Seksuell kontroll og -vold i unges relasjoner på tvers av minoritets- og majoritetssamfunn

Utøvere av vold i nære relasjoner: risiko, behandling og utfall.

Early Support after Exposure to Trauma (EASE)

In EASE, the Norwegian Center for Violence and Traumatic Stress Studies is collaborating with governmental agencies, municipalities, user groups, and national and international research partners, with the shared goal of substantially improving access to evidence-based psychosocial services for victims of trauma. With a hybrid effectiveness-implementation trial, we aim to show that an innovative internet-delivered condensed treatment can be a preventive solution that is clinically efficient, cost-effective, and implementable at scale in Norwegian municipalities 

The primary objective of EASE is to determine the effectiveness, cost-benefits, and implementability of Condensed Internet-delivered Prolonged Exposure (CIPE), a preventive psychological intervention for victims after crises and disasters delivered in municipal crisis services. 

The secondary objective is to establish and maintain a strong interdisciplinary and cross-sectional collaboration of organizations involved in psychosocial response to crises and disasters in Norway, including user groups, municipalities, and representatives from county governors, health authorities, and The Norwegian Association of Local and Regional Authorities (KS).  

The overall methodological approach of EASE is a hybrid type I effectiveness-implementation trial. This innovative design is developed to significantly shorten the translational pipeline from research to practice. It combines a traditional randomized effectiveness trial, which enables strong causal interferences about the effect, with the simultaneous investigation and improvement of the implementability of the intervention. In EASE, this design is extended with analyses of cost-effectiveness and the investigation of how health policy impact implementation of CIPE.

Treatment of traumatized children and adolescents, TF-CBT

The study has three objectives:

  1. to give therapists training in a trauma-focused therapeutic model
  2. to implement this model in regular polyclinics
  3. to study the extent to which this therapeutic model is more effective in relation to traumatized children and adolescents than usual polyclinical practice.
The therapeutic model that was examined is Trauma-Focused Cognitive Behavioural Therapy (TF-CBT).
TF-CBT was developed by Ester Deblinger, Judy Cohen and Anthony Mannarino in the USA. It was first used with children exposed to sexual abuse. It has been gradually adapted for use with children who have been exposed to types of traumas other than violence, who have been witnesses to violence and certain disasters. In addition, work is being done to adapt the model for use with children who have been exposed to traumatic grief. Several studies show documented effectiveness, and the treatment principles have been included in ‘Best Practice’ guidelines in the USA and England.
Similar studies have not been conducted in Norway or in the rest of Europe. NKVTS is the first organization to test TF-CBT in Europe. Experiences from this study will also provide the basis for planning similar studies pertaining to the treatment of refugee children and adult refugees.
The study is a randomized, controlled study conducted in regular polyclinics in Norway. Therapists from eight mental health clinics were trained in the model. Other therapists in the clinics were the control group.
Children who meet the criteria for participation were randomly allocated to receive TF-CBT or traeatment as usual. Each is assessed at the start of therapy, during the course of therapy, at the end of treatment, one year after treatment start and at 18 months follow-up. 
International and national partners
Judith Cohen and Anthony Mannarino of the Center for Traumatic Stress in Children & Adolescents in Pittsburg, USA, have assisted in both the training and the research aspects associated with carrying out the project.
Professor Stephen Shirk of the University of Denver has advised on process objectives.
Collaboration with Dr. Lutz Goldberg of the Department for Child and adolescent Psychiatry, University of Ulm, Germany, is established. A joint European cooperation on implementing TF-CBT in Europe has started. 

Implementation of TF-CBT at Norwegian Child and Adolescents’ Mental Health Clinics and Child Advocacy Centers

The effect of TF-CBT has been investigated in a study conducted at eight Child and Adolescents’ Mental Health Clinics (BUP) in Norway. The results of the study showed that the method is more effective for severely traumatized children than therapy as usual. Please find information and results from this study here. The first project period lasted from 2012 to 2017. By the end of 2017, half of the BUP clinics in Norway had participated in the project. You can find additional information about this project here.

In Implementation of TF-CBT at Norwegian Child and Adolescents’ Mental Health Clinics 2018-2021, the aim is to maintain the treatment capacity of TF-CBT at these clinics, and to implement TF-CBT at the remaining clinics so that all children and adolescents who are struggling with posttraumatic stress can receive evidence-based treatment for their symptoms. From 2020, the Child Advocacy Centers will implement TF-CBT to make sure that we reach children in need for trauma focused treatment who do not receive services elsewhere. The implementation have a particular focus on ensuring sustainment of the method through thorough training, guidance and follow-up of TF-CBT therapists.

In line with the research literature, our experiences indicate that leadership support and organizational planning are important for sustained use of TF-CBT with fidelity. We implement and test an empirical and theoretical supported model for implementation leadership. The aim of the research is to investigate whether the inclusion of the Leadership and Organizational Change for Implementation (LOCI) will result in changes in implementation climate and the clinic’s ability to provide TF-CBT to children in need for trauma focused treatment.

The project will use a stepped wedge design to investigate the effectiveness of LOCI in supporting the implementation of TF-CBT. Questionnaires will be used to collect data from therapists and leaders at baseline and after 4, 8, 12, and 16 months. In addition, client data will be collected throughout the study period.

Questions about the project can be addressed to: 
Marianne Skogbrott Birkeland
Project leader 
Implementation of TF-CBT in Norwegian child and adolescent mental health services

 m.s.birkeland@nkvts.no 

Stepping Together for Children after Trauma: Investigating the effectiveness of a parent-led, therapist assisted, treatment for traumatized children (the NorStep study)

Stepping Together for Children after Trauma (Stepping Together CT) is a treatment method for children aged 7-12 years who struggle with symptoms of post-traumatic stress. In the method, parents are included as co-therapists and are given a large part of the responsibility for carrying out the treatment, under the close guidance of a therapist. The method is developed by Professor Alison Salloum and colleagues at the University of South Florida, and has shown good results in the USA. It has not previously been tested in another country.

In the period 2019-2022, NKVTS conducted a pilot study to investigate whether the method is feasible as a low-threshold treatment in the first-line mental health services for children and children in Norway (kommunale tjenester for barn og unge). The results showed that Stepping Together CT was well liked by children, parents and therapists, and that it fits within the framework for treatment in municipal services. However, we do not know whether Stepping Together CT is more effective compared to the treatment usually provided (TAU). To investigate this, a randomised controlled trial (RCT) was started in 2023 in which the participating families are randomly allocated to receive either the Step by Step treatments, or TAU.

The goal is to recruit 160 families to participate in the study, from a total of 30 first-line mental health teams in Norway.

The research questions are:

  • Does Stepping Together CT contribute to better health and functioning for children and caregivers, compared to the ordinary services? 
  • Is Stepping Together CT more cost-effective compared to TAU?
  • Can Stepping Together CT help prevent the future need for health and care services and prescribed medicines?
  • What are the barriers and facilitators for implementing Stepping Together CT into the first-line services?

For more information about the study see:
Trinnvis sammen – NKVTS 

The study has a hybrid effectiveness design type 1, meaning that we investigate both effectiveness and implementation factors.

