Green Flags: Preventing Relationship Abuse and Violence – PediaCast 556

Show Notes


  • Dr Megan Letson and Sheryl Clinger visit the studio as we explore teenage relationships and their potential for abuse and violence. Where’s the line between appropriate and abusive behavior? What are relationship red flags… and green flags? Tune in to find out!


  • Teenage Relationships
  • Relationship Abuse and Violence
  • Where’s the Line?
  • Red Flags
  • Green Flags




Episode Transcript

Announcer:     This is Pediacast. ♪♪♪ Welcome to Pediacast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr Mike Patrick:     Hello everyone and welcome once again to Pediacast. It is a pediatric podcast for moms and dads. This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio.

Dr Mike Patrick:     It's Episode 556. We're calling this 1 Green Flags, Preventing Relationship Abuse and Violence. I want to welcome all of you to the program. We'll talk a little bit about what our episode this week is going to focus on, green flags. What exactly are those?

Dr Mike Patrick:     We will get into that in a moment. First, those of you who know me personally or have been listening to this podcast for a long time, we'll know that I have a little bit of roller skating in my past. And really I learned to roller skate when about the same time that I learned how to walk which you know meant a childhood of Visiting the roller skating rink and in fact my parents Managed a skating rink and my first job the age of 10 was working as a disc jockey at this local skating rink. And then I went on to work at a couple of radio stations and then went to medical school and forgot about broadcasting until podcasts came out. And so really DJing at that skating rink really is a part of PediaCast because without that experience, I don't know that I would have gone down this road and been a podcast host.

Dr Mike Patrick:     Well, fast forward to Christmas of 2022 And that skating rink where I grew up had a flood on Christmas Day. There was a water pipe that froze, a very large 1, and it burst. And because no 1 was there, because of the Christmas holiday, the place flooded. And it flooded really badly. And the skating floor was completely ruined.

Dr Mike Patrick:     Now, a lot of skating rinks would have just called it quits at that point and knock the thing down and sold the property, but no, not this skating rink. They spent much of 2023 rebuilding and they tore up the old floor and made commemorative pieces of the old floor and they actually sold those like for 8 bucks each last summer but I found out a bit late because I would have loved to have had 1 of those you know given the history and growing up there and all. And so they cut up pieces of the floor and they embossed them with the Skating Rinks logo and the dates that that floor was available for use. But by the time I found out about it, they were completely all spoken for and I wasn't able to get 1. And then yesterday, miracle of miracles on Facebook, they announced that there were a handful of pieces that were never picked up.

Dr Mike Patrick:     And so a road trip to Springfield, Ohio immediately commenced and they only had 2 left, but I snagged 1. And I put pictures on social media. So if you look up PDA Cast on Facebook, Twitter X, LinkedIn, Instagram, threads, all those places, Just take a look and you'll see what I'm talking about. And I was so excited about it that I had to share that find with all of you. Okay, let's move on.

Dr Mike Patrick:     What are we talking about today? We're talking about relationships and dating with a focus on teenagers. Of course, dating and relationships are normal during the teenage years, but there is potential for trouble in the form of abuse and violence. And abuse is not only a physical, there's also emotional abuse, spiritual abuse, psychological abuse, sexual abuse, all of those things. And it's actually more common than we would like to think.

Dr Mike Patrick:     And so it is really important to check in with our teens and to ask questions about their relationships. And, you know, It also emphasizes the importance of open lines of communication with our kids from a very young age so that when they get to be teenagers and things are a little bit more complicated, maybe a little bit more difficult to talk about, Because we have nurtured open lines of communication and nonjudgmental conversations, we can really do our kids a great service and helping them navigate through healthy relationships and dating. And you know, dating and relationship issues are not always cut and dry. You know, when does appropriate behavior become a problem? What are red flags in relationships, ones that point to the potential for abuse and violence?

Dr Mike Patrick:     And what are green flags, which indicate that a relationship is healthy? Well, stick around because we are going to provide answers to those questions and more. And we have a couple of really terrific studio guests joining us today. Dr. Megan Lettson is chief of child and family advocacy for Nationwide Children's Hospital.

