text: Norwegian national and local policies on prevention of violence against children NOVA 2008 CONTENTS I: INTRODUCTION ................................................................................................................ 4 Objectives and background .......................................................................................... 4 Definition and delimitation .......................................................................................... 4 A. The size and nature of the problem .............................................................................. 6 Trends, changed priorities and a broader interpretation of violence against children .................................................................................................................... 6 The size of the problem ................................................................................................ 9 B. Root causes underlying the problem .......................................................................... 11 II: PREVENTING VIOLENCE AGAINST CHILDREN: THE SYSTEM IN PLACE .................................................................................................................................... 12 A. Legal framework and institutional framework ........................................................... 12 1. International legal instruments concerning violence against children acceded to by the country. ..................................................................................... 12 2. National legal instruments concerning the various aspects of violence against children (e.g. prohibition of all forms of corporal punishment of children in domestic legislation) ....................................................................... 13 3. Problems encountered in attempts to improve the application of existing texts and/or supplementing or reforming the national legal framework ............................................................................................................. 17 4. Role and mandate of the various governmental and non-governmental organisations in the data collection, reporting, prevention and protection systems (ministries, agencies, care and support services, scientific community, etc.). ................................................................................... 18 B. Policymaking .............................................................................................................. 19 1. Role and mandate of the various governmental and non-governmental organisations in the data collection, reporting, prevention and protection (ministries, agencies, care and support services, scientific community, etc.) Involvement of stakeholders and how these sectors are involved in the planning process (Consultations, intersectoral advisory committees, working group, etc.) ........................................................... 19 2. Is there an agency taking a lead in setting the agenda for the eradication of violence and coordinating the multisectoral involvement of other stakeholders? ............................................................................................ 25 C. Prevention strategies and their implementation ......................................................... 25 1. Prevention mechanisms.......................................................................................... 25 2. Intervention mechanisms ....................................................................................... 29 D. Capacity development ................................................................................................ 38 1. Training programs .................................................................................................. 38 2 "Surveillance system" – systematic data collection on violence............................. 39 3. Researching violence – investigation of risk factors associated with violence ................................................................................................................. 39 4. Sustainability .......................................................................................................... 40 2 III. FRAMEWORK FOR CHANGE – Conclusions and recommendations .................... 40 A. The System"s achievements and inadequacies. Organization .................................... 40 B. Priorities and policymaking........................................................................................ 42 1 Policymaking........................................................................................................... 42 2. Capacity development ............................................................................................ 45 3 Prevention strategies and their implementation ...................................................... 49 C. Conclusions ................................................................................................................ 50 References ....................................................................................................................... 