The research project is funded by the Norwegian Directorate of Health (HDiR), and is conducted in collaboration with the University of South Florida (USF).

The study is pre-registered at Clinicaltrials.gov:  
ClinicalTrials.gov Identifier: NCT05734547 

TREAT INTERACT: Implementing a user involved education- and health system INTERACTive task-shifting approach for child mental health promotion in Uganda

Project aims:

Through intersectoral (health, education, police, community, religious leaders, NGOs, local political leaders) collaboration, the aim is to promote mental health and treat mental health problems among primary school children: 

1.Teachers deliver evidence-based psychosocial support to primary school children.

2.Teachers identify children with mental health problems in primary schools.

3.Teachers refer primary school children with mental health problems to the CAMHS.

The project is divided into four work packages:

1. Develop a school version (mhGAP-IGs) of the mhGAP-IG with user involvement.

2. Implement the adapted mhGAP-IGs in primary schools and investigate effective implementation strategies and teacher outcomes.

3. Implement and test the mhGAP-IG in the mental health system, and investigate an intersectoral supervision, referral and communication model between the health and education sector.

4. Develop implementation advice to guide policy-makers in how to implement and sustain large-scale evidence-informed interventions for youth. 

Work package 1: Intervention and implementation mapping to plan the intervention in a systematic way.

Work packages 2-3: Implement the mhGAP-IG and the mhGAPs and test implementation and teacher outcomes through a stepped-wedge cluster randomized trial where 18 schools will be randomized into 6 cohorts that will receive training in mhGAP within 18 months. Data will be collected at baseline and before and after a new cohort receives mhGAP training.

Work package 4: Participatory action research and framework analysis to develop evidence supported implementation strategies to ensure sustainability.

The Norwegian Center for Violence and Traumatic Stress Studies (NKVTS) is project owner. The project is conducted in collaboration with Makere University of Public Health (Kampala, Uganda). Norwegian collaborating partners are: The Norwegian Institute of Publich Health, University of Bergen, and the Norwegian University of Science and Technology. The research project is supported by grants by the Norwegian Research Council.

The landslide disaster in Gjerdrum municipality: Early intervention and healthtrajectories after mass trauma

This study has two aims. The first is to understand more of what may be typical healthtrajectories after mass trauma for children (age 6 and above) and adults and what predictsthese trajectories (Study 1). The second is to understand what may be effective earlyinterventions to prevent long-term health and psychosocial problems for youth (age 6-19) (Study 2).

By building knowledge related to trajectories after mass trauma and early interventions, this study will contribute with novel knowledge that will make the health system more prepared to reoll out evidence-supported early interventions following mass traumas. 

Study 1: Participants will be followed in a longitudinal design from the first assessmentapproximately 8 weeks after the landslide and every four weeks over a one year period. 

 

Study 2: Participants and their parent will receive treatment based on Trauma-Focused Cognitiv Beahvioural Therapy (TF-CBT). Data will be collected to investigate the effect of the intervention. To versions of TF-CBT will be compared in randomized design,  a verision focused on skills-training and version focused on narrative exposure. 

TF-CBT in Norwegian Child Advocacy Centers

The study will investigate the following three research questions:

  1. How do children and caregivers experience receiving trauma treatment at Child Advocacy Centers?
  2. How do employees at Child Advocacy Centers experience providing trauma treatment within this context? How do they perceive their workdays, and can the use of evidence-based treatment act preventatively for workload? 
  3. What is the prevalence of burnout and secondary trauma symptoms among employees at Child Advocacy Centers, and can individual or job-related factors predict the occurrence? 

Research question 1: Interviews with children and caregivers after they have received treatment with TF-CBT. 

Research question 2: Interviews with professional staff at the Child Advocacy Centers. 

Research question 3: Questionnaire data from professional staff at all Child Advocacy Centers in Norway. 

The project has received ethical approval from REK 9.9.2020 and 26.1.2021, reference nr. 120884 as well as approved DPIA from NSD, reference nr. 469831.

Implementation of TF-CBT at Norwegian Child and Adolescents’ Mental Health Clinics

The effect of TF-CBT has been investigated in a study conducted at eight Child and Adolescents’ Mental Health Clinics (BUP) in Norway. The results of the study showed that the method is more effective for severely traumatized children than therapy as usual. Please find information and results from this study here. The first project period lasted from 2012 to 2017.  You can find additional information about this project here. The second project period lasted from 2018 to 2021 and you can find more information about this project here. By the end of 2021, NKVTS had contributed to implementation in about 80% of the BUPs in Norway.  

In Implementation of TF-CBT 2022-2024 we aim to contribute to implementing TF-CBT to all BUPs of Norway, as well as support the sustainment of TF-CBT in all participating clinics. 

Questions about the project can be addressed to: 
Marianne Skogbrott Birkeland
Project leader 
Implementation of TF-CBT in Norwegian child and adolescent mental health services

m.s.birkeland@nkvts.no 

ZoomIn: Individual dynamics in trauma treatment

Experiencing traumatic events can have significant consequences, both for the individual affected, their close ones, and for society. Youth who have experienced trauma face more mental and physical challenges and have poorer connections to education and the future job market compared to their peers. More than one in four Norwegian youths have experienced one or more traumatic events. 

Common reactions to trauma include re-experiencing, avoidance of reminders of the event, negative thoughts, or feelings, and/or hyperarousal. For many, these symptoms resolve on their own, but for some, the symptoms endure, leading to post-traumatic stress disorder (PTSD). It is therefore important to offer effective treatment for PTSD.

Treatment effectiveness varies

There are several evidence-based treatments for PTSD, but even for the recommended first-line treatment for children and adolescents, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), treatment effectiveness varies considerably. Preliminary figures from 2018-20 suggest that 30-40 % of children receiving TF-CBT do not experience clinically significant improvement and/or drop out. This means that TF-CBT is not equally effective for everyone. 

A better understanding of individual trajectories of change or lack of change would be a useful step towards more personalized treatment. To pinpoint what should be done for youth who do not experience improvement, it would be useful to look at trajectories of change in individual symptoms from before to after treatment and identify common residual symptoms. There is also need for a better understanding of how recovery from PTSD occurs from day to day and how positive improvement in one symptom can be followed by improvement in other symptoms, creating a positive chain reaction.

In collaboration with user panels (youth who have had PTSD as well as therapists), The Norwegian Council for Mental Health (NCMH), and national and international researchers, NKVTS will conduct the first study examining changes in daily symptoms during evidence-based treatment for PTSD, among youth. It is also the first study to investigate individual recovery processes after PTSD. ZoomIn has the potential to contribute to a better understanding of individual change processes, which is necessary to make trauma treatment more personalized and effective for more people.

By combining studies of group-level associations with in-depth studies of individual youths’ symptom levels from day to day, we will have the opportunity to better understand similarities and differences in recovery. This will provide us with more information and new ideas on how TF-CBT can be made more personalized and thereby help even more youth.