Dr Mike Patrick:     And Cheryl Klinger is director of external affairs for the Center for Family Safety and Healing, also at Nationwide Children's. Don't forget, you can find us wherever podcasts are found and we always appreciate when you leave a review wherever you listen to podcasts so that others who come along looking for evidence-based child health and parenting information, we'll know what to expect. We also have a contact page. If you would like to suggest a future topic for the program, that's over at And then I do want to remind you the information presented in our podcast is for general educational purposes only.

Dr Mike Patrick:     We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your healthcare provider. Also, your use of this audio program is subject to the Pediacast Terms of Use Agreement, which you can find at So let's take a quick break. We'll get Dr.

Dr Mike Patrick:     Megan Lettson and Cheryl Klinger settled into the studio, and then we will be back to talk about teenage relationships. It's coming up right after this.

Announcer:     ♪♪ ♪♪ ♪♪

Dr Mike Patrick:     Dr. Megan Letson is division Chief of Child and Family Advocacy, Program Director of the Child Abuse Fellowship Program, and Medical Director of the Center for Family Safety and Healing, all at Nationwide Children's Hospital. She's also an Associate Professor of Pediatrics at The Ohio State University College of Medicine. Cheryl Klinger is Director of External Affairs with the Center for Family Safety and Healing at Nationwide Children's. Both have a passion for helping teenagers navigate healthy relationships, ones that foster trust, respect, and emotional well-being.

Dr Mike Patrick:     And they are equally passionate about the prevention of relationship abuse and violence. That's what they're here to talk about, healthy relationships. As we answer the question, where's the line and explore the concept of green flags. But before we get into all of that, let's offer a warm PediaCast welcome to our guests, Dr. Megan Letson and Cheryl Klinger.

Dr Mike Patrick:     Thank you both so much for stopping by today.

Dr Megan Letson:     Hi, Dr. Mike. Thank you for having us.

Sheryl Clinger:     Hi, Dr. Mike. It's great to be here with you today.

Dr Mike Patrick:     Yeah, I really appreciate both of you taking time out of your busy schedules to join us. Let's start with you, Megan. What exactly is dating violence and how can that manifest in a relationship?

Dr Megan Letson:     Dating violence is any behavior that causes harm or threatens the risk of harm to a young person by a current or former dating partner. The statistics are actually quite staggering. 1 in 3 teens in the United States is a victim of dating violence, a figure that far exceeds the rates of other types of youth violence. These behaviors can manifest in a number of ways and are typically coercive and manipulative. Also the behaviors often gradually increase in intensity over time.

Dr Megan Letson:     It might start with a partner who says, oh, I just want you to be safe. Please share your location with me while you're out with your friends. But this might turn into a demand to share their location 24-7, or the partner may even show up to events unannounced. So if young people aren't taught what healthy behaviors look like and feel like, it can be difficult to recognize the difference between healthy, unhealthy, and abusive behaviors in a relationship.

Dr Mike Patrick:     Yeah, yeah, absolutely. And it's all kind of context-driven too, right? So like if you, if you know, your partner was going somewhere and you were concerned about them, like maybe you would, it would be okay to share their location because of that circumstance, but then, you know, then it's time to turn that off when we're not concerned anymore. So, and I think that's where I know we've really sort of changed to green flags and we're going to talk about that. There's also a national campaign called Where's the Line?

Dr Mike Patrick:     And I think that that kind of embodies that, you know, what's okay and what's not okay. And there's some things that there's no question it's not okay. And especially as we think about like physical abuse and physical violence. But when we're talking about emotional issues and psychological harm, you know, mental health, that can be a little more difficult to determine what's okay and what's not, correct?

Dr Megan Letson:     Absolutely, and that's part of what the Green Flags campaign is hoping to educate teens and our communities on, is really focusing on what does that healthy relationship look like so that hopefully as things go, you know, if things were to turn and become less healthy, abusive, that people are be able to recognize it.

Dr Mike Patrick:     Yeah, really important. Cheryl, I would imagine that there are some pretty common misconceptions about dating violence and abuse. What are some of those that we should be on the lookout for?

Sheryl Clinger:     A common misconception about dating violence is that it only happens to certain communities or to teens with vulnerabilities. And the reality is that dating violence impacts adolescents from every zip code, income level, race, religion, and nationality. Another common misconception is that dating violence is primarily physical abuse. And teens are more likely to report acts of coercive control, like being isolated from friends or feeling like they can't make choices for themselves, or technology-facilitated abuse, like pressuring for sexting or excessive DMs, than physical abuse. Finally, the most common misconception is that caregivers only need to talk about dating violence with girls because they're more likely to experience abusive behaviors from a partner.

