not co-signing an inaccurate or limiting diagnosis.

I often say to clients who present their diagnoses to me, "In our profession, diagnosing is not meant to label. It is meant to provide a roadmap for treatment. If you came to your doctor complaining of a stomach ache and told your doctor that you thought it was probably indigestion. Your doctor didn't do any further exploring and just took you at your word; they would likely prescribe you Pepto-Bismol and send you on your way. But what if further exploration could detect an allergy, stomach cancer, or a blockage and a need for surgery? Your doctor needs to diagnose you accurately to determine treatment, which we do here too. Let's explore this diagnosis. I would love to hear more about what's coming up for you and what made this diagnosis seem likely. We'll see if it changes our treatment plan and how we move forward." It's essential to see Gen Z where they are and not just say, "I'm older, and I know better." Instead, say, "I hear you; let's talk about it, and then here's my expertise as a clinician. I'm going to add this to the conversation.

Gen Z's strong awareness of mental health benefits because they're often solution seekers who do really well with validation and psychoeducation. The key is validation first. Teenagers are so used to being told by adults that they're wrong and they don't know anything. That makes them entrench even further into their beliefs. I use this particular approach because it validates clients coming to me with knowledge of their selves, which they will always be more of an expert in than I am. Also, it asks them to trust me as a practitioner to work alongside them.

With more time at home and more idle time for social media apps like TikTok, which has 2.4 billion views, experts have seen an unusual spike in mental health cases in hospitals and behavioral health facilities across the country. Interestingly, Tourette-like tics have had a real surge in many locations. A study found that after creating individualized treatment plans at various hospitals, including two weeks off of TikTok, many patients returned to normal in these hospital settings. This shows just how powerful and influential these videos can be. Some videos showed people with Tourette's or some tic disorder. The children in the study were so susceptible, seeking communities and belonging, and alone during the pandemic. They started to mimic some of these behaviors, not consciously and not in any way they would recognize it, but because it's what they saw. Eventually, they needed to be removed from that stimulus to have their practitioner acknowledge that it was a cluster.

When presenting new information to our clients, we can use TikTok or social media to start a conversation. That includes discussing self-diagnosing, which we always want to work clients away from doing, no matter how old they are. We know from years of peer pressure campaigns that children's peers are their primary influences. Today's adolescents see the entire internet as their peers. If they follow someone on social media or interact with them regularly, they can build a sense of community and intimacy that causes them to feel aligned with this person.

Adolescents often don't understand conceptually that social media is a business designed to keep them on the platform and that individuals want you to buy what they're selling, whether literally or figuratively. If we come in as older practitioners and tell them that their internet friends aren't real friends or that they are not a member of an identity-based community they feel strongly about, we're going to lose any therapeutic alliance we are trying to form. Gen Z also doesn't just want to be passive consumers. They want to create content to validate likes, follows, and shares and to build community by reciprocating. If they see someone online with an identity that they either want subconsciously or see some part of themselves in, they will start to absorb that.

In other words, there are some aspects where they see having a diagnosable disorder as the thing to do. I can't tell you how many Gen Z'ers have come into a session with me and said some version of, well, I feel like I'm the only person without depression, as if now that has become something that they're in the outgroup for not having a diagnosable disorder. That is interesting because even just a few years ago, that would've been quite different. This community-building desire can cross boundaries. I've had conversations with clients about not recording their virtual therapy sessions to post on social media. There was a trend recently where Gen Z would be on a computer and have their phone off to the side, recording them with video so that they could later provide funny commentary because they saw someone else do it. They did not realize that the original recording that started the trend was, in all likelihood, faked for the bit. 

As practitioners, we can watch those videos and say, that's probably not how the therapy session went. It's either spliced together or edited, or it's entirely a comedy bit or meant to go viral. But they don't know that. Thinking about the developmental stage of adolescent brains, we need to be an ally and not say to them, you're wrong, but say, here's some psychoeducation you might not have had before. The first neuroimaging study of teens' brain responses to social media found that when teens believed their photos had gotten more likes, they showed greater activation in the brain's reward circuitry. Getting likes feels good, even at the neural level, and conversely, seeing negative content online, like an ex's post with their new partner, triggers the same part of the brain that activates when you run into that person in real life. In our client's brains, when they continue to follow someone online who makes them feel bad, like an ex-partner, ex-friend, or influencer who makes them feel inferior, or anybody else who triggers negative feelings, it is as if our clients are interacting with these people repeatedly all day long. I often tell clients to be careful not to pathologize their personalities because sometimes, aspects of your personality aren't evidence of pathology. They're just a part of your personality. It's a huge challenge as a clinician. 