Sample data

The project will utilize data from two clinical samples of children and youth aged 8 to 18 years. Both samples have undergone TF-CBT in child and adolescent psychiatric outpatient clinics (BUP). 

  • Sample 1 consists of 567 children who have answered questions about their PTSD symptoms three times – before, during, and after treatment. 
  • Sample 2 consists of 60 youths who have answered daily questions about PTSD symptoms throughout the treatment. Their therapists have also recorded therapy sessions and their content. 

Nasjonal nettportal om vold i nære relasjoner og voldtekt, utvikling og implementering

The ATVT project: A study of processes and outcomes of therapy of men who seek help for their use of violence

The overall objective for the project is to assess the effect of the treatment given at ATV to clients who seek treatment for violence-related problems
The study will be a naturalistic, prospective and exploratory study of process and outcomes. It will be conducted at five ATV offices located in different parts of Norway. All men who meet the criteria for participation will receive an invitation to participate in the study. Measurements will be taken before, during and after treatment, as well as a follow-up one and a half years later. Data collection will comprise questionnaires, clinical interviews and sound recordings of every single hour. The content in the collected data will cover general outcome measurements, specific outcome measurements for the group of clients in question, as well as process measurements such as therapeutic alliance, group climate and session assessments. The study will include 100-150 people.
The issues to be investigated are linked to three areas:

The client group:

  • Background, social affiliation, pre-history of violence, substance abuse, psychological stress factors and personality traits.

Outcomes:

  • Do changes occur in the client himself, his relations to others, in relation to violence?
  • What effects does treatment have on other, more general symptoms?
  • Do any changes remain stable over time?
  • Are there any differences between group and individual treatment in terms of general effect?
  • Are there differences in the effect of treatment for sub-groups of clients?

Process:

  • How do the client and therapist perceive the relationship they have to one another; what contributes to a good relationship?
  • How do the client and therapist evaluate each conversation; what seems to contribute to a positive or negative evaluation?
  • Are there any identifiable characteristic traits in the therapeutic process that appear to contribute to change?
  • What characterizes the process/outcomes for those who respectively attend individual therapy sessions, group therapy or who drop out of treatment?
  • What factors predict dropout?

The terror attack: Experience and reactions among Utøya survivorsThe project manager for this project is Dr. Grete Dyb (PI) and Dr. Synne Stensland is the co- Principle Investigator (PI).

The Utøya massacre is considered a severe trauma due to the scope of injuries and fatalities, the young age of those affected, and the fact that they were designated targets. How individuals cope after extreme stress depends on a number of factors and will vary over time. The study will provide new and important knowledge about the impact of terrorism on young survivors and their families, as well as the course of the trauma and risk factors. This knowledge is essential for planning early interventions and treatment after disasters and other traumatic events.

The overall aim of this study is to identify factors associated with long-term health development and everyday functioning in adolescent and young adult victims of a terrorist attack. The study will also provide knowledge about how young people and their next of kin experienced their encounter with the support system, and how they were met in local communities and schools.

The Utøya study started a few months after the terror attack at Utøya Island on July 22nd 2011. The study has since then become a reputable study which has produced a large number of publications. Through four rounds of data collection, the research project has had a participation of 79 percent (398 survivors).  

The Utøya Study is a prospective, longitudinal interview study, in which data collection has been conducted at four points: 4-5 months, 14-15 months, 30-31 months and 8,9 years after the terror attack. All survivors of the mass-shootings on the Utøya island have been invited to participate in the study. Additionally, the survivors’ parents were invited to participate. Survivors, as well as parents of youth 20 years or younger, were interviewed face-to-face separately. Parents of older survivors received a questionnaire.

The study was approved by the Regional Committee for Medical and Health Research Ethics in Norway.

 Dr. Grete Dyb is the PI and Dr. Synne Stensland is the co-PI for Utøya 4.

Implementation of evidence-based treatment for PTSD in adults

The goal of the project is to implement evidence based treatment for post-traumatic stress disorder (PTSD) in adult specialized mental health clinics all over Norway. The research in the project takes aim at evaluating an implementation program (Leadership and Organizational Change for Implementation; LOCI) and its effect implementation outcomes through a stepped-wedge cluster randomized design. The protocol for the research project can be found here

 

 

 

My everyday life

The main goal of this project is that adolescents with posttraumatic stress disorder (PTSD) will recover as fast as possible. It is also a goal to have more user involvement in treatment of PTSD, and that patients will attain more insight in, and better possibilities to influence, their own therapy courses.

In order to do this we will

1. Develop an app where adolescents with PTSD can learn about and cope their own symptoms, thoughts and feelings, in a user-friendly, fun, useful, and effective way, and

2. Conduct a preliminary assessment of the effect of this app (both from the perspective of users, and with a quantitative pilot study)

The main questions to be explored in this project are therefore: What should the content of this app be, and how should it look, in order to be useful for adolescents in treatment for PTSD? Is the app helpful from the users’ perspectives (both patients and therapists)? Is the app effective in reducing symptoms of PTSD?

The project is approved by the Regional Committee for Medical and Health Research Ethics in South-East Norway (REK), and will be conducted in line with recommendations on data privacy from the Norwegian Centre for Research Data (NSD).

Work package 1: Creating and designing a pilot version of the app

Work package 2: Testing the app

Work package 3: Evaluate the effect of the app

Work package 4: Dissemination and making the app available

To get input on relevant functionality and design of the app, we will undertake interviews of adolescents and therapists, and we will gather information regarding experiences with similar apps. For now, we think that the app will have four main functions:

1) Psychoeducation: The app will provide information about trauma, common reactions, and how recovery can be promoted.

2) Tools: The app includes a variety of breathing and meditation exercises, and suggest ways to cope with trauma reactions.

3) Support to set goals and do the necessary tasks to achieve them: The app encourage the adolescent to set their own goals, and they can schedule reminders to do tasks they have given themselves, and register their accomplishments.  

4). Feedback about their own profile of symptoms and development: Once a day, the participants will be asked to indicate to what extent they have experienced intrusive memories and other symptoms of PTSD that day. Based on this, the app will provide information about what the adolescent and the therapist should focus on.

These are elements that can be changed during the process of developing and designing the app.

This project is funded by the Dam Foundation through The Norwegian Council of Mental Health.

Therapist-reported knowledge, prevalence, and treatment of problematic and harmful sexual behavior among youth receiving services in Norwegian Child and Adolescent Mental Health Clinics

We have the following main aims:

  1. Investigate the therapists’ experiences and concerns about problematic and harmful sexual behavior among children and adolescents referred to child and adolescent mental health clinics.
  2. Investigate what methods, systems, and support therapists have access to when working with children with problematic and harmful sexual behavior.
  3. Explore the therapists experience of competency, support, and self-efficacy, and its relationship with burnout, and secondary traumatic stress.
    We will use a cross-sectional design where data will be collected at one given time point in a pre-defined population including therapists and leaders working in Norwegian child and adolescent mental health clinics. In addition, qualitative interviews will be conducted by a sub-sample of therapists and leaders.
    The study is part of this project.