52 The National report on policies and measures to prevent violence against children has been made possible by economic contribution to the Norwegian Social Research (NOVA) from the Council of Europe and the Norwegian Ministry of Children and Equality. The Ministry is grateful to Mona Sandbaek who has been the project leader, to Elisiv Bakketeig who is the author of the report and to Hafdis Einarsson who has assisted her. In addition The Ministry is also grateful to institutions and organisations for their support and contributions at the national seminar discussing policies and measures in this field. The Ministry hopes that this report will be a constructive contribution to The Council of Europe"s work to develop recommendations and guidelines for policies preventing violence against children. March 2008 Ministry of Children and Equality, Oslo 3 I: INTRODUCTION Objectives and background Violence against and abuse of children constitute a serious violation of children"s rights. The aim of this report is to provide a survey of Norway"s work on prevention of violence against children. The report is part of the work of the Council of Europe on the development of a common European model for prevention of violence against and abuse of children. The work on the development of such a common European model must be viewed in relation to the Council of Europe programme "Building a Europe for and with children". This programme resulted from the Council of Europe Third Summit in May 2005, the aim of which was to foster children"s rights and eradicate all forms of violence against children. The main objective of the programme is to assist decision-makers and contributors to policy formulation in developing national strategies and policy aimed at fostering children"s rights and preventing violence against children. Another anchor in this process is the Council of Europe action plan "Children and Violence". (For more information, see www.coe.int/children. This work must also be viewed in connection with other international processes associated with the work on preventing and combating violence against children. In this connection, the UN study on this issue plays a central role. In 2002, on the initiative of the UN High Commissioner for Human Rights, UNICEF and the World Health Organization, the UN General Assembly decided to make a global study of violence against children. The study has been led by Paulo S. Pinheiro (2006), and is based on answers to a questionnaire from 133 countries, national and regional consultations, talks by invited experts and field studies. Children and young people have been directly involved in this process. One of the main recommendations of the study is that a post of Special Representative of the UN Secretary General be established for this area. This is supported by Norway and the EU. Norwegian NGOs, particularly Norwegian Save the Children, have engaged themselves in work on the study and on following it up. Definition and delimitation Violence Elucidation and analysis of Norway"s work on prevention of violence against children requires clarification of what is to be regarded as "violence"1 in this connection. Views as to what is to be regarded as violence change over time and the term is understood in different ways in different cultural and social contexts. The term covers a broad range of acts and relational and contextual conditions. It can concern physical and mental violence either in the family or outside of it, witnessing of violence between parents or other adults and sexual abuse in or outside of the family. Examples of other forms of violence are forced marriage and female genital mutilation and abuse through trafficking (for example through prostitution or child labour). Violations can also be carried out via the Internet. Violence and abuse do not only occur between adults and children, but also between children. Children and young people may 1 The question of what acts should fall under the term "violence" has been much debated. If the term is given too broad an application, there is a risk of watering it down. On the other hand, too narrow a definition would also be unfortunate. Often, the seriousness of the act will be the basis for deciding whether or not the term violence is to be used. However, the assessment of seriousness also gives rise to challenges. If, for example, one considers only the physical act, this may not in itself appear to be so serious, and the term violence may seem imprecise. at the same time, the context in which the act took place or the subjective experience of the victim may indicate that the act should be designated a violent act. 4 also experience bullying at school. These different forms of violence, abuse and violations have both common and specific features that it is important to be familiar with in order to be able to develop targeted and efficient preventive strategies at both national and European levels. It is outside the scope of this report to provide an account and an analysis of preventive work associated with all of the above-mentioned forms of violence and violations. We have chosen to refer to the range of violations that children are exposed to, while addressing in greater detail some forms of violence that have been paid particularly close attention in national work in this area. We have chosen to place the main emphasis on physical violence against children, children who witness violence2 and children exposed to sexual abuse as these forms of violence are defined by Norwegian legislation, cf. more details concerning this under II (A) (2), below. The violence referred to in the expression "witness to violence" is the violence that the child sees, hears or senses in other ways, but where the violence is not directed against the child itself. The above-mentioned forms of violence have been selected because they constitute core areas of the violence affecting children and have the most general impact area. These forms of violence are often part of the use of violence associated with other forms of violence, for example forced marriage and human trafficking. The report throws light on violence against children both within and outside the context of the family. In addition, we focus on children who are bullied at school. Other areas such as forced marriage, female