Både spesielt og ikke spesielt : BUP terapeuters møte med ikke-heterofil ungdom

Dette er en studie foretatt blant terapeuter innen Psykisk Helsevern for barn og unge, BUP. Studiens hensikt er å undersøke hvorvidt det er åpenhet rundt temaet ikke-heterofili i terapeuters møte med ungdom, hva åpenhet kan bety i denne sammenheng og hva som hemmer og hva som fremmer åpenhet om temaet. Åpenhet om temaet defineres både som terapeutenes bevissthet om ikke-heterofili og om temaet snakkes om i samtaler med klienter og kolleger. Datamaterialet er basert på et fokusgruppeintervju med 6 terapeuter, hvor fagprofesjonene lege, psykolog, pedagog og sosionom var representert. Studien inneholder en gjennomgang av homofile og lesbiskes livssituasjon i historisk lys og forskning som sier noe om deres situasjon i dag, spesielt levekår for ikke-heterofil ungdom. For å belyse problemstillingen har jeg tatt i bruk teori om ulike måter å forstå natur, kultur og normalitet på, samt teori om underliggende strukturelle forhold som jeg mener har betydning for relasjoner mellom terapeuter og deres klienter. Datamaterialet viser at terapeutene hadde ulike erfaring på å være åpne om ikke-heterofili, fra å åpent annonsere at dette tema kunne ungdom komme og snakke om, til en mer passiv holdning til å la det være en mulighet for ungdom til å ta opp temaet. Med bakgrunn i andre forfatteres rapportering fra hvordan lesbiske og homofile kan oppleve det å møte helsepersonell, konkluderes med at terapeuten må innta en aktivt deltakende rolle for å trygge klienten på at temaet kan tas opp i BUP. Materialet viser at terapeuter på mange måter tar heteronormen for gitt og derfor trenger å bevisstgjøres på hvilke konsekvenser dette kan ha for klientene. Forhold som at temaet ikke-heterofili ennå er preget av stigma og tabu virker inn og hemmer åpenhet om temaet. Dagens offisielle syn på ikke-heterofili som nærmest likeverdig med heterofili gjør temaet vanskelig å ta opp for mange terapeuter. Det er både spesielt og ikke spesielt hvis en ungdom er ikke-heterofil og det oppfattes ikke nødvendigvis som noe som skal tematiseres. Denne mellomposisjon mellom å ta inn over seg en positiv og ikke-diskriminerende holdning overfor ikke-heterofile, samtidig som gamle forestillinger fremdeles, gjerne ubevisst, gjør seg gjeldende, satte mange terapeuter i en posisjon som syntes å virke lammende på åpenhet. Studien viser at terapeutene hadde en uklar holdning til nødvendigheten av kunnskap om ikke-heterofiles livssituasjon og levesett, noe jeg mener bidro til usikkerheten rundt temaet. 5 Konklusjonen er at terapeuter trenger kunnskap og verdidrøftinger for å binge temaet mer opp på dagsorden. I denne sammenheng er bevissthet rundt maktforhold i terapeut-klient situasjonen viktige perspektiver.This is a study of therapists working in an outpatients` clinic within Child and adolescent mental health services. The main purpose of the present work is to study if therapists are open to the subject of non-heterosexuality when meeting adolescents in the mental health service context, what it means to be open about the subject and what the barriers to openness are, and what supports openness. “Openness” about the subject is defined as whether the therapists have a consciousness about non-heterosexuality and if the subject is discussed with clients and colleagues. The data collection is based on a focus group interview among 6 therapists, where the professions of medical doctor, psychologist, teacher and social worker were represented. This study includes a report on how it has been to live like a gay or lesbian in an historical perspective, and previous research about the situation today, particularly focused on adolescent non-heterosexuals. To shed light on the subject matter I have employed perspectives on what is considered biological and cultural explanations on human “nature”. I also look into which underlying, structural conditions may influence the therapist-client relation. The data shows that the therapists had different experiences on openness about nonheterosexuality. Some invited adolescents to talk about the subject of different sexuality. Others played a more passive role, but still wanted clients to feel they had the option to talk about non-heterosexuality. In concordance with other authors` descriptions of how lesbian and gay have experienced their meeting with health care personal, the study finds that the therapist must play an active, participating roll to ensure the client that the subject can be talked about in the mental health clinic. Heteronormativity is taken for granted, and therapists need to be aware of the consequences this assumption has for the client. The stigma and taboo still 6 clinging to non-heterosexuality represses openness around the subject. Today, the official attitude is that being non-heterosexual is no longer of lesser value than being heterosexual. This makes it somehow difficult for therapists to bring up the subject. The fact that nonheterosexuality is both special and not special makes it a subject which is not necessarily natural to raise. The therapist position is somewhat trapped in between a positive, nondiscrimination attitude towards non-heterosexuals and old unconscious heteronormative attitudes. This position seemed for some of the therapists to be somewhat paralysing to openness. The study shows that therapists had no clear ideas about necessity of knowledge about the situation for non-heterosexuals. The conclusion is that therapists need both knowledge and discussions about values to reach the goal of more openness around the subject. Consciousness about hierarchical relationship between therapist and client is important in this context.Master i sosialt arbei