Sheryl Clinger:     Our statistics tell us 1 in 5 girls and 1 in 10 boys will experience dating violence and girls are more likely to experience significant and negative emotional and physical outcomes from abuse. But leaving boys out of the conversation may inadvertently silence those who are experiencing abuse and also avoid accountability for those who are engaged in abuse.

Dr Mike Patrick:     Yeah, absolutely. So really we should think about it in all of the teenagers that we take care of, regardless of their background or where they live or really anything because it really affects everybody. And we not only wanna think about girls, but boys too, and maybe physical abuse isn't as common for boys, but certainly emotional abuse, struggles for power and control are definitely something that's going to be there and we should be thinking about it and as parents and providers not being afraid to talk about it, you know, just to normalize the conversation about relationships. And I guess The earlier of an age that we start to do that the more natural that it'll sound when things get more complicated Because our kids are used to us talking about it. Anyway, megan.

Dr Mike Patrick:     What are green flags then that's the title of our episode today What is the green flags Campaign and then how can that help prevent or raise awareness and then prevent dating abuse and violence?

Dr Megan Letson:     Yes, we are so excited about the launch of our new green flags campaign The green flags campaign educates teens in central Ohio on the characteristics of healthy relationships. It encourages boundary setting, equips youth to identify signs of abuse, and directs them to resources to address and prevent abuse. Teens may not recognize that a relationship is unhealthy or that a particular behavior is considered abusive. What Green Flags can do is help teens recognize what they want from a partner, how to look for those traits in themselves and others, and how to set safe and healthy boundaries. The Green Flags campaign has call, text, and chat support resources that are available Monday through Friday from 8 a.m.

Dr Megan Letson:     Until 8 p.m. Our Green Flags program is operated by a specially trained team of experts that we call Green Flags Pros. These Green Flag Pros address teens' questions and concerns about relationships and dating violence. I think it's also important to highlight that the Green Flags campaign is also a resource for safe adults in our community, such as parents, guardians, and educators. Green Flags is here to help support them and help them talk to their teens and their lives about healthy relationships and dating safety.

Dr Mike Patrick:     Yeah, so when you use the term green flags, my mind goes to also red flags because and especially as we think about relationships like that's a red flag and so I would think red flags are things that raise suspicion that maybe things aren't healthy. And then a green flag though, would be characteristics of a relationship that just give the impression that this is going in the right direction, that this is a healthy relationship. Is that correct?

Dr Megan Letson:     Yep, that is absolutely correct. And we really wanted to focus on those positives to get the word out to help them recognize what is a healthy relationship.

Dr Mike Patrick:     Yep, absolutely. And we will get to the green flags in a moment. I did want to talk a little bit about red flags just so folks can get an idea of the things that we're talking about that could be abusive. So what are some early warning signs that a relationship might be heading down an unhealthy path?

Dr Megan Letson:     A common early warning sign that we see is something called love bombing. For those who aren't familiar, love bombing is a pattern of over-the-top affectionate behavior that often happens at the very beginning of a relationship. Teens will talk about it and say it feels like it's too much too soon. Common signs include buying expensive gifts, especially if these gifts are given in front of a public setting like given to them at school. It can also be spending as much time together as possible and saying intense statements to their partner like, you're my soulmate, or we're only going to be together forever.

Dr Megan Letson:     Another early warning sign that we see is reducing contact with friends and family. A partner might say no 1 else understands our love or our parents are just trying to keep us apart. As a result, a teen might start to pull away from other healthy relationships with families and friends and that really truly can be a sign of an unhealthy relationship.

Dr Mike Patrick:     What are some strategies if that sort of thing is starting that teens could use? So if I'm a parent out there and I'm you know noticing that my kiddos getting a lot of texts and you know I see you know they say I love you love you love you you know if as a parent I'm kind of worried that there might be a red flag how can we best address that?

Dr Megan Letson:     Yeah I think that's a great question it starts with having a conversation with the teen and asking them how they feel about that and trying to explore what else might be going on. Are there other controlling behaviors that you're not aware of? And just starting to develop that relationship or that safe space with your teen and starting the conversation is important.