    Self-reported experiences with exposure and perpetration of problematic and harmful sexual behavior among youth receiving services in Norwegian Child and Adolescent Mental Health Clinics

    We have the following research questions:

    1. What is the prevalence of problematic and harmful sexual behaviour (online and offline) among children referred to child and adolescent mental health services?
    2. What are the association between problematic and harmful sexual behaviour and factors such as physical violene, use of porn, peer pressure, and social support?
    3. What is the relation between exposure and perpetration of sexual violence in youth referred to child and adolescent mental health services?
    A cross-section design where quantitative data will be collected from children and adolescents in Norwegian child and adolescent psychiatric outpatient clinics. 
    The study is related to this project.

    Sexual violence in young people’s close relationships – exposed, perpetrator and institutional frames

    This study has two themes: Young people’s understanding of sexual violence and institutional understanding and handling of sexual violence.  

    The first theme consists of young people’s stories about and understandings of sexual violence in young people’s close relationships. We want to include both young victims, young perpetrators and young people without their own experiences of violence.

    The context of the study is the lived experience of Norwegian youth, both online and offline. Like the non-digital world, the digital arena is a place where young people can be exposed to violence, aggression and abuse. The role digital media plays in sexual violence in young people’s lives will be a central theme in this project.

    The meaning of gender in sexual violence

    One of the aims of the study is to examine how gendered power-relations affect understandings and handling of sexual violence in young people’s relationships. Sexual violence is a gendered phenomenon. Prevalence studies show that young women are most vulnerable.

    The struggle for definition power is played out in interaction with norms for masculinity and femininity. There are institutional and cultural norms that color the understanding of what «making a move» is, what’s crossing the line, and how a sexual offense is understood in a close relationship. How and why something feels like and is perceived by others as sexual violence depends on whether it is the perpetrator or the victim who is allowed to define the situation.

    Handling in schools and in the judiciary system

    The second theme has as an overarching goal to explore the institutional handling of sexual violence in young people’s close relationships. Institutions are understood here as places where young people meet society’s norms and requirements.

    As part of the preparatory work for the empirical studies, we will review relevant case- and management documents, such as action plans, white papers, draft legislation and legislation. We will examine how sexual violence in young people’s close relationships is understood and constructed as an analytical category in these documents. Documents that deal with the schools’ response and duty to act will therefore be included. The two sub-studies firstly deal with the school’s handling and understanding of sexual violence. The second deals with the legal response, with particular emphasis on juvenile punishment.

    Collectively, the studies will shed light on and provide insight into both the understandings of  individuals affected by violence, and the institutional understandings and handling of sexual violence between young people. By examining the discrepancy between young people’s understanding and institutional understandings our findings could help to make it easier to build trust between young people and social institutions. Thus, our study will contribute to more effective prevention.

    The project group will produce a total of four peer-reviewed articles in addition to a Norwegian report. 
    • Individual interviews with young perpetrators and young victims of sexual YIPV
    • Focusgroup interviews with young people in secondary schools
    • Interviews with school staff
    • Interviews with county governors 
    • Interviews with staff at the Norwegian Mediation Service 
    • Document study of court decisions and planning documents from the Norwegian Mediation Service

    Shelters in Norway and Slovakia

    The project consists of three work packages (WP):

    WP 1 – Children and adolescents seeking support from domestic violence shelters. WP leader at NKVTS: Sabreen Selvik. Other participants: Carolina Øverlien.

    WP 2 – Mothers in contact with domestic violence shelters. WP leader at NKVTS: Solveig Bergman. Other participants: Nora S. Ruud. 

    WP 3 – The societal role of the shelters: WP leader at NKVTS: Solveig Bergman. Other participants: Nora S. Ruud.

    Qualitative in depth-interviews with mothers/ fathers, children /adolescents and staff /employees, as well as expert interviews with policy makers, NGO-activists etc. Document analysis. 

    Preventative work in schools for children experiencing domestic violence

    Research estimate that an average of two children in each school class in Norway are exposed to severe child abuse and neglect. Schools are important arenas for preventing CAN at several levels, both before the emergence of violence and through stopping ongoing violence. This is where children spend the main part of their day. Teachers and school nurses are uniquely positioned to see children’s signs if they are in a difficult situation. However, students training to become teachers feel that they do not receive enough education on this topic to be prepared for future work in their profession and personnel working in schools experience issues of CAN as particularly difficult to manage. Children who have experiences with CAN use different strategies to deal with difficult thoughts, often without help from a teacher. Only one in five children exposed to CAN in Norway has been in contact with the support system.

    The primary objective of this study is to generate knowledge, understanding, and experiences from teachers, school leaders, and health nurses about Norwegian primary schools’ preventive work against child abuse and neglect. More specifically: how do professionals in school describe and understand their and other professionals’ roles, responses, and cooperation? Furthermore, what kind of responses and approaches do children victims of child abuse and neglect describe that they need and benefit from being met with at school? Two different qualitative methods will be used to collect data. 

    Two different qualitative methods will be used to collect data. We will conduct 2 profession-specific focus groups with 7 teachers and 7 health nurses and focus groups with 14 children aged 8-16, in addition to individual interviews with the same teachers and health nurses, 7 school leaders, and 7 children victims of child abuse and neglect (aged 8-16).

    Background:
    The project is a public sector Ph.D. in Osloskolen, where the candidate works 75% of the time with research and 25% in the public sector over four years from 2022 to 2026.

    Supervisors:
    Main supervisor: Carolina Øverlien, Norwegian Centre for Violence and Traumatic Stress Studies

    Co-supervisor: Thormod Idsøe, the Department of Special Needs Education, UiO

    Financing:
    The Research Council of Norway

     Utdanningsetaten, City of Oslo 

    Cooperation:
     Norwegian Centre for Violence and Traumatic Stress Studies

    Utdanningsetaten, City of Oslo

    Sofienberg School, Oslo

    The Research Council of Norway

    University of Oslo, Department of Special Needs Education

    Participants:

    Linda Holen Moen, Public Doctoral Research Fellow

    Carolina Øverlien, Professor, Norwegian Centre for Violence and Traumatic Stress Studies and Stockholm University Department of Social Work

    Thormod Idsøe, Professor University of Oslo, Department of Special Needs Education

     

    Veteraners familier: Psykisk helse og hverdagsliv etter utenlandsoperasjoner

    Vold i nære relasjoner og seksuelle overgrep i samiske samfunn

    Unaccompanied minor asylum seekers – Trauma experiences and mental health problems

    The study has three purposes. The first is to acquire more knowledge about the potentially traumatizing experiences that young, single asylum seekers have had before arriving in Norway. The second purpose is to gain more knowledge about the psychological difficulties they have. And the third is to understand more of their longterm mental health problems and acculturation. Knowledge of this type will be important both for the assessment of the individual child’s treatment needs and for planning and preparation of interventions at the care centres that receive young, single asylum seekers.
    The following research issues are to be addressed:

    • What are the experiences that young, unaccompanied asylum seekers have had before their arrival in Norway?
    • To what extent do they have mental health problems?
    • How do their mental health problems develop over time and how do they cope?
    • How do they describe their situation before and during the flight to Norway, and how do they percieve their current situation?
    Semi-structured interview and survey of PTSD, experiences of trauma and general psychological health at three time points: The first is when they are newly arrived to Norway and the second and third is when they have moved to the municipality.

