The most crucial approach, however, is not easy even for the best intentioned of parents: they must set aside their differences to commit to co-parenting together as well as they possibly can. That is, they have to put the well-being of their kids ahead of their own emotional needs. Divorced parents have to be able to communicate with one another about their children-and to make joint decisions whenever appropriate. They must avoid making negative comments or complaining about the ex-spouse to their children, who greatly resent and suffer from being used as confidantes by their divorced parents. Similarly, children should never be asked to serve as go-betweens to carry messages (or threats) from one parent to another. Parents should also avoid competing for the attention and affection of their children, especially with over-indulgence of material possessions and privileges. When divorced parents are able to maintain civilities, good communication and, especially, strong relationships with each of their children, kids have the best chance of growing up feeling secure, content, and able to cope constructively with adversity.

What unique struggles do teenagers face when their parents divorce?

As teenagers try to assert their autonomy, rebel, and separate from their families, ironically that is when they most need their parents to be stable, emotionally available, and attentive. During a divorce, mothers and fathers usually struggle with their own feelings as well as dramatic changes in living situation, lifestyle, financial resources, and so forth. If parents are distracted, overly focused on their own issues, and unable to parent as effectively, teenagers may become anxious and insecure. It is as if they have lost their safety net. Some teens unconsciously act out, using increasingly outrageous, attention-getting behavior to test how far they have to go before their parents take notice and act. Also, when teens are exploring their own sexuality and dating for the first time, the last thing they usually want is to imagine their parents dealing with these same issues. Even the idea of a sexually active parent can be embarrassing and/or overwhelming to a teen girl, especially if she feels protective of her other parent.

What is the best way for parents to introduce teenagers to a new boyfriend or girlfriend?

Slowly, gradually, and mindfully. It is often awkward and uncomfortable, if not scary, for teenagers to meet the new person in their mothers' or fathers' lives. As described, they may feel judgmental of their parents' choices, especially if they see the new boyfriend or girlfriend as a replacement for their biological parent. Parents should be sensitive to their teenagers' reluctance to meet the new people in their lives. Even after a parent has established a lasting or serious new relationship, they should not assume their teen will be as excited as they are, but rather ask their teen how she feels about meeting the individual. Parents should respect their teens' wishes. Discussing beforehand how and when introductions might take place should help alleviate everyone's discomfort.

Do you have any advice for successfully blending families when there will be stepsiblings?

While parents may well be enthusiastic about remarrying, they have to be exquisitely sensitive to the enormous changes this will cause in the lives of their teenagers-and that children may have feelings about not having any say or control over these momentous life events. Change is usually frightening, difficult, and requires adjustment. Before remarrying, parents and children should have many open and direct discussions about what will take place and when-as well as what will be expected of each family member. Avoid unrealistic goals such as instant and permanent bliss, but rather anticipate inevitable difficulties. Step-siblings should not be expected to get along perfectly-or even necessarily to like one another. Instead, they should be encouraged to be honest and straightforward in carving out new relationships, resolving whatever conflicts arise, and making compromises that will enable the new blended family to live together most peacefully. Planning, flexibility, and communication go a long way in dealing with challenges. Many blended families find that some counseling-either before or after remarriage-can soothe tensions and help prevent minor problems from becoming bigger ones.

Additional resources:

Woman's Divorce
Tips on how to parent your teenager while navigating through your divorce.
http://www.womansdivorce.com/parenting-teenagers-during-divorce.html

TroubledWith.com
Learn how you can build a healthy household and well-adjusted children while going through a divorce.
http://www.troubledwith.com/ParentingTeens/TeensandDivorce.cfm

In general, teen girls often use the control of food to cope with painful feelings that otherwise seem overwhelming. While dieting, bingeing, and purging start out as strategies to feel in more control of their lives, ultimately teen girls damage their self-esteem as well as their physical and emotional health. Anorexia also impedes normal adolescent development. Girls are at greater risk for developing this disorder when they are vulnerable to cultural pressures to be thin; have a history of depression, anxiety, anger, or loneliness; find it hard to express emotions; have troubled family relationships; or struggle with weight and body image. Also at particular risk are girls who have been “model” children or perfectionists.

What can you do if you suspect your daughter has anorexia or bulimia?

Be on the alert for signs of disordered eating in your teen or preteen. While denying they are ill, many girls prepare elaborate meals for others but severely restrict their own intake of calories, especially carbohydrates and fats. These behaviors, along with weight loss, wearing baggy clothing, and avoiding situations in which eating typically occurs, are some of the signs a girl is experiencing anorexia. If parents think their teen daughter might be suffering from anorexia-or even is on the verge of doing so-it is important to discuss your concerns while gently monitoring her food intake. Sit with her when she has her meals, watch what she eats, and make sure she is not purging afterward. Track her weight to document any significant loss. A physician can determine if your daughter's weight is appropriate for her height and build. If you see that her symptoms are not temporary but persist, take her to a qualified professional.

What are the treatments for eating disorders and to whom should one go if they need help?