genital mutilation and human trafficking are dealt with less thoroughly. However, we wish to stress that these priorities have been made owing to the tight time frame for the work, and are not to be interpreted as expressing that these forms of violation are viewed as being of less importance for preventive work. Child The term "child" is used in this report to refer to persons under the age of 18. This is consistent with the definition of child in the Convention on the Rights of the Child, which was implemented in Norwegian law in 2003. The Norwegian Guardianship Act3 (cf. section 1), the Children Act (cf. chapter 8) and the Child Welfare Act (cf. section 1-3) also apply a limit of 18 years of age when specifying what is meant by "child". The Norwegian Penal Code applies several age limits when categorizing different criminal offences associated with sexual abuse of children. The age of consent according to Norwegian law is 16. It is thus not until he or she is 16 years of age that a child may consent to sexual acts. However, these specific age limits will be described in the contexts where they are relevant. Prevention 2 Different terms are used to describe situations where children see, hear or are in other ways exposed to violence between their parents (as a rule, the father"s or stepfather"s violence against the mother). These are expressions such as "to witness violence", "to observe violence", or "to experience the parents" violence". Överlien (2007) has provided an account of the differences in the use of terminology in relation to this form of violence on the basis of Nordic and international research. She herself uses "children who experience Daddy"s violence against Mummy" since the term "to experience" includes all of the senses with which the child perceives the violence. In this report, the expressions "to be exposed to violence" and "to witness violence" are used synonymously in relation to the violence that the child sees, hears or otherwise perceives. This choice has been made because these expressions distinguish more clearly between violence seen, heard or otherwise perceived by the child, where the child has not been directly subjected to physical violence, and violence to which the child is directly subjected. Överlien stresses that, in international research, the expression "to witness violence" is no longer used, among other reasons, because it implies an objectification of the child, removing it from the context of which it is a part. In this report, we have nevertheless chosen to use this expression because it is used in official documents that describe national, regional and local policy in this area. 3 Cf. the Guardianship Act of 22 April 1927 No. 3, the Children Act of 8 April 1981 No.7 and the Child Welfare Act of 17 July 1992 No. 100. 5 In this report, we have chosen to distinguish between primary, secondary and tertiary prevention. General preventive work is often referred to as primary prevention. These efforts are directed at all children and young people, and are designed to prevent the onset of negative developments. Examples of primary preventive work are promotion of attitudes against bullying in day care centres and schools and guidance interviews for parents. By means of secondary prevention, efforts are directed at groups of children and young people where there is a high risk of problems arising. Examples in this area are measures for children of drug and alcohol abusers and measures directed at children and families affected by poverty. Tertiary prevention involves measures that attempt to prevent, reverse or limit the consequences of an established problem or a negative development that has arisen. Examples are guaranteed maximum waiting time for young drug abusers and young people with mental illness, and various methods of treatment (cf. Ministry of Children and Equality circular Q 16/2007). Particularly vulnerable groups A number of groups of children and young people are particularly vulnerable to violence and abuse. This applies for example to children with disabilities, lesbian and homosexual children and young people and children belonging to ethnic minorities. The scope of this report has only allowed a limited elucidation of the specific issues associated with violence against and abuse of these groups. Here too, we wish to stress that this does not express any underestimation of the importance of preventing such acts against these groups of children and young people. A. The size and nature of the problem Trends, changed priorities and a broader interpretation of violence against children The social awareness surrounding violence against children has varied historically during different periods, and this also applies to the forms of violence that have been the focus of attention. At the end of the 1960s and beginning of the 1970s, the women"s movement played a central role in putting violence against women on the agenda. Among other things, this led to the establishment of shelters for battered women. As an extension of this work, there was a growing awareness that children too were affected by physical violence and failure of care in the family. This resulted in renewed attention to child abuse (see Official Norwegian Report NOU 1982:86). However, in the middle of the 1980s, the social focus shifted from physical violence to sexual abuse of children, particularly incest. Such abuses received considerable attention both from the media and from the public authorities, and in many ways dominated this decade (see Bakketeig, 1999). The first scope survey of sexual abuse of children was conducted in 1985 (Sætre, Holter and Jebsen, 1986). Furthermore, from the middle of the 1980s, a number of