    Custody and visit arrangements

    The goal of this project is to investigate the impact that these amendments have made in terms of legal practice with regard to issues of custody and place of residence for children after divorce.
    Any observable changes in legal practice will be explored on the basis of the rulings made by the Court of Appeal for the years 1998-2000, 2006-2007 and 2012, 2014 and 2015. For the years 1998-2000, a previous analysis of legal practices related to child custody is available (K. Skjørten: Forståelser av overgrep i barnefordelingssaker [Notions of abuse in child custody cases] Tidskrift for familierett, arverett og barnevernsrettslige spørsmål nr. 3-4/2004). The results from this study will now be compared to analyses of more recent material from the courts, after the latest amendments to the Children’s Act that are directly relevant to cases involving alleged abuse.

    RefugeesWellSchool: Preventive school-based interventions to promote the mental well-being of refugee and migrant adolescents (Horizon 2020)

    The RefugeesWellSchool project aims to further the evidence-base on the role of preventive school-based interventions in promoting refugee and migrant adolescents’ mental well-being, and on how such interventions can be implemented in diverse educational contexts. We specifically look at interventions furthering social support and social cohesion, since these factors are known to be highly beneficial for newcomers’ well-being.

    Five interventions – school-mediation intervention, classroom drama therapy, social support groups in refugee classes, support networks on school level, and teachers’ training – will be implemented in six European countries. We will assess the interventions’ long-term impact on newcomers’ well-being (n=2500), particularly their impact on mental health problems, resilience, school attendance/drop-out, and social support.

     

    A mixed-methods longitudinal approach will combine questionnaires completed by adolescents, parents and teachers, focus groups with these groups, data on adolescents’ academic achievements, and an economic assessment of the societal costs and benefits related to the implementation.

    Additionally, focus groups and national committees with other stakeholders will evaluate the impact of contextual factors (e.g., educational system) in order to design models to implement the effective interventions in other contexts. As such, this study will lead to a solid evidence-base on the impact of preventive school-based interventions on young newcomers’ mental well-being and the possibilities to implementing these interventions in differing contexts.

    RefugeeesWellSchool is conducted by a consortium of research institutions in the six participating countries, led by the University of Ghent:

    • Belgium: Department of Social Work and Social Pedagogy, Ghent University
    • Belgium: Education, Culture and Society Research Group, Katholieke Universiteit Leuven
    • Denmark: Danish Research Centre for Migration and Health, Department of Public Health, Copenhagen University
    • Finland: Department of Psychology, University of Tampere
    • Norway: Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS)
    • Sweden: Child Health and Parenting Research Group, Department of Public Health, Uppsala University
    • UK: Centre for Innovation and Research in Wellbeing, School of Education and Social Work, University of Sussex

    The RefugeesWellSchool project is funded by the European Commission under Horisont 2020 (H2020-EU.3.1.2. – Preventing disease: SC1-PM-07-2017 Promoting Mental Health and Well-Being in the Young. Project ID: 754849).

    PROTECT: Prospective Research On Terrorist Events and Collective Trauma

    Unmet health care needs have been found among those exposed to terror attacks. The project further aims to develop a method that can be applied after terrorist attacks and similar events across Europe to allow for coordinated research internationally and to develop knowledge to strengthen the health care delivery to affected individuals and communities.

    The unpredictability and chaotic circumstances of terrorist attacks make it extremely challenging to conduct methodologically sound research in the wake of such events. Previous studies have important limitations. They have usually applied a cross-sectional design and lacked detailed data on health service utilization as well as comparable data from the general population. Furthermore, their results can often not be compared or applied across different settings or countries. There is an urgent need for better knowledge on how to enhance the provision of health services and psychosocial support to terror-exposed individuals and populations. PROTECT assesses both national plans for psychosocial care and health services provided in the wake of terror attacks. The project involves international interdisciplinary collaboration where perspectives from political science have been integrated into the health services research to generate knowledge about the strengths and weaknesses of different health care systems in the context of terrorist attacks. An investigation of the psychosocial care responses to terrorist attacks in Norway, France and Belgium revealed that the responses differed substantially between countries, in spite of available international guidelines for post-disaster psychosocial care and that all countries have universal health coverage with largely publicly financed health services. All countries had plans for the acute provision of psychosocial care, but there were variable and partly scarce information about how to ensure long-term follow-up of those in need of care beyond the acute phase. Furthermore, we identified several differences between the health care systems and characteristics of the attacks that may have impacted the psychosocial care responses. For instance, the provision of acute psychosocial care was primary-care based in Norway, while in France the emergency psychosocial units were mainly composed of professionals from the specialized mental health services. This was also reflected in the research results regarding individuals directly exposed to terrorist attacks, which indicated that the use of General Practitioners (GPs) was clearly more common in survivors of the Utøya attack in Norway than in survivors of the 13 November attacks in France. The findings underscore the need for more systematic monitoring, evaluation and research that can be compared across countries. We further collect longitudinal register-based and administrative claims data on health problems and different types of health service utilization from directly exposed individuals and the general population before and after terrorist attacks. So far, our analyses of register-based data from Norway indicate that it is important to anticipate an increased healthcare utilization several years following terrorist attacks. Both primary care physicians/GPs and practitioners within specialized mental health services played important roles in providing healthcare for psychological problems in young survivors of terrorism, although the health care utilization increased most within specialized mental health services. Norway has universal and mostly publicly financed healthcare and a regular GP-based gatekeeping system. It is important to bear in mind that the healthcare utilization after mass trauma may be different in countries with other health systems or psychosocial care responses. Hereafter, register-based data will be linked with self-reported information from terror-exposed individuals, e.g. about their perceived health, satisfaction with care and other factors that may be important in the planning and implementation of post-disaster health services. This approach may enable both a temporal and geographical comparative perspective with data from before as well as the early and late aftermath of terrorist attacks. This could further provide new and important insight into how the health care needs may change over time, and help us develop better models for follow-up after mass trauma.

    The objectives will be investigated using a temporal and geographical comparative perspective by assessing health service utilization and medication prescriptions before and after attacks in Norway and France.
    PROTECT is funded by the Research Council of Norway. The project is conducted in collaboration with NTNU (Norway), the French National Institute of Health and Medical Research (Inserm) and the French Public Health Agency (Santé publique France)

    Stress responses and health complaints in hospital personnel during the COVID-19 pandemic

    The overall project objectives of this study is to map and monitor exposure to trauma, stress,emerging psychological and somatic reactions among health workers in hospital wards and intensivecare units over time with the aim to identify measures that must be addressed to safeguard the wellbeing of healthcare personnel
    The study recruits health care personnel involved in treatment of hospitalizedpatients infected of Covid-19 in different hospital units in four regionaluniversity hospital in Norway. Participants report on Covid-19 work strainand critical incidents at work, individual and work place related factors,work schedules, levels of psychological distress and health complaintsincluding headache, musculoskeletal pain, sleep problems and burn-out.