Dr Mike Patrick:     Yeah, and I guess it's not only parents, but also friends may be the ones who notice this. So this is even if your child, you know, if you have a teenager and maybe they're not in a relationship or you really are not concerned at all with their relationship, this is still a great conversation to have around the dinner table because your teenager might have a friend who is having this issue and then they may be able to be the 1 to kind of point it out and make, kind of check in and make sure that their friend is doing okay. So Cheryl, how can friends and family members identify if someone is in an unhealthy or abusive relationship?

Sheryl Clinger:     Yeah, like we were just saying, it's so important to have that conversation. And I think, you know, 1 thing to really remember is that teens who are engaging in abusive behaviors usually don't want to tell their friends and family. They don't want them to know about their behaviors, so it can be really hard to see something from the outside. Things to look for could be including a controlling attitude towards their partner, like saying things such as, my girlfriend isn't allowed to wear leggings to school. Or a belief that abusive behaviors are acceptable or normal.

Sheryl Clinger:     Saying things such as, everyone looks through their partner's cell phone and their accounts or saying I didn't hit them that was okay and rationalizing that behavior a lot of times I think it's they'll they think because they love them so much and they're, you know, concerned that the person might be jealous. A lot of times we know cell phones have become the important piece of every young teenager's world and they spend a lot of time on those devices talking and communicating with that partner. A lot of times that's really late at night. So teens who are experiencing abuse may not want others to judge their relationship so they'll hide those things or minimize them. Things to look out for, including, you know, them saying, I just don't want to go to soccer anymore, retreating from those school activities or things that they're engaged with, or making changes in their clothing appearances, such as, I just don't want to wear makeup anymore, or I just want to wear baggy sweatpants.

Sheryl Clinger:     You know, you may notice that exhibiting anxiety, hypervigilance, engagement and substance abuse, or other risky behaviors. Again, receiving lots of text messages from their partner late at night.

Dr Mike Patrick:     Yeah, yeah. So really a lot of red flags and as you were going through those, most of them really did make sense. And I think that most parents, if they were aware that those things were going on, and also friends, if you're aware of those things, a little radar goes off. Kind of that's what happened to me as I was listening to you go through those, and I'm sure that parents would feel the same way. And I think that things are even more complicated today compared to 20, 30 years ago because of social media and technology playing a role in all of this.

Dr Mike Patrick:     Cheryl, speak a little bit to how more complicated it is these days with the digital engagement that's pretty much 24-7.

Sheryl Clinger:     It is really Complicated, Dr. Mike. We know that 1 in 4 teens report digital abuse and harassment from their dating partner. Technology-facilitated abuse includes sexual coercion, like pressuring to sext, digital aggression, like sharing an embarrassing photo or a video about a partner or digital monitoring and controlling, like tracking a location. It can also include sextortion, when teens are threatened or coerced into sending explicit images or someone might threaten to expose them in exchange for favor, money, and et cetera.

Sheryl Clinger:     A lot of times images can be real, or they may be in the deep fakes using the AI technology. And that's that artificial intelligence that's available to our young people, and it's really increasing that pressure on our young people.

Dr Mike Patrick:     Yeah, yeah, absolutely. And I mean if there's AI generated images that weren't even real that constitutes harassment. And I think It's really important for parents to talk about all of these things with their kids because your child may make a mistake and send a picture that they aren't proud of and be really embarrassed to tell their parents and then just sort of get deeper and deeper in because they're being threatened for someone to, you know, that they would reveal this and that can even end up, you know, in an extreme case with human trafficking and those kind of things that can be sort of an entrance route in there. And so it's just so important for there to be an open line of communication between kids and parents with no judgment, but just so that kids feel like it's a safe place to be able to talk to their parents when these uncomfortable situations arise. And I guess again, the sooner that we do that with our with our kids, the more comfortable it's going to feel.

Dr Mike Patrick:     Would you agree with that?

Sheryl Clinger:     Absolutely. And we know this is a national trend. So our teams are aware and we're providing education to both professionals and youth on this topic on healthy digital boundaries and how we can support adults and help teenagers navigate media, technology, and relationships. Artificial intelligence is really a new trend that we're starting to see happening for our young people, and it's an emerging topic. And there's a lot of really great information on the website and the Internet Crimes Against Children's Task Force.