support measures were established to assist victims of incest and sexual abuse, such as the first support centre for incest survivors (1986). During this period, physical abuse of children was less prominent on the social agenda. The attention associated with sexual abuse and incest reached its peak in 1993 in connection with an extensive case where a number of children were assumed to have been subjected to sexual abuse at a day care centre in Bjugn, a small rural district (the so-called "Bjugn case"). For a period, several persons were under suspicion. Only one person was indicted, and was subsequently found not guilty of sexual abuse both in the domestic courts and in the European Court of Human Rights. This case is important in Norway owing to the extensive press coverage it received (Hva skal vi tro? Etter Bjugn-saken 1994) [What are we to believe? After the Bjugn case, 1994], and contributed to the erosion of 6 the credibility of expert witnesses in such cases, resulting in a more cautious view of whether one can believe children who tell of sexual abuse. One of the results of this was a reduction in the number of cases of sexual abuse of children reported during the years following the Bjugn case (see Olsen, 2007). Towards the end of the 1990s, attention was directed towards forced marriage. The background was a number of cases reported in the media where young girls belonging to ethnic minorities were taken to their parents" country of origin and married against their will. In 1997, the Storting requested the Government to prepare an action plan against forced marriage. As a stage in the work on the action plan, the then Ministry of Children and Family Affairs held a seminar on forced marriage with participants from relevant organizations and public agencies. The purpose of the action plan, which was prepared after the seminar, was to prevent young people from being subjected to forced marriage and to provide better help and support (see Action plans against forced marriage 1998 and 2003). In June 2007, the action plan against forced marriage 2008–2011 was presented. The plan includes 40 measures and is coordinated by the Ministry of Children and Equality. The measures are aimed both against prevention and support, among other ways, by establishing secure residential and treatment facilities for young people over and less than 18 years of age. Public coordination will be strengthened while providing increased support to NGOs. On 11 October 2000, the Storting decided to request the Government to prepare an action plan against female genital mutilation (2001–2003). The action plan gave a unified presentation of how the Government intended to strengthen and further develop efforts to combat female genital mutilation. The action plan was implemented over a period of three years (2001– 2003), and focused both on national responsibilities and on a local project. This included a national programme for implementation of measures against female genital mutilation (the OK project). The project had two purposes: to prevent female genital mutilation and to ensure help for those subjected to it. The project was evaluated in 2005, when it was established that these efforts had resulted in positive effects in a number of areas, among other ways, by promoting greater awareness of the issue of female genital mutilation. At the same time, it was maintained that these efforts were not sufficient (Lien 2005). Appropriate measures in this connection are production of brochures, a handbook for medical and auxiliary personnel and information on legislation. Preventive measures under the auspices of the Primærmedisinsk verksted (Primary Medicine Workshop) have been evaluated and, in summer 2007, 15 emergency measures were implemented, including a 24-hour telephone help line. A new action plan4 against female genital mutilation was presented in February 2008 for the period 2008–2011. The measures are aimed at the following areas: efficient handling of legislation, enhanced competence and dissemination of knowledge, preventive and attitudinal work in affected environments, available medical services, increased efforts in connection with holidays and increased international efforts. With a view to assessing whether the measures are sufficiently targeted and efficient, and to assure the quality of the work, annual assessment reports shall be prepared (cf. Action plan against female genital mutilation 2008- 2011). A survey of female genital mutilation was commenced in 2007. The survey will throw light both on the assumed scope and on whether relevant occupational groups comply with their 4 It is stated on the Ministry"s website that the action plan is the result of a concerted effort by seven ministries, the health service, the child welfare authorities, the school, the day care centres, the police and affected groups (cf. http://www.regjeringen.no/nb/dep/bld/pressesenter/pressemeldinger/2008/Kjonnslemlestelse---fra-privat- anliggend.html?id=499165). 