Healthy Adolescent Partner Relationships: Pediatric Mental Health Minute Series

Relationships with peers, including dating and other forms of intimacy, are a common part of adolescence and have substantial impacts on social and emotional development. Healthy relationships can be an important influence on resilience and healthy development, whereas unhealthy relationships can pose critical risks. Pediatricians play an important role in helping young people develop the knowledge, skills, and behaviors to promote healthy adolescent partner relationships and set a foundation for positive and fulfilling relationships into adulthood.

Scope in Pediatrics

• One in four adolescents reports verbal, emotional, physical, or sexual violence each year. These unhealthy patterns can lead to depression, anxiety, and a range of unhealthy behaviors. These experiences may also lead to future risks of violence involvement.
• Teen dating violence is a substantial personal and public health problem, and pediatricians have a critical role to play in educating youth, preventing problems, and responding to difficulties.
• Pediatricians are developmental experts and should take a proactive stance in supporting young people as they experience different types of partner relationships.
• Positive social and emotional development are essential aspects of a healthy adolescence. Promotion of positive development lays a foundation for healthy relationships and behaviors throughout adolescence and into adulthood. Such relationships and behaviors can have a meaningful impact on overall health.
• Close peer relationships are common in adolescence and represent important opportunities to promote positive social and emotional development. However, unhealthy relationships can pose risks which may undermine positive developmental trajectories and overall health.
• During adolescence, youth develop their views and attitudes toward peers, friends, partner relationships, and issues of safety and violence. Pediatricians should begin these conversations with youth during early adolescence.
• Pediatricians are key partners of youth and their parents/caregivers and can help them understand the role of partner relationships in adolescent development. With this understanding, parents/caregivers can support young people as they navigate relationships, model positive relational dynamics, and monitor for any problems that may arise.

Teaching Points

• Pediatricians are an essential influence in guiding youth as they explore partner relationships. Starting early is critical as many youth form attitudes and beliefs about relationships during school age years and begin pursuing relationships in middle school.
• Healthy relationships are based on equality, respect, and trust, and are characterized by honest communication, mutual support, cooperative decision-making, comfort and safety, and clear boundaries.
• Key relationships skills include compromising, negotiation, conflict resolution, and setting boundaries.
• Self-respect and self-love are an essential foundation for youth to engage positively and safely in partner relationships.
• Consent is a critical topic that pediatricians should discuss with youth as part of anticipatory guidance related to positive, healthy, and safe relationships.
• As youth explore relationships without prior experiences to build on, they may rely on perceived norms and overt stereotypes to guide their behaviors and expectations, which can be detrimental.
• Parents, caregivers, older siblings, and other caring adults are key role models and advisers. They can mention position relationship characteristics, model them, and monitor youth over time.
• There is a wide range of fulfilling, healthy relationships – sexual relationships are only one possible type.
• Youth need support in accruing essential knowledge, developing positive attitudes, learning key relational skills, and practicing those behaviors within safe boundaries and supports.
• Understanding the specific importance of cultural and social group memberships as it relates to relationship development is important. Teens who are pregnant and parenting, youth who identify as LBGTQ+, and youth with disabilities or illness are key examples.