Sheryl Clinger:     And that website is, which again is the Internet Crimes Against Children's Task Force. And the root of all of this again is about that power and control. And so I want listeners to know that the Center for Family Safety and Healing is here and we offer free training to support our healthy digital boundaries for our young people. We are able to help Adults navigate how to work with our children and our teens by using media, technology, and relationships. If you want to learn more or schedule a training, you can email us at info at family safety and healing dot org.

Dr Mike Patrick:     Yes, and we will put a link to that in the show notes for this episode over at It's episode 556. And we'll also put links to and the ICAC, which again is Internet Crimes Against Children. And we'll put links so folks can find those very easily and check those out. What other resources are available for those experiencing dating violence?

Dr Mike Patrick:     I would expect that parents are gonna be a fantastic first resource. Really, we wanna get and open those lines of communication. Primary care providers are going to be safe places for kids to talk about anything they want. And hopefully in the teenage years, providers are asking parents to step out at some point during the exam, especially routine physicals and just asking, hey, is there anything else that you want to talk about? And that's something we all learn in medical school to do, but in the course of a busy office practice, sometimes that can get pushed over or pushed out.

Dr Mike Patrick:     And we'd want to remember to do that so that kids have an opportunity to talk to us. But I would suspect that there's other local resources that folks can tap into if you are experiencing abuse or violence, correct?

Sheryl Clinger:     Yes. We know that teens are often worried about reaching out to formal resources for support because they aren't sure if they're ready to take action or if their confidentiality will be respected. So that's why we developed Green Flags. We were very intentional about balancing the need for autonomy and support. We were intentional about the teens being able to reach out anonymously with our Green Flag Pros, so they're really up front about mandated reporting responsibilities.

Sheryl Clinger:     And at the same time, if a Green Flag Pro is really worried about safety, they will encourage that teen to reach out to the next level of support and provide those resources. We want to respect their privacy and we want to help them seek that support. So we encourage our teens and our adults to visit to learn more about our call, text, and chat resources, as well as community resources to support those experiencing dating violence. There is a national teen dating abuse hotline which is Love is Respect. This is available 24-7 and you can learn more at or by visiting the community resource section of

Dr Mike Patrick:     Yes, and we'll obviously put a link to in the show notes as well. You know, in some instances, especially when there already is sort of a pattern of control, you may not feel safe as a teenager reaching out for help because you're worried that you're the partner who you're having an issue with will find out that you're reaching out for help. A browser history, for example, might give it away. And there are other ways too. Megan, are there ways that people can seek help safely when they are in sort of a controlling, abusive relationship?

Dr Megan Letson:     Yeah, this is a great question and a really important 1. Teens are the experts of their relationships and know what support they need in order to feel safe. As I mentioned previously, we have our Green Flag Pros who are available via call, text, and chat and have been trained extensively on safety and knowing how to communicate with teens and ensure their acute safety as well as the longer term safety. So these pros can help teens navigate a plan to increase their safety and decrease their isolation. It's also important that safe adults, like caregivers and medical providers, are upfront and honest about any of their professional responsibilities, including mandated reporting, and that we approach teens with a curiosity instead of judgment when supporting safety and approaching the topic of teen dating violence.

Dr Megan Letson:     We actually have a nice section on our website that Cheryl already mentioned, It's called Be an Advocate section that provides a lot more information about this.

Dr Mike Patrick:     Yeah, absolutely. You know, in addition to like green flags and primary care providers and parents and obviously friends, what role do schools play in supporting victims of dating abuse and violence?

Dr Megan Letson:     Yeah, schools are a key piece, right? Our kids spend a lot of time in the school system. In the state of Ohio, schools actually are required to provide developmentally appropriate instruction in dating violence prevention education and sexual violence prevention education during the health education classes to students in grades 7 through 12. So there is some of this education going on in all schools. The instruction must include recognizing dating violence, warning signs, and characteristics of healthy relationships.

Dr Megan Letson:     I think it's also important to highlight that school counselors, social workers, and mental health specialists that are embedded in schools also play a key role in supporting healthy relationships and making sure that teens know that those resources are available to them. We also know that there are safe, healthy adults in our communities, like coaches, youth leaders, and other caregivers that can support healthier teen relationships and disrupt that unhealthy, abusive, violent behavior earlier if they have training on teen dating violence. So all of these adults in the community can be advocates for teens and provide education about healthy relationships. And that Cheryl was already highlighted, but our center, the Center for Family Safety and Healing, offers free training for safe adults in the community setting.