7 statutory prevention obligations. The project report is due to be issued in May 2008. It is planned that the question of compulsory clinical genital examinations of girls will be finally considered when the results of this project have been made available. Immediately after the turn of the millennium, we saw the first signs of public focus on another type of violence against children, the witnessing by children of violence in the home. This form of violence attracted attention in connection with a national focus on combating violence against women. This is documented in the Government"s strategic plan for the mental health of children and young people (2003). In connection with the implementation of the Government"s action plan on violence against women, it was emphasized that provisions for children who witness violence are unsatisfactory. As a stage in the Ministry"s work on preventing and combating violence against women, an attempt was made in 20035 to survey the scope of such violence, among other ways, by investigating the number of enquiries made to the police and to other public services by persons subjected to violence. In this connection, an estimate was also made of the number of children6 affected by such violence. In 2003, the Commission on Violence Against Women also published its report (Official Norwegian Report NOU 2003:31), and the Commission established that, when children are exposed to violence between parents, this is to be regarded as failure of care. In connection with preparation of a new action plan for the interministerial work on combating domestic violence in 2003, children affected by such violence were one of the main target groups and the Government"s measures were set out in the Government"s action plan "Domestic Violence" (2004–2007). At the start of the current decade, human trafficking was at last given a prominent place on the social agenda. Attention was directed at the many thousands of women and children, both girls and boys who were victims of human trafficking in Western Europe. Norway was primarily affected as a recipient country. Human trafficking involves exploitation for various purposes, both for use as labour and for sexual purposes. In the case of Norway, it is particularly exploitation of women and children for sexual purposes that have been focused on. The Government"s action plan against trafficking in women and children with duration from 2003–2005 was coordinated by the Ministry of Justice and the Police. The action plan included 23 measures aimed at ensuring victims of human trafficking protection and assistance, preventing recruitment, limiting the demand, detection and prosecution, and strengthening competence and cooperation. This action plan has later been followed up by the Government"s action plan (2006-2009) "Stop human trafficking" with 18 further measures. In this action plan, the objective is to strengthen the perspective relating to children. The measures directed at children include strengthening of the information to young unaccompanied asylum seekers concerning their rights and entitlement to protection, as well as preventing and clearing up more disappearances from reception centres. Another measure involves the survey of the experience of local and regional agencies in providing assistance to young victims of human trafficking and developing tools for identifying children. Thus far, we have described the development of various forms of violence against children during the period from 1960 to 2007. Bullying and the prevention of such behaviour has been an issue in the school for many years. However, not before the beginning of the 21st century was any systematic work initiated to prevent this form of negative behaviour. As a follow-up 5 This survey was repeated in 2005 (Both surveys can be found at www.jd.dep.no). 6 From 2007, child welfare statistics will include registration of when a child receives assistance owing to exposure to domestic violence (see also chapter II D 2). 8 of Report No. 39 to the Storting on living conditions for children and young people (2001– 2002), a research-based anti-bullying programme developed by Professor Dan Olweus was offered to all municipalities for use in the schools (primary and lower secondary school grades 1–10) in 2003. Later, other programmes have been added, such as "Zero" and "PALS". The approach followed in the latter programme7 is to promote positive behaviour, a supportive learning environment and interaction, and it thus follows a broader approach than other programmes, which have been slanted towards prevention of negative social behaviour of children and young people. In the revision of the new Gender Equality Act a new provision was introduced applying to sexual harassment, cf. section 8a of the Gender Equality Act. This provision imposes on managers of educational institutions the responsibility for preventing and seeking to preclude the occurrence of sexual harassment within their sphere of responsibility, cf. Proposition No. 77 to the Odelsting (2000–2001). An important stage in the preventive work is the Government"s Manifesto against Bullying, where central bodies have committed themselves to giving this work priority. The first time such a manifesto was drafted was in September 2002. This has since been continued as the Manifesto against Bullying for 2006–2008 in cooperation with the Norwegian Association of Local and Regional Authorities, the Union of Education, Norway and the National Parents" Committee for Primary and Lower Secondary Schools (Manifesto against Bullying 2006–2008). These developmental characteristics have resulted in greater breadth in the public authorities" work associated with violence against children. We are more aware than we were before that children are exposed to several different types of violence and violations. This development concerns not only developmental characteristics associated with violence; it also concerns a keener focus on children"s rights as independent individuals following Norway"s ratification of the Convention on the Rights of the Child. The international instruments are actively used in the work on preventing and combating different forms of violence. At the same time, we see a continued need to draw attention to certain types of violence that have a tendency to be lost sight of in violence prevention work. This applies especially to physical abuse of children in general, particularly