The first thing parents should know is that left untreated, anorexia can result in starvation and death. So mothers and fathers should act on their concerns as quickly as possible; with intense treatment, there is a better chance of long-lasting recovery. Parents should seek help from psychologists, psychiatrists, and social workers who have specialized training and experience in the treatment of eating disorders. Physicians are usually aware of and able to discuss treatment options. There are outpatient clinics for eating disorders as well as dedicated units within psychiatric and general medical hospitals. Once a teen girl has been brought for an initial evaluation, a team of clinicians can determine the best individualized treatment plan for her, depending upon the severity and pervasiveness of her symptoms, how long she has suffered from the disorder, her medical condition, any associated difficulties, and many other factors.

Treatment for eating disorders can be done on an outpatient basis, in an inpatient facility, through partial hospitalization, or in a residential treatment center. Comprehensive treatment does not just focus on the disordered pattern of eating, but also addresses the underlying emotional difficulties through individual psychotherapy, group counseling, nutritional counseling, family work, and possibly psychiatric medication. Parents need to become advocates for their daughters, finding and implementing the best available treatment to maximize the chance of a full and lasting recovery.

For more information:

The National Eating Disorder Association: www.nationaleatingdisorders.org

For treatment referrals, see the appropriate tab on the above website or try: Eating Disorders Referral and Information at: www.EDReferral.com

Additional resources:

FamilyDoctor.org
From the warning signs to treatment options, a one-stop spot for easy to understand information.
http://familydoctor.org/online/famdocen/home/common/mentalhealth/eating/063.html

MedicineNet.com
A detailed site that reviews the causes, diagnosis, treatment and more.
http://www.medicinenet.com/anorexia_nervosa/article.htm

Girls typically cut themselves to cope with tremendous emotional pain that they otherwise feel powerless to manage. Thus, girls who suffer from low self-esteem, anxiety, depression, or physical or psychological trauma are at greater risk. Whether cutting merely scratches the skin, makes shallow cuts, or results in gashes deep enough to cause scars (typically with scissors or razors), the act results in a satisfying emotional release. Cutting enables teen girls who feel out of control in other areas of their lives to experience some sense of control over their own pain and bodies. In fact, many describe the comfort of transforming psychological pain into physical pain. Others cut as a last resort when they feel desperate to communicate to others how much they are suffering. Cutting is addictive because (a) it feels good, and (b) it releases a rush of adrenaline not unlike a drug. It should be noted, however, that self-injury is not the same as suicidal behavior; the goal of cutting is not death or escape, but rather an attempt to cope with intense pain.

What should you do if you injure yourself on purpose or you know someone who does?

Since self-injury usually occurs in private (in a girl's bedroom or bathroom), it often remains a secret. If a girl is cutting or knows someone else who is, she should realize that no one needs to suffer silently. Help is available. The first step is talking with a trusted adult. If a first attempt isn't helpful, talk to someone else-and keep doing so until you find someone who listens supportively without being horrified or judgmental. School guidance counselors, physicians, favorite relatives, youth group leaders, and therapists are usually knowledgeable about treatment and are in the best position to make appropriate referrals.

Is there a way to prevent this disorder before it starts?

Since girls usually self-injure when they feel powerless and unable to express overwhelming emotions, parents can help prevent this behavior by encouraging open communication as well as teaching and modeling good coping skills. Parents should not only remain attuned to their teenager's feelings, but also encourage her to express the full range of her emotions. Girls are most likely to disclose how they really feel when they are confident of being taken seriously rather than ridiculed or dismissed. To prevent feelings of powerlessness, parents can also give their teenagers age-appropriate choices and say in decision-making. Help girls brainstorm alternative solutions to problems before they seem overwhelming or get out of hand. Role play how girls can best express their feelings and ask people for what they need. That gives girls much-needed practice and confidence before they feel comfortable doing so outside the home. Also, teach girls healthy ways of soothing themselves when they are distressed, such as writing in their journals, exercising, practicing yoga or meditation, listening to relaxing music, taking a bath, reading for pleasure, and so forth. Above all, girls need to know they can come to their parents and express whatever they are experiencing inside, no matter how shameful or scary.

What are some of the treatments for self-injury?

Although many parents are understandably alarmed by their daughters' self-cutting and want to eliminate this behavior, treatment must address the sources of underlying pain and how girls can cope better with emotions. Questions that should be addressed include: What is she feeling? Where is the pain coming from? In what areas of her life does she feel powerless? What is the quality of her family life and relationships with each of her parents? How can she learn to express her feelings more constructively? How can she be taught to soothe herself more adaptively? Along with psychotherapy, girls should be encouraged to do whatever activities are pleasurable and give them a sense of competence and self-worth. Learning new skills boosts confidence. Above all, parents should express their abiding love and support throughout the treatment process, spend enjoyable time with their teens, and keep them safe during periods when they experience the greatest urge to cut.

For more information:

http://www.restoreteens.com/Teenage-Problems/Self-harm-and-Cutting/

Additional resources:

SAFE (Self Abuse Finally Ends) Alternatives Program
A nationally recognized treatment approach, professional network, and educational resource base, which is committed to helping you and others achieve an end to self-injurious behavior.
www.selfinjury.com

Self Mutilators Anonymous
A 12-step support group where men and women share their experiences, strength and hope with each other.
http://www.selfmutilatorsanonymous.org