Dr Mike Patrick:     Yeah, and from a parent standpoint, I mean this is something that, again, even if you're a teenager, you're not worried about abuse in any of their relationships. But someone in the community, you know, at school board meetings, parent-teacher conferences, like it's probably a good idea just to ask the folks in the school like, hey, are you educating our teenagers about dating abuse and violence? And just sort of be in the squeaky wheel in your own school system that can make a difference in the lives of the kids because you're pointing it out and hopefully making it apparent that the school should be considering all of this. Cheryl, another thing I wanted to bring up is from a friendship standpoint, you know, if you are a friend and you notice this is happening, there's probably best practices for bringing this to the attention of your friend Because I feel like it'd be really easy for someone that is in an abusive relationship to, you know, especially when it's sort of gray zone stuff, to become defensive and, you know, kind of explain why this is happening, because you've probably explained it to yourself of why you're still in this relationship.

Dr Mike Patrick:     So what are the best ways to sort of bring this up with your friend and talk about it?

Sheryl Clinger:     Well, we know watching someone you care about going through an abusive relationship is really tough. If someone you know is in an abusive dating relationship, it's important that they get help safely. It's dangerous to tell someone just to leave or get out, especially if they don't have a plan. And you don't wanna just say that to your friend. Don't say, just get out.

Sheryl Clinger:     Make sure they have a plan in place. There's so many things that you can do to support your friend, like expressing your concern for their wellbeing, encouraging them to reach out to professionals who can help them make a safety plan, reminding them of their strengths, and reminding them also that abuse is not their fault. And just being supportive and again, referring folks to

Dr Mike Patrick:     Yeah, and so I do want to turn our attention now to green flags because we've really spent a lot of time here talking about red flags and negative things. What are some green flags that show a relationship is healthy and supportive?

Sheryl Clinger:     Sure, it's about that experiencing engaging. You know, it's about giving and receiving. How do you act when you receive something from your partner? Some of those signs that teens are experiencing in a healthy behaviors from a partner, first that they're open with others about the relationship in their life. For example, they might talk about their relationship with a trusted adult or be excited to share that relationship with their friend.

Sheryl Clinger:     Secondly, they take care of themselves outside of the relationship. For example, they do self-care, they have a great time with their friends and family without their partner. And thirdly, they find success with school and they're engaged with school activities and they feel like they can be their real self or be that same person that they are when they're with their friends, that they are with when they're when they are with their partner. Some other signs that someone is engaging or in healthy behaviors is seeing that power and control in the relationship is equal. For example, they make decisions with their partner and they take responsibility for their actions.

Sheryl Clinger:     Secondly, they have skills to communicate in a healthy way. For example, they talk about the pace of the relationship and if that makes them feel comfortable, both feel comfortable. And they value that partner's opinion and their thoughts. Thirdly, they're able to be vulnerable with that partner and that will help them be successful in their relationships. These are skills that teens can develop and learn and not Everyone will have all of them, but they can get help on navigating those so that they can be successful.

Dr Mike Patrick:     Yeah, yeah, absolutely. So I wanna just rephrase those again, those 3 things, because they really are so important. And it's something that parents can really get an idea of what's going on if you, if you think through the lens of these 3 things. And the first was if, you know, in the relationship, obviously you have a lot of activities and you're doing things together, but then also having time outside of that relationship and being allowed to have that time outside of the relationship. So your partner is supportive of your other friendships and being with your family and really wants what's best for you, which isn't always being with that partner because no 1 person can meet all the needs of another person.

Dr Mike Patrick:     We really do need community around us. And so just making sure that that is happening and feels comfortable. The second key piece of a healthy relationship and a green flag to watch out for is that shared decision-making and understanding the relationship is give and take so that you, you know, there are times when you're going to do what you want to do. There's times that you're going to kind of give up your own exciting thing and do something that your partner wants to do. And that's really part of a healthy relationship for all of us, not just teenagers, but adults as well, is just, you know, putting your partner first.

Dr Mike Patrick:     And then if you do that, hopefully your partner is also putting you first. And so really is a sort of a give and take in the relationship. And then number 3 is just being vulnerable and understanding that you're going to have some hardships and you're going to feel icky sometimes and it's okay to talk about that and to talk about where those feelings might be coming from both with your partner, but then also with your friends and your parents and maybe folks at school. So that, you know, if you do, and that comes back to sort of to emotional intelligence, right? If we have self-awareness that something's not right, kind of digging into that a little bit and figuring out where's that feeling coming from.