    Childhood Experiences of Violence and Abuse – a National Survey of Norwegian Adolescents 12 to 16 Years of Age

    The goal of this study was to contribute to the preventive work and research on violence towards youths and children. The study also presents findings related to the association between violence and abuse in childhood and mental and somatic health during adolescence. The participants that report violence and abuse experiences are also asked about their experiences with accessibility and support from health care services. 

     

    The aim of the longitudinal study is to assess stability and change both at a person- and group level in child abuse and neglect, mental and somatic health, daily functioning and access to health care services.

    The survey was conducted during school hours, and data collection took place during the months of January and February 2019. A total of 9,240 adolescents participated in the study. This constitutes 94.6 % of all students attending school the day of the survey, and 75.5 % of the total gross sample. The survey was web-based, and was administered on PCs or tablets in the classroom. A digital survey format allows for flexibility in follow-up questions, and specifically tailored questions for respondents yielding experiences with child abuse and neglect. The survey comprised five thematically distinct parts: 1) background variables, 2) experiences with child abuse and neglect (including physical violence, psychological violence, sexual abuse by adults and peers, and neglect), 3) health, well-being and quality of life, 4) help-seeking experiences, 5) daily functioning as it pertains to sleep and school. We made use of behavior specific questions which is the recommended survey methodology, also in research on child abuse and neglect.

     

    An abbreviated version of the 2019 survey was administered remotely as a web-based survey in May/June 2020 (wave 2). Children’s experiences of the CORONA-virus preventive measures directed towards children were also assessed. 3564 12-16-yar-olds participated, for which 1439 had participated at the first data collection in 2019.

    In May/June 2021, a third data collection was administered in schools, again as a web-based survey remotely administered. The same topics as covered in 2019 were included in the survey. 3540 12-16-year-olds participated, of which 746 adolescents had participated in 2020 (wave 2) and 521 adolescents participated at all three data collections (wave 1, 2 and 3).

    The study was made possible because of a change in the Norwegian law of health research (Helseforskningsloven § 17) allowing children from the age of 12 years to participate in health research without parental or guardian consent. This can help to guarantee a child’s right to be heard, as stated in the Convention of the Rights of the Child article 12.  

     

    The study was initiated and financed by what was formerly named theNorwegian Ministry of Children and Equality. The ethical approval for this study is made by REK (Regional committees for medical and health research ethics). The study satisfies the ethical requirements for responsible research on children. 

    Cognito: Examining the role of cognitive processes for long-term adjustment after trauma.

    The primary objective of the Cognito project is to better understand the dynamic relationship between core cognitive processes and the development and maintenance of posttraumatic stress symptoms.

     

    We will examine the role of two key cognitive processes for psychological reactions such as symptoms of posttraumatic stress disorder (PTSD), depression and anxiety:

    • Maladaptive appraisals are negative thoughts about oneself, the world, and the future such as “anyone could hurt me” or “I will never be able to have normal feelings again”. Previous studies have found that maladaptive appraisals are highly related to psychological reactions after trauma.
    • Counterfactual thinking (CFT) are mental simulations of alternative outcomes of an event. It can involve thoughts about how a dangerous and frightening situation could have been avoided (upward CFT) or how the outcome could have been worse (downward CFT), and these thoughts can have different qualities regarding emotionality and vividness. Previous studies have found that such thoughts are frequent after trauma, and that they are related to posttraumatic stress reactions. 

     The Cognito project is a part of the Utøya Study. In this project, we use data from survivors after the terror attack at Utøya 22. July 2011, and from the Norwegian RCT-study on TF-CBT.

    The PhD-project is financed by the DAM foundation and the Norwegian Centre of Violence and traumatic stress studies, in collaboration with the Norwegian Council for Mental Health.

    Disclosure – A lifecourse perspective on barriers and facilitatorss to disclose

    The primary objectives of Disclosure are to 1) develop fundamental new understanding of the barriers and  facilitators for disclosure of violence and abuse across the lifespan; and 2) enhance knowledge about how victims reach out to help services, characteristics associated with formal disclosures and how primary care and the police facilitate such disclosures across age – and in different vulnerable groups of society. The secondary objective is to make the data generated from the scientific study of disclosures available to practice and to enable insights from practice guide our interpretation of the research findings. 

    Disclosure seeks to address these issues across the lifespan in two large representative population samples. Further, Disclosure will gain systematic knowledge of victims’ help seeking and associated characteristics by examining data on individuals of all ages seeking help through national helpline services. Finally, a crucial component in preventing violence is implementing evidence-based research in the service sectors and facilitate cross-sectoral collaboration. Disclosure seeks to bridge the gap between research and the service sectors by applying a translational approach including key players from the trauma and violence research field (NKVTS), the low-threshold helpline services (The National Helpline Services for victims of violence and abuse) and specialized services (Oslo Police District). 

    Disclosure is funded by the Research Council of Norway (project no. 341397). 

    Prevalence of violence and abuse in Norway 2021

    Arbeid etter vold: Konsekvensene av vold for arbeidslivet

    En pille for smerten? Bruk av smertestillende, vanedannende medikamenter og utvikling av psykisk sykdom hos unge

    Trust after Sexual Trauma

    Barneverntjenestens arbeid med vold og overgrep

    The Norwegian Youth Victimization and Health Study

    The negative association between childhood victimization and health is well documented. In addition, being exposed to one type of abuse significantly increases the risk for new exposure both for the same and different types of victimization. 

    To date, except from the prevalence of child maltreatment, we have limited knowledge of adolescents’ exposure to different crimes on- and off-line. In addition to child maltreatment, these can be acts of theft, robbery, harassments, youth violence and fraud. 

    We are also still in need of more knowledge regarding the association between being a victim of several types of violence, abuse and crimes and associations with health. Moreover, and related to violence and crime exposure, whether adolescents worry about being victimized and if that impacts their choices in daily life, is understudied and highly relevant in order to understand associations with health and well being.

    The study will provide new and important knowledge on youth victimization rates in Norway and associations with psychological and somatic health and well-being. 

    The main objective of the study is to investigate associations between crime victimization, health and well-being during an age at which exposure to crimes escalate and psychological and somatic health complaints increase. We aim to study victimization in a broad sense, including acts of maltreatment at home and exposure to other crimes outside the family home and online. 

    Treatment and rehabilitation of traumatized refugees (TR-REFUGEES)

    • Aims of the study are:

    • To gain increased knowledge of how psychological health, quality of life, and functioning in everyday life in Norway develop over time – before, during, and after mental health treatment in specialist services

    • To gain knowledge about how pre-flight, flight, and post-flight personal history, potentially traumatic experiences, social and cultural factors relate to the participants’ health and well-being in their exile living 

    • To investigate how the patients and the therapists experience the therapeutic process, and what promotes or hinders a beneficial therapeutic process

    • To examine therapeutic processes in search of factors and interventions that relate to a positive treatment outcome

    A naturalistic, qualitative and quantitative, longitudinal study.

    Approvals: The project was approved by the Regional Ethics Committee REK, by the Data Protection Official, Norwegian Social Science Data Services.