Både spesielt og ikke spesielt : BUP terapeuters møte med ikke-heterofil ungdom

Dette er en studie foretatt blant terapeuter innen Psykisk Helsevern for barn og unge, BUP. Studiens hensikt er å undersøke hvorvidt det er åpenhet rundt temaet ikke-heterofili i terapeuters møte med ungdom, hva åpenhet kan bety i denne sammenheng og hva som hemmer og hva som fremmer åpenhet om temaet. Åpenhet om temaet defineres både som terapeutenes bevissthet om ikke-heterofili og om temaet snakkes om i samtaler med klienter og kolleger. Datamaterialet er basert på et fokusgruppeintervju med 6 terapeuter, hvor fagprofesjonene lege, psykolog, pedagog og sosionom var representert. Studien inneholder en gjennomgang av homofile og lesbiskes livssituasjon i historisk lys og forskning som sier noe om deres situasjon i dag, spesielt levekår for ikke-heterofil ungdom. For å belyse problemstillingen har jeg tatt i bruk teori om ulike måter å forstå natur, kultur og normalitet på, samt teori om underliggende strukturelle forhold som jeg mener har betydning for relasjoner mellom terapeuter og deres klienter. Datamaterialet viser at terapeutene hadde ulike erfaring på å være åpne om ikke-heterofili, fra å åpent annonsere at dette tema kunne ungdom komme og snakke om, til en mer passiv holdning til å la det være en mulighet for ungdom til å ta opp temaet. Med bakgrunn i andre forfatteres rapportering fra hvordan lesbiske og homofile kan oppleve det å møte helsepersonell, konkluderes med at terapeuten må innta en aktivt deltakende rolle for å trygge klienten på at temaet kan tas opp i BUP. Materialet viser at terapeuter på mange måter tar heteronormen for gitt og derfor trenger å bevisstgjøres på hvilke konsekvenser dette kan ha for klientene. Forhold som at temaet ikke-heterofili ennå er preget av stigma og tabu virker inn og hemmer åpenhet om temaet. Dagens offisielle syn på ikke-heterofili som nærmest likeverdig med heterofili gjør temaet vanskelig å ta opp for mange terapeuter. Det er både spesielt og ikke spesielt hvis en ungdom er ikke-heterofil og det oppfattes ikke nødvendigvis som noe som skal tematiseres. Denne mellomposisjon mellom å ta inn over seg en positiv og ikke-diskriminerende holdning overfor ikke-heterofile, samtidig som gamle forestillinger fremdeles, gjerne ubevisst, gjør seg gjeldende, satte mange terapeuter i en posisjon som syntes å virke lammende på åpenhet. Studien viser at terapeutene hadde en uklar holdning til nødvendigheten av kunnskap om ikke-heterofiles livssituasjon og levesett, noe jeg mener bidro til usikkerheten rundt temaet. 5 Konklusjonen er at terapeuter trenger kunnskap og verdidrøftinger for å binge temaet mer opp på dagsorden. I denne sammenheng er bevissthet rundt maktforhold i terapeut-klient situasjonen viktige perspektiver

Improving public cancer care by implementing precision medicine in Norway: IMPRESS-Norway