Dr Mike Patrick:     And that's where that you do have to be vulnerable in order to start digging into yourself like that. And I think that's another reason why therapy is such a good thing because it really will can help teenagers dig in and so parents, therapy is a good thing and you can role model that yourself by going to therapy and encouraging your kids to do that as well. So Megan, what then, when we think about these 3 big green flags for relationships, how do those contribute to long-term relationship success?

Dr Megan Letson:     Yeah, research indicates that healthy adolescent romantic relationships are associated with positive long-term outcomes and this includes a decrease in externalizing behaviors as adolescents grow into adulthood. Early education about healthy communication and conflict management skills can increase positive outcomes well into their adult lives.

Dr Mike Patrick:     Yeah, and I can't stress how important that that is. Really, during the teenage years, we're learning how to do relationships as an adult. And so, there's going to be trials and errors. Things are not going to be perfect, just like anything that we learn. But it is so important to figure these things out so that when you are in long-term relationships as an adult, which may be that same relationship that you had as a teenager, but it likely is not, but just learning, you know, how to cultivate green flags is just so important.

Dr Mike Patrick:     Cheryl, what are some ways that teens can, and really, actually, all of us, how can all of us cultivate green flags in our relationships?

Sheryl Clinger:     Yes, green flags can help teens recognize what they want from a partner, how to look at those traits in themselves and others, as well as set healthy boundaries. At the section we have information around relationship facts versus myths, healthy boundaries, digital rights, and safety planning resources.

Dr Mike Patrick:     And again we'll put a link in the show notes to which will goes into more detail I would imagine, right?

Sheryl Clinger:     Yes, it does.

Dr Mike Patrick:     And then how can we recognize green flags as we are starting to date? So when you first meet someone, I would suspect if there's red flags, you know Talk about them or get out But I would imagine you'd want to see if green flags are there before you really kind of dive deep into a relationship Would you agree with that?

Sheryl Clinger:     Yes, absolutely.

Dr Mike Patrick:     And how can teenagers go about vetting their potential partner for green flags versus red flags, especially when you don't know them all that well right out of the gate?

Sheryl Clinger:     That's a great question. I think it's really taking time in that relationship to get to know that person and ask those critical questions and look for common interests.

Dr Megan Letson:     Yeah, I would agree. And I think it goes back to some of those things that you highlighted before about what are green flags. And so I think having teens start to reflect on what is important to them in a relationship and thinking about role models that they might have had with healthy relationships. And it's, you know, Are they still able to take time to do the other things that they enjoy in life? And so I think it all comes back to education.

Dr Megan Letson:     And unfortunately, many teens in our community haven't necessarily had role models of what a healthy relationship looks like. And so I think that's where the education of, you know, whether it's in the schools, in the community, their primary care provider, parents, other caregivers, or people in their lives. It's really important that that education, that foundation gets built.

Dr Mike Patrick:     Yeah, yeah, absolutely. And I also think that kids are always observing relationships that maybe they're not a part of. And so 1 thing that you could do if you're interested in dating someone is really pay attention to the relationship that they have with their friends. Or if you have any information about past relationships that that person might have had. Now obviously, you know, 2 people are going to tell 2 different stories and you know, who knows exactly which 1 is right.

Dr Mike Patrick:     But if you do see patterns that are concerning where green flags are not present, then maybe you wanna think twice about going deeper into that relationship. So the way that folks treat each other is pretty much often on public display, unless it's involved in digital social media stuff, which again, makes it so difficult these days to always know the truth about the folks that you're interested in.

Sheryl Clinger:     That's what's so important about People have that ability to call, text, or chat to talk with a Green Flag Pro. They may not have that trusted adult or know who to talk to, but here is somebody that can help them provide that support.

Dr Mike Patrick:     Yeah, Megan, tell us a little more about the Center for Family Safety and Healing at Nationwide Children's Hospital. We mentioned that both of you are affiliated with the center. What exactly is that?

