Adolescent dating violence affects upwards of 1 in 5 girls and 1 in 10 boys in the United States. It is now well-established that dating violence is associated with a range of very problematic behaviors and emotional states, such as alcohol and drug use, eating disorders, high risk sexual behaviors such as not using contraception, suicide attempts, depression and anxiety, and poorer self-esteem. But it hasn't been clear whether dating violence was just associated with these health risks, or if dating violence caused the start of them or a worsening of these behaviors and emotional states. Thus, we didn't know a lot about the long-term impact of dating violence.

Last year, we had the opportunity to investigate the longitudinal impact of dating violence among teens. We grouped ten behaviors and emotional states together (extreme weight control, binge-eating, suicidal ideation, suicide attempts, regular cigarette smoking, weekly alcohol use, monthly marijuana use, high body dissatisfaction, high depressive symptoms, and low self-esteem) to form a "high risk" index, and compared those who reported having been violated by a dating partner to those who did not.

Our study findings indicate that dating violence increased the odds of being "high risk" (having three or more of the problems listed above) by 1.8 times for males and 2.2 times for females. This means that males and females who have been abused by a dating partner are more likely than their peers who have not been abused to see the uptake or worsening of at least three of the problem areas noted.

What can we do? First, we can help teens choose respectful people to hang around and develop a plan for how to get out of a potentially violent situation if it arises. Strategies such as dating with trusted individuals, going to public places, carrying a cell phone and cash in the event of an emergency and knowing several important phone numbers by memory may not fully prevent a bad event from happening but may help to deter violence.

Second, screen for abusive dating situations. Ask broad questions that include a number of different acts of violence. For example, asking "Has a date or romantic partner ever physically hurt you? By hurt, I mean slapping, shoving, hitting, restraining by force, punching, or any other use of force that scared you or was painful?" Also, don't assume that violence is limited to opposite-sex relationships; violence can and does occur in same-sex relationships.

Third, try to learn the language of youth culture. Know the differences between "hooking up" versus "hanging out" versus "friends with benefits" versus "boyfriend/girlfriend" and what implications those categories have on sex.

Finally, check-in with teens about their dating life and be observant. Sudden changes in behavior and emotional well-being may be a sign that something may be wrong, so don't hesitate to ask questions.

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'Sweat equity' is a term that describes the time, energy, knowledge and effort put into a situation to make a result. For example, let's say that you want new drapes for your living room windows. You could go out and buy them and hire someone to hang them, which involves little to no sweat on your behalf, but probably costs you a lot of money. Or, you could go purchase some fabric and sew the drapes, install the drapery rod, and hang them yourself . . . saving money but costing you more time, energy, knowledge and effort.

Treatment has a significant 'sweat equity' component. People can come to appointments and talk about their life, but not delve into the core issues and not work on them outside of their appointments. That's minimal sweat, and minimal equity as a result. In that scenario, you don't get much out of the therapy because you aren't putting that much in.

In order to get the most value out of therapy, you will need to spend time both in the appointments and outside of the meetings working on the issues of greatest importance. You will need to find the energy to make changes to your life that may be difficult and draining. You will need to have the knowledge of the issues and how you can improve your life, and know when to involve others in your journey. And you will have to expend a lot of energy and effort toward improving these issues. Alright, so that sounds pretty overwhelming. But isn't the reason for going to therapy because you want something to be different in your life?

It comes up all too often... There's someone in your life that you care about who starts to exhibit some behaviors that make you wonder if he or she has an eating disorder, and you are worried about that person. What can you do?

First, learn more about eating disorders by discussing your concerns with a professional or trusted adult, and consulting a resource on eating disorders.

Next, talk to the person that you are concerned about, but talk to him or her compassionately and in an informal, confidential setting. Express concern for their health, happiness, and safety. Focus your talk on your direct observations (for example, "I notice that you have been skipping lunch lately," or "I've noticed that you are talking about foods as 'good' or 'bad' foods.") and don't label them as having an eating disorder or any other problem for that matter. Ask if there's something going on in their life that is causing distress. Then listen, and listen, and listen.

Third, provide encouragement that whatever they are going through can be treated, addressed or helped. If appropriate, offer to help them find that help if they are willing to seek it.

Then brace yourself for denial. It's possible that your friend isn't ready to hear what you have to say or may not agree, or may even have some explanations for their behaviors. Your goal shouldn't be to convince them that they have a problem. Your goal should be to leave the door open for your friend to trust you and see you as an ally, and to come back and talk with you later.

Finally, consider talking with a trusted person about your own feelings about the situation.

I wrote the following e-book, downloadable for free, for the National Register of Health Providers in Psychology. The motivation behind the book is that many clients wonder what they should be looking for in a therapist. Beyond the practical topics such as location, availability and affordability are so many highly relevant factors in finding a therapeutic relationship that is as good as it can be. If you or someone you know is wondering how to find a therapist that is a good fit for you, I encourage you to read through this e-book resource.

One of the larger obstacles that arises in therapy relates to the fear of trying things that are new or unfamiliar. The anxiety that a person experiences just thinking about making this change can be so great that the person never decides to even try. This is a paralyzing problem in treatment - - not to try something new or forge a different path in life means staying stuck in the same ruts. Trying something new can be anxiety-provoking, of course, but that anxiety can be a good sign, a signal that something is changing for the positive. And the even better news is that in time, with mastery of this thing that is new, the anxiety will gradually lessen and perhaps even go away.

Before you decide that you can't do something because your anxiety is too great, consider if you can break it down into smaller steps that might be more manageable. An analogy that I like to use is this: We can't know the depths of our natural waters without jumping in - - but that doesn't mean we have to jump in without a wetsuit or flotation device! We may still have to jump in, but we can do so with some protection and a good solid back-up plan. Are you ready to dip a toe into the water?