Cultural Barriers and Issues of Intersectionality Related to Gen Z

It's important to remember that we don't want to reject Gen Z or any other clients. When discussing social media use as a diagnostic tool, therapists can use the "yes and" validation. Encourage exploration while providing psychoeducation on the limitations, and remind clients that social media does not function the same as therapy, where individualized care is given by a licensed, trained health professional. Highlight the disinformation spread on social media due to a lack of regulation. This generation, the first to come of age with an understanding that ecological collapse is not a dystopian movie premise but a real possibility, is dedicated to public action and public service. Members of Gen Z appreciate that their whole lives will unfurl in a state of emergency.

Driven by that knowledge, they look down-shore, but more often and powerfully, they look out. Gen Z is filled with bold and original thinkers. Teens of the sunrise movement are fighting for a future with a planet that's still around. Survivors of gun violence led by the Parkland, Florida students are fighting for American safety. Like Millennials before them, Gen Z is fighting for those living with mental illness and finding new ways to destigmatize and discuss suicidal thoughts. Far from a flash-in-the-pan moment, these are long-term advocacy and community-building projects we need to validate in our clients.

Another issue to consider is anger towards older generations. One of the effects of being extremely online is Gen Z learning about what they have not been taught in school and feeling like things have been hidden from them, including the whitewashed version of history taught in books versus the lived history of the country. Podcasts like 1619 have brought forward a story many Gen Zs feel they were never told. That's one among many. Gen Z also thinks that when they bring up these discrepancies, they can be told by older generations that they're unpatriotic and entitled, which fuels their anger at their inherited conditions. Inflation is challenging for younger generations because they have to bear all the costs but don't necessarily own the assets that would help their balance sheet keep pace with inflation going forward.

The most significant price jump in four decades is greeting Gen Z just as they graduate from college, move out on their own, and start their first jobs. I'm located in New York City, and the average rent for a one-bedroom apartment reached $4,000 a month on average this month for the first time in history. I can understand being angry at entering a workforce and not having the money to pay that rent and saying, I see this in every city across the country, I didn't do anything to cause this, what am I supposed to do? It now takes consumers more money to buy the same amount of goods, plus Gen Z'ers don't really have cash savings yet. Whatever they had is worth far less than it was a year ago.

As we touched on briefly, the development and maturation of the prefrontal cortex occurs primarily during adolescence and is thought to be fully accomplished at the age of 25. The prefrontal cortex development is significant for complex behavioral performance, as this region of the brain helps perform executive brain functions. Brain maturation occurs during adolescence due to a surge in the synthesis of sex hormones implicated in puberty, including estrogen, progesterone, and testosterone. Sex hormones also significantly influence food intake and sleep requirements during puberty. In addition to dramatic changes in secondary sex characteristics, sex hormones may also affect adolescents' learning, intelligence, memory, and behavior. Again, we have this semi-arbitrary age of 18 as thinking that adolescence ends when high school ends, but we know more and more from neurobiology that that's not true. So when we ask 23, 24, or 25-year-olds to make decisions as if they are on par with a 30-year-old, we're asking a teenager to do that. We need to think differently about how we might approach our college-aged and post-college, early adulthood clients, thinking of them more similar to teenagers than we would to someone in their late 20s.

Remember, Gen Z refers to people born in the late 90s and the early 2000s. While many of them won't remember 9/11, this generation grew up in its aftermath, felt the effects of the 2008 recession, and are now the first kids to navigate social media as things like the Black Lives Matter movement and ongoing protests against police brutality have shown is an activism force of its own. Now all of that is against the backdrop of COVID-19, the worst pandemic the world has seen in 100 years. In 2020, young activists were focused on representing all groups of different people who are impacted by specific issues and supporting people with diverse racial, ethnic, sexual, or gender backgrounds than themselves.

This also reflects what Gen Z sees as the growing diversity of America as entirely normal to them. In contrast, older generations saw a different distribution of diversity in America when they were the same age. According to US News and World Report, nearly 70% of the country's largest cities are more diverse than they were just ten years ago. In addition, Gen Z as a group is more diverse than previous generations. About half of Gen Z'ers are white, while more than 60% of Millennials are white, according to the Pew Research Center. Gen Z grew up with social media. Facebook was founded in 2004, YouTube in 2005, and Twitter in 2006, which gives them a widespread digital platform no generation has had before.

The speed at which social media moves is truly mind-boggling. Their social media feed will be consumed with something that happened today on Twitter or something they had not heard of yesterday. There will be thousands and thousands of retweets about one issue. Technology allows us to keep up to date in real time. These tweets, videos, TikTok, or Instagram posts can go across the globe within a matter of minutes and allow us to see each other in each other's struggles.

Tips for Gen Z Clients to Become Critical Consumers of Information

What do we do with all this information? Here are some helpful talking points in therapy sessions with Gen Z'ers. Talk to them about being careful who they look to and where they go for advice, monitoring the 'for you' or 'explore page,' and pressing reset on settings, which is an option on TikTok, but I don't believe Instagram. 