Dr Megan Letson:     Yeah, the Center for Family Safety and Healing addresses all aspects of family violence, including child maltreatment, teen dating violence, domestic violence, and elder abuse. We actually have many different services at the center to support victims of family violence as well as their caregivers. For example, there are several services that are specifically for children and teens, and I'll highlight a few of them. The first 1 is the Child Assessment Center, which is also, we know, we call it the CAC. And this provides medical evaluation as well as interviews of children who may have experienced child maltreatment or been exposed to family violence.

Dr Megan Letson:     We also have the Fostering Connections Program, which is a specialized clinic that provides comprehensive health care services to children and adolescents who are placed in foster or out-of-home care. And we really serve as their medical home while they're in this alternative placement, providing initial assessments, providing well child care, sick visits, as well as care coordination. The Fostering Connections Program, our whole goal is to streamline their access to all of the necessary medical services that we have as efficiently as possible, knowing that this is often an acute event in their life and they need a lot of support wrapped around them. And then we're also fortunate to have behavioral health services co-located at the center through Nationwide Children's, and this is the Family Support Program. The Family Support Program provides evidence-based trauma treatment counseling for children and adolescents who have a history of child abuse or who have been exposed to family violence.

Dr Megan Letson:     So this is a really great resource for our community. And Cheryl, would you like to share

Sheryl Clinger:     a little bit about our services that we have for adults as well as the prevention services? Yes, we also have adult services for survivors of domestic violence. So we have therapists, we have advocates, we also have a legal team, lawyers for kids that's available to help with legal issues. We have a support team that really is just there for that adult that really needs that extra support. We also have our home visitation programs.

Sheryl Clinger:     We have 2 models. We have Healthy Families America and Nurse Family Partnership. These are home visitation programs that go into the home. And we also provide our prevention education and consultation in the community. That's working with employers, healthcare providers, legal systems, faith leaders, and the public and community education.

Dr Mike Patrick:     Right. And we will put a link to the Center for Family Safety and Healing at Nationwide Children's Hospital in the show notes so that folks can find that easily and they'll be able to connect with you and find out lots more about the various things that you guys do and the services that you provide. And again, that'll be over at in the show notes for this episode 556. So once again, Dr. Megan Lettson, Chief of Child and Family Advocacy at Nationwide Children's Hospital, and Cheryl Klinger, Director of External Affairs for the Center for Family Safety and Healing.

Dr Mike Patrick:     Thank you both so much for stopping by and chatting with us today.

Dr Megan Letson:     It's been my pleasure. Thank you for having me.

Sheryl Clinger:     My pleasure as well. Thank you so much.

Dr Mike Patrick:     We We are back with just enough time to say Thanks once again to all of you for taking time out of your day and making Pediacast a part of it. Really do appreciate that. Also thank you once again to our guests this week, Dr. Megan Letson, chief of child and family advocacy and Cheryl Klinger, director of external affairs for the center of family safety and healing, both from Nationwide Children's Hospital. Don't forget you can find us wherever podcasts are found.

Dr Mike Patrick:     We're in the Apple and Google podcast apps, iHeartRadio, Spotify, SoundCloud, Amazon Music, YouTube and most other podcast apps for iOS and Android. Our landing site is You'll find our entire archive of past programs there, along with show notes for each of the episodes, our terms of use agreement, and that handy contact page if you would like to suggest a future topic for the program. Reviews are helpful wherever you get your podcasts. We always appreciate when you share your thoughts about the show and we love connecting with you on social media.

Dr Mike Patrick:     You'll find us on Facebook, Instagram threads, LinkedIn, and Twitter X. Simply search for Pediacast. Also, don't forget about our sibling podcast. It is similar to this program. We do turn the science up a couple notches and offer free continuing medical education credit for those who listen It's called pediacast cme and of course cme stands for continuing medical education We do offer credit for physicians also nurse practitioners physician assistants nurses pharmacists psychologists social workers and dentists And since Nationwide Children's is jointly accredited by all of those professional organizations, it's likely we offer the exact credits you need to fulfill your state's continuing medical education requirements.

Dr Mike Patrick:     Of course, you want to be sure the content of the episode matches your scope of practice. Shows and details are available at the landing site for that program, You can also listen wherever podcasts are found. Simply search for PDACastCME. Thanks again for stopping by And until next time, this is Dr.

Dr Mike Patrick:     Mike saying, stay safe, stay healthy, and stay involved with your kids. So long, everybody. This

Announcer:     program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.

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