Adolescence is a troublesome time for many people and adolescent girls tend to be more vulnerable than boys. In particular adolescent girls tend to have a lower self-esteem than boys; this is important as a high self-esteem is considered to be a protective factor for mental-health problems. Many girls between 11-14 are still in the concrete operational stage of development and often have difficulty in expressing their feelings adequately in words so group activity therapy may be more appropriate in this group. Group sandtray therapy is an intervention in which "group members build small worlds with miniature figures in individual trays of sand and share about their worlds as they are willing." Sessions are facilitated by a trained therapist who explores some of the psychological and interpersonal issues raised by participants. A U.S. study of 37 girls found that after nine sessions of sandtray therapy self-esteem was improved in the areas of: scholastic competence, social acceptance, physical appearance, behavioural conduct and global self-worth.
Shen, Yu-Pei and Armstrong, Stephen A. - Impact of group sandtray therapy on the self-esteem of young adolescent girls Journal for Specialists in Group Work June 2008, 33(2), 118-137