    The project is financed by NKVTS. The project has had 1.5 – 1.0 researchers during various periods.

     

    Treatment and rehabilitation of traumatized refugees  (the umbrella project), 2006 – 2025.

    – A prospective and naturalistic study of 54 patients with refugee and trauma backgrounds who were recruited consecutively as they were admitted to individual treatment in outpatient clinics or by psychiatrists and psychologists in solo- or ’private’ practices within the psychiatric specialist health care system. Therapy sessions were audio taped in the solo practices, but this turned out not to be feasible in the clinics. The objective with audiotaping was to study some treatment processes more closely.

    The project began formal data collection in October 2006, and ended data collection in January 2018. The patients were interviewed up to eight times (each time including one to six interviews) over the course of up to ten years: Upon admission to treatment (T1), one year after our first contact with the patient (T2), three years after our first contact with the patient (T3), whenever treatment was discontinued (Tx), and for many, at additional 2-3 years intervals. At treatment start, we investigated demographics, family relations, personal history, traumatic experiences in childhood, adolescence, and adult years, flight history, experiences of coming to Norway as a refugee, factors pertaining to work and education, and language acquisition in exile. In addition, we assessed personality function, psychological and physical complaints, particularly PTSD, anxiety and depression, social difficulties, resources and interests. Furthermore, the patients and the therapists were interviewed about the treatment process. Questions were also asked about other relevant aspects of the patient’s life, and certain psychometric measurements were repeated. The repeated qualitative interviews and quantitative assessments at follow-ups recorded the changes or fluctuations in the participants’ mental health, well-being, and social situation. Our interviews have comprised 5 to 10 years of the participants’ lives, from treatment start, through treatment of various lengths, and on in life. Publishing from the study is ongoing.

    Publications: See Norwegian Version.

     

    Marianne Opaas’ doctoral degree project (Completed April 29., 2016): "Trauma, personality function, and posttraumatic reactions: A retrospective and prospective study of traumatized refugee patients".

    Main supervisor: Professor Ellen Hartmann, Institute of Psychology, University of Oslo, Norway.

    Assisting supervisor: Sverre Varvin, Dr. Philos., MD, Norwegian Centre for Violence and Traumatic Stress Studies/since fall 2014: Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway (HiOA).

    – An investigation of the connection between background factors, personality function, symptoms of mental distress, quality of life, employment, exile language proficiency, and psychological treatment among the traumatized refugee patients of the main/umbrella study. The Rorschach method was central in the investigation of personality function, supplemented by and compared with a number of other investigative methods.

    Findings:

    In her thesis, Marianne Opaas and co-authors found that childhood adverse experiences were even more strongly related to their present suffering than more recent experiences of war, persecution and other human rights violations (HRVs). Moreover, we found two new Rorschach components or personality dimensions that characterized the way these individuals functioned under the relative stress of assessment: 1) ‘Trauma Response’, along a continuum from constricted (i.e., restrained or limited associative and emotional activity) to flooded (i.e., traumatic intrusions, emotional regulation problems, and logical breaches in thinking), and 2) ‘Reality Testing’, along a continuum from impaired to adequate perceptual reality testing (i.e., ability to notice ordinary aspects of the environment and perceive events and objects in ways that correspond with realities and the ways others perceive them). Perceptual Reality Testing was more strongly related to the participants’ overall mental health and well-being than the other, more trauma-specific variable.

    At the three-year follow-up, the participants’ mean results showed statistically significant improvements in depression, anxiety, PTSD, and quality of life, but the individual variation in outcome was pronounced. At T3 most participants still qualified for a mental health diagnosis. Higher scores on the Reality Testing dimension continued to predict better functioning during follow-up. The problems with reality testing identified in this study were of an apparently trauma-based nature, not to be confused with the reality testing difficulties of psychotic patients.

    Thesis

    Marianne Opaas (2016). Trauma, personality function, and posttraumatic reactions: A retrospective and prospective study of traumatized refugees. Dissertation for the degree PhD, Institute of Psychology, University of Oslo. Permanent link to the dissertation:  http://urn.nb.no/URN:NBN:no-53824

     

    Mehdi Farsbaf’s doctoral degree project (2012 –  discontinued in 2017): "Healing trauma: Curative processes in psychotherapy with traumatized refugees".

    Main supervisor: Sverre Varvin, Dr. Philos., MD, NKVTS, from 2014: HiOA.

    Assistant supervisor: Erik Stänicke, Dr. Psychol, Associate Professor, University of Oslo (UiO).

    Mehdi Farsbaf’s doctoral project was a prospective naturalistic study of the treatment processes of patients with refugee and traumatized backgrounds undergoing psychodynamically-oriented treatment by psychologists and psychiatrists in publicly funded ‘private practice’. The patients were part of the participants of the umbrella project. The project was terminated without completion in 2017. One publication may be forthcoming.

    Health, well-being and working environment after the 22nd of July: A study of Government Quarter and Ministry employees.

    This research will document employees health, working environment and perceived safety and risk at the workplace after the bomb explosion on the 22nd of July 2011.  This project aims to find answers on how a terror attack influences employees health, status of health over time, and how different factors of management and work environment are either beneficial or detrimental on employees health, functioning and life quality. Another objective is to obtain the employees perception of their place of work as secure and safe before the attack, how this perception has been influenced by information, drills or concrete safety procedures, and to what degree does feeling unsafe have on health.
    All employees in the Government Quarter and the Ministries will be invited to participate.

    The study will use a web-based questionnaire.

    The investigation will have a longitudinal design, with at least two points of measurement.
    The first collection of data will take place in February/March 2012. 
    The last one is planned for the summer of 2014.

    Sexual violations in close relationships – perpetrator perspectives

    This project’s main objective is to acquire new knowledge on sexual violence in close or acquaintance relationships by mainly focusing on the perpetrators’ perspective and description of the act(s) of violence. Many sexual violations occur between people who have an established relationship prior to the occurrence of violence. For this reason, ensuring well-founded knowledge of this specific type of violence and the individuals who commit it is essential.

    This project includes qualitative interviews with a number of men who have committed this type of sexual violence. Interpretation and comprehension, both of the violations and of the perpetrators’ sense-making of themselves following the abuse, are central analytical tenets. Thus, we will be able to shed light on how these men interpret their own actions. We examine self-conceptualization, interpretation of acts of sexual violence, situational factors, background factors, life situation and conditions, and motivations, rationalizations and justifications in men who have committed this type of sexual violence.

    This project primarily uses qualitative methods. The majority of the data will be comprised of semi-structured one-on-one interviews.

    This project was part of the Violence in Close Relationships research programme at the Norwegian Centre for Violence and Traumatic Stress Studies (2014-2019).

     

    Previous and current somatic- and psychological health problems amongst children at the Government’s Barnehus (Children’s advocacy center)

    This study will investigate health problems in children at the Government’s Barnehus. What type of contact these children have had with medical- and other welfare services prior to when the violence and abuse was disclosed will also be investigated. We will also see if there were any missed opportunities where the violence could have been disclosed at an earlier time point.  