Media literacy is the ability to identify different types of media and understand the types of messages they're sending. Beyond traditional media, the types of media that kids consume daily include everything from text messages, memes, and viral videos, to social media posts, video games, and advertising. Media literacy involves helping our clients identify these different media types and recognizing that someone created the messages for a reason. Learning to think critically is a crucial skill. Setting timers or taking a time-out from social media with screen time limits is essential and something you can do on your phone.

The internet limits attention in the sense of a deep aesthetic experience that changes the engaging person. The business model of digital advertising incentivizes brief, shallow interactions. A consumer's gaze is primed to absorb a logo or brand name and not much else. Our feeds are designed to prod us ever onward from one monetizable object to the next. We have a tough time concentrating for long periods, especially as adolescents who are already looking for stimulation. Contextualize information. Help clients understand that social media is not therapy. They are not receiving individual care from a health professional.

There are strategies that you can use with adolescents to evaluate sources. One of them that I have used with middle schoolers is called the CRAAP test. They love the name of it. CRAAP stands for currency, relevance, authority, accuracy, and purpose. Ask clients what the currency is of the information and when it was published. Thinking about relevancy, how is this related? Authority refers to who said it, and accuracy is how we vet reliability and truthfulness. Purpose reflects on why this exists. Asking them to think critically about these things will use a muscle they must exercise repeatedly. Still, it is a way that they can learn to become critical consumers of information over time.

As I said before, validate that clients are experts on themselves. Work with them and talk with them to not dismiss their concerns, but help them learn to shift their focus to the present and on what they can control instead of identifying with someone online or that they haven't met to feel more belonging. Remind them that the job of an influencer, literally in the title, is to influence. It's learning how to constantly accommodate themselves to the means of establishing and maintaining visibility to maintain that influence.

Influencer creep is that on-edge feeling that our clients aren't doing enough for social media to be relevant. They may feel that they could be more on-trend, authentic, responsive, and always more. That feeds into that constant on-ness of social media and always wanting more and more. Also related is assessing larger environments and boundaries between personal expression and entrepreneurship and socializing and commerce. They're eroded when everything is painstakingly aesthetically organized to please and accommodate our eyes. We have to be conscious, critical consumers of what we see.

Tips for Gen Z Clients to Become More Tolerant of Distress

There are several ways to help our Gen Z'ers become more tolerant of distress. This may be a review of the information you already know for many of you. Dialectical behavior therapy (DBT) includes several strategies. One of those is DEAR MAN, where you describe the situation, express your feelings, assert yourself, reinforce the person ahead of time, mindfully keep your focus on the goals, appear confident, and negotiate. Another strategy is to practice radical acceptance by observing that you're questioning or fighting reality and reminding yourself of the unpleasant reality. Urge surfing involves practicing mindfulness and having breath and thoughts that come up when I'm without judgment and letting them keep going down that river.

Cognitive behavioral strategies include identifying the cognitive triangle and the thoughts, behaviors, and feelings related to social media and these posts that are coming up. Strength spotting determines where a client already has the strengths to deal with challenges and problems. It also includes identifying where the exceptions are that can increase their awareness of and confidence in their abilities outside of the session.

Mindfulness might be guided meditation, live meditation that you walk them through, or teaching them physical grounding techniques like 5, 4, 3, 2, 1, box breathing, or four square breathing. You can use eye movement desensitization and reprocessing (EMDR) techniques without becoming EMDR-certified. Things like body scanning, or anything with a rhythmic activation of alternating sides of the body, could be used for self-administered EMDR. You can get creative and use walking, running, horseback riding, and drum circles.

The reason that I say all of this is that I want you to remember that you already know how to do this. Just because social media is a new tool doesn't mean that you are not already the right therapist for the client in front of you. Don't be scared of TikTok or Gen Z's particular way of talking about things with specific language, whether using shorthand or acronyms you don't know. You already know how to help them through this, even if they say a word like discord, and you think, is that a social media term or a movie?

References

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Akgül, G. (2022). Emerging adults during the pandemic: The experiences of Generation Z in the context of self-determination theory. Child & Youth Services, 1–24. Retrieved from https://doi-   org.ezproxy.uu.edu/10.1080/0145935x.2022.2065982

Collisson, B., Eck, B. E., & Harig, T. (2021). Introducing Gen Z psychology majors: Why they choose to major in psychology (and what they expect to learn). Scholarship of Teaching and Learning in Psychology. Retrieved from https://doi-org.proxy.library.nyu.edu/10.1037/stl0000249

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Suwinyattichaiporn, T., & Turner, M. (2020). "Just text me": Investigating the effects of computer-mediated social support on mental health outcomes among millennial and Generation Z populations. Kentucky Journal of Communication, 39(2), 53–73.