Background Matching treatment based on tumour molecular characteristics has revolutionized the treatment of some cancers and has given hope to many patients. Although personalized cancer care is an old concept, renewed attention has arisen due to recent advancements in cancer diagnostics including access to high-throughput sequencing of tumour tissue. Targeted therapies interfering with cancer specific pathways have been developed and approved for subgroups of patients. These drugs might just as well be efficient in other diagnostic subgroups, not investigated in pharma-led clinical studies, but their potential use on new indications is never explored due to limited number of patients. Methods In this national, investigator-initiated, prospective, open-label, non-randomized combined basket- and umbrella-trial, patients are enrolled in multiple parallel cohorts. Each cohort is defined by the patient’s tumour type, molecular profile of the tumour, and study drug. Treatment outcome in each cohort is monitored by using a Simon two-stage-like ‘admissible’ monitoring plan to identify evidence of clinical activity. All drugs available in IMPRESS-Norway have regulatory approval and are funded by pharmaceutical companies. Molecular diagnostics are funded by the public health care system. Discussion Precision oncology means to stratify treatment based on specific patient characteristics and the molecular profile of the tumor. Use of targeted drugs is currently restricted to specific biomarker-defined subgroups of patients according to their market authorization. However, other cancer patients might also benefit of treatment with these drugs if the same biomarker is present. The emerging technologies in molecular diagnostics are now being implemented in Norway and it is publicly reimbursed, thus more cancer patients will have a more comprehensive genomic profiling of their tumour. Patients with actionable genomic alterations in their tumour may have the possibility to try precision cancer drugs through IMPRESS-Norway, if standard treatment is no longer an option, and the drugs are available in the study. This might benefit some patients. In addition, it is a good example of a public–private collaboration to establish a national infrastructure for precision oncology. Trial registrations EudraCT: 2020-004414-35, registered 02/19/2021; ClinicalTrial.gov: NCT04817956, registered 03/26/2021

Improving public cancer care by implementing precision medicine in Norway: IMPRESS-Norway

Background Matching treatment based on tumour molecular characteristics has revolutionized the treatment of some cancers and has given hope to many patients. Although personalized cancer care is an old concept, renewed attention has arisen due to recent advancements in cancer diagnostics including access to high-throughput sequencing of tumour tissue. Targeted therapies interfering with cancer specific pathways have been developed and approved for subgroups of patients. These drugs might just as well be efficient in other diagnostic subgroups, not investigated in pharma-led clinical studies, but their potential use on new indications is never explored due to limited number of patients. Methods In this national, investigator-initiated, prospective, open-label, non-randomized combined basket- and umbrella-trial, patients are enrolled in multiple parallel cohorts. Each cohort is defined by the patient’s tumour type, molecular profile of the tumour, and study drug. Treatment outcome in each cohort is monitored by using a Simon two-stage-like ‘admissible’ monitoring plan to identify evidence of clinical activity. All drugs available in IMPRESS-Norway have regulatory approval and are funded by pharmaceutical companies. Molecular diagnostics are funded by the public health care system. Discussion Precision oncology means to stratify treatment based on specific patient characteristics and the molecular profile of the tumor. Use of targeted drugs is currently restricted to specific biomarker-defined subgroups of patients according to their market authorization. However, other cancer patients might also benefit of treatment with these drugs if the same biomarker is present. The emerging technologies in molecular diagnostics are now being implemented in Norway and it is publicly reimbursed, thus more cancer patients will have a more comprehensive genomic profiling of their tumour. Patients with actionable genomic alterations in their tumour may have the possibility to try precision cancer drugs through IMPRESS-Norway, if standard treatment is no longer an option, and the drugs are available in the study. This might benefit some patients. In addition, it is a good example of a public–private collaboration to establish a national infrastructure for precision oncology

Improving public cancer care by implementing precision medicine in Norway: IMPRESS-Norway

Background Matching treatment based on tumour molecular characteristics has revolutionized the treatment of some cancers and has given hope to many patients. Although personalized cancer care is an old concept, renewed attention has arisen due to recent advancements in cancer diagnostics including access to high-throughput sequencing of tumour tissue. Targeted therapies interfering with cancer specific pathways have been developed and approved for subgroups of patients. These drugs might just as well be efficient in other diagnostic subgroups, not investigated in pharma-led clinical studies, but their potential use on new indications is never explored due to limited number of patients. Methods In this national, investigator-initiated, prospective, open-label, non-randomized combined basket- and umbrella-trial, patients are enrolled in multiple parallel cohorts. Each cohort is defined by the patient’s tumour type, molecular profile of the tumour, and study drug. Treatment outcome in each cohort is monitored by using a Simon two-stage-like ‘admissible’ monitoring plan to identify evidence of clinical activity. All drugs available in IMPRESS-Norway have regulatory approval and are funded by pharmaceutical companies. Molecular diagnostics are funded by the public health care system. Discussion Precision oncology means to stratify treatment based on specific patient characteristics and the molecular profile of the tumor. Use of targeted drugs is currently restricted to specific biomarker-defined subgroups of patients according to their market authorization. However, other cancer patients might also benefit of treatment with these drugs if the same biomarker is present. The emerging technologies in molecular diagnostics are now being implemented in Norway and it is publicly reimbursed, thus more cancer patients will have a more comprehensive genomic profiling of their tumour. Patients with actionable genomic alterations in their tumour may have the possibility to try precision cancer drugs through IMPRESS-Norway, if standard treatment is no longer an option, and the drugs are available in the study. This might benefit some patients. In addition, it is a good example of a public–private collaboration to establish a national infrastructure for precision oncology