    Investigate current or previous somatic and psychological health problems in children that are at the Government’s barnehus for forensic interviewing and/or medical examination due to suspected child maltreatment or sexual abuse, and to identify differences in health issues amongst these children compared to other children. 

    Investigate what type of contact the children at the Barnehus have had with medical- and welfare services before the suspicion of abuse and violence was raised.
    Look into if the abuse and violence could have been discovered at an earlier date.
     

    Case-control study will be conducted where health problems in children who come to at the Government’s barnehus for medical examination and forensic interviewing will be compare with health problems in children where violence and sexual abuse is not suspected.

    Qualitative interviews with a thematic analysis will be used to get a more comprehensive picture of prior contact with healthcare and welfare services and the disclosure process.

     

    Trauma and adult learning. Re(gu)lation – refugees’ experiences with helpful strategies for emotional regulation, learning and well-being

    Aims of this study are twofold. First, to deepen our understanding of how adult refugees attending the Introduction Programme experience the impact of trauma on learning. Second, to study the ways refugees are helped, or help themselves, to regulate emotions, thoughts, and behaviour, in order to learn and function the best way possible.
    We will conduct a phenomenological qualitative study among former and/or present refugee participants in the Introduction Programme. The study comprises thirty semi-structured in-depth interviews, and a focus group interview of four to six persons. The in-depth interviews will address topics such as PTEs’ impact on learning and function, and emotional regulation as a potential success factor for adult refugees’ learning. Subsequently, the focus group interview aims to bring forth additional perspectives on the insights obtained from the individual interviews. We will also use questionnaires about past stressful life events, symptoms, and current psychological distress after PTEs; the Stressful Life Events Screening Questionnaire – Revised (SLESQ-Revised), and the PTSD Checklist for DSM-5 (PCL-5).     

     

    Violence in intimate relations: gender, gender equality and power

    The project welcomes students from different disciplines who want to write master theses on relevant topics. 

    The importance of health for the prevention apparatus’ understanding and management of violent extremism

    In recent years, Norwegian municipalities and local police have been required to work to prevent radicalization and violent extremism. In a study of this work from NKVTS (Førde & Andersen, 2018), one of the key findings is that a large proportion of so-called ‘cases of concern’ (bekymringssaker) concern young and adult men with various psychosocial difficulties and challenges. It is not uncommon for cases to be labeled "psychiatry" by the police. Furthermore, these people’s situations are often described with the term «exclusion», and include challenges and vulnerabilities such as unemployment, dropping out of school, substance abuse, experience of violence, social isolation, bullying, mental illness, migration and minority backgrounds (Førde & Andersen, 2018). The challenges thus extend beyond mental health in the narrow sense. Psychosocial health, which also includes the emotional, social and spiritual dimensions of health, can thus be a more useful concept in this context.

    With this as a background, we will in this project explore the role that the prevention services attach to health in a double sense, both specifically in the sense of «the health sector», and as a framework for understanding the phenomenon of extremism. Furthermore, we will look at how the prevention services understands and encounters exclusion in their work against radicalization and extremism, especially within the framework of health. In the project, we will thus combine perspectives from extremism research and health research in an exploration of the relationship between violent extremism and health.

    We aim to provide more knowledge about how violent extremism and related issues can best be prevented by the services, especially in connection with the role of health in this work. Furthermore, we want to shed light on the growing importance of health as an approach to society’s challenges, how perceptions of health are related to various forms of difference, and what advantages and disadvantages an expanded understanding of health can have, not least in relation to democratic values such as individual freedom and diversity.

    Our issues will be analyzed through an exploratory qualitative methodology, where we examine how cases of concern — where there is a suspicion of both extremism and mental illness — are understood and handled in the police, municipalities, welfare services, schools and health. Data on this will be collected through a combination of interviews with employees who handle cases in various instances, and analysis of various documents related to prevention work — such as supervisors and information materials — where a comparison will be made of management documents and practices with the goal of identifying potential similarities / differences and say something about the causes and outcomes of these. It is also being considered to make a systematic survey of the extent of cases of concerns in general and cases where radicalization and suspected psychosocial ill-health come together. 

    Female Genital Mutilatin/Cutting – National centre for competancy

    Development of method in engagement against Female Genital Cutting- Replace Norge

    The main aim is to ensure improved health care for girls’ and women suffering from FGC-related health complications, and to prevent the mutilation of girls based in Norway, and to strengthen the competency among service providers and NGO as well as the network between services and user groups.

    Of the more than 17 000 girls and women in Norway subjected to FGC, most have been cut prior to their immigration. It is therefore important to strengthen preventive work transnationally, and secure health care for those already affected.

    Risk and prevalence of female genital mutilation/cutting (FGM/C) among the immigrant population in Norway – an updated and refined extrapolation study

    We organize the study in two work packages (WP). The first WP aims to identify factors influencing attitudes and behaviors towards FGM/C in Norway and estimate the effect size of migration and acculturation and preventive and protective measures (MAPPM) on attitudes and behaviors towards FGM/C among different affected migrant groups. For this package, we will combine a literature study with the expanded use of Delphi. In the second WP, we will adjust the extrapolated data for the effect of MAPPM calculated in the first WP and estimate the number of girls and women subjected to FGM/C and the number of girls at risk.

    REFUGE-studien: Helse og livskvalitet blant syrere i Norge

    Digitale seksuelle overgrep og krenkelser mot barn og unge – gjerningspersoner, fornærmede og arenaer

    Psychosocial assessment and needs in Ukrainian refugees

    Main objective

    We have recently carried out the pilot study “Should we talk about mental health” and the results indicate that there is both unmet psychosocial health care needs among Ukrainian refugees, as well as a desire to talk about reactions to war and flight soon after arrival. Our findings have provided us with a good knowledge base for planning future research studies on the psychosocial needs of newly arrived refugees from Ukraine.

    We are currently in the process of piloting a survey of psychosocial conditions and support needs in newly arrived children and adolescents from Ukraine. This pilot study will seek to collaborate with community health services in the municipalities in implementation of systematic assessment of psychosocial conditions. This to obtain an overview of the support needs of children and adolescent refugees.

    The main aim of the project is to pilot the systematic implementation of assessment of psychosocial conditions and support needs of recently arrived children and adolescents’ refugees from Ukraine.

    Subsidiary objectives

    Method

    The pilot is a naturalistic cross-sectional implementation study. In collaboration with selected municipalities, we will implement a systematic assessment of children and young refugees’ psychosocial conditions and support needs quickly after settlement. During the study period from June to November 2023, we will request that the municipalities ask all children and adolescents arriving from Ukraine to be assessed, and quantitatively investigate the number of children under 18 years of age who come to the municipality, the number of these who consent (parents of children under 16 ) to assessment, and the number of these who confirm moderate to severe mental or stress-related health problems with the assessment instrument. Through qualitative interviews, we will explore the municipal employees’ experiences with, and barriers to, the use of the assessment instrument. We will also carry out a mid-term evaluation and final workshop with municipal employees, the user group, and international partners.

    Further information

    Assessment instruments in English, Ukrainian and Russian here >