the smallest children. The size of the problem Knowledge of the scope of violence against children and of the groups particularly exposed to violence is of major importance for being able to plan and carry out efficient preventive work and for being able to implement targeted support measures. This is also emphasized in the Government"s "Strategy for combating sexual and physical abuse of children 2005–2009". In Norway, there is relatively little systematized knowledge of the extent of violence against children. Such knowledge can be obtained, among other ways, by means of self-report surveys, from the number of enquiries registered by various public services and from registrations of crime figures. We have chosen to limit8 the presentation to certain surveys in nationally representative samples associated with the core areas of the report. 7 The book "Positiv atferd og støttende læringsmiljø" ["Positive behaviour and supportive learning environment"] (Arnesen, Ogden and Sørlie 2006) sums up four years" research and development in connection with the school wide intervention model, PALS. 8 See Action plan against forced marriage (2007) for an overview of scope based on enquiries to public services. A survey of female genital mutilation was commenced in 2007 and is due to be completed in 2008, see above). 9 In Norway, a few surveys have been conducted on sexual abuse of children in nationally representative samples. The surveys employ different definitions of sexual abuse, which makes the results difficult to compare. The first nationally representative survey associated with sexual abuse of children was conducted by Sætre, Holter and Jebsen (1986) in 1985. This survey showed that 19 per cent of the women and 9 per cent of the men stated that they had been subjected to sexual abuse one or more times before their 18th birthday. The percentage of responses was relatively low (48 per cent). In 1994, Tambs (1994) conducted a survey of the scope and detrimental effects of sexual abuse of children. However, the percentage of responses was low, only 37 per cent. Of all the persons who responded to the survey, 23.2 per cent reported that they had been subjected to one or more sexual abuses before their 18th birthday (31 per cent of the women and 16 per cent of the men). Since the percentage of responses was so low in both surveys, there is a degree of uncertainty associated with the results. In 2003–2004, a regionally comparative study was also conducted in six countries that are members of the Council of the Baltic Sea States (CBSS), of which Norway is a member. This study has conducted a survey of experience of sexual abuse in a nationally representative sample of school pupils aged 17–19 (Mossige and Abrahamsen, 2007). The most recent survey of a nationally representative sample in Norway is a survey of school pupils aged 18– 19 conducted during the first half of 2007. This survey also includes other forms of violence, which are therefore referred to collectively below. In addition to the above-mentioned surveys several surveys have been conducted of the scope of sexual abuse of children in samples that are not nationally representative (see, for example, Schei, 1990, Schei, Muus and Bendixen 1994, Pedersen and Aas 1995). In Norway, scope surveys have not previously been conducted of nationally representative samples of physical abuse and children who witness violence. During the first half of 2007, a nationally representative survey was conducted by NOVA including physical abuse of children, children who witness domestic violence and sexual abuse of children. In this survey, more than 7000 pupils in their final year of the upper secondary school completed a questionnaire where the main topic was experience of violence and abuse while growing up. In this survey, the percentage of responses is high (77 per cent). As regards physical violence9, 20 per cent of the girls and 14 per cent of the boys stated that they had experienced such an incident (Stefansen 2007). The survey further showed that 9 per cent stated that they had witnessed at least one incident of physical violence against their mother while growing up. The corresponding figure where the father was the victim is 4 per cent (Stefansen 2007). The study showed low figures for respondents" experience of abuse before the age of 13. As regards experiences before the age of 18, 12 per cent of the girls reported experience of unwanted sexual incidents in the form of sexual intercourse, while the corresponding figure for boys was 7 per cent. As regards fondling, the corresponding figure was 23 per cent for girls and 8 per cent for boys. (Mossige, 2007). It is furthermore worth noting that a total of 9 per cent of the girls as against 0.8 per cent of the boys reported being subjected to rape or attempted rape. In reported cases of unwanted sexual incidents, the perpetrator was often in the same age group. A self-report survey has provided information on 15–16 year-olds" experiences of violence and sexual abuse in six counties of Norway. 3.3 per cent of the boys and 4.6 per cent of the girls reported having experienced violence from adults. A far greater proportion had experienced violence from other young people, (23.6 per cent of the boys and 11.8 per cent of the girls). As regards sexual abuse, 1.6 per cent of the boys and 6.1 of the girls reported such experience (cf. Schou, Dyb and Graff-Iversen 2007). 9 The question was phrased as follows: "Has an adult in your family ever hit you on purpose?" 10 Thus far, we have examined some surveys concerning sexual abuse of children, physical violence and children who witness violence. As regards the scope of bullying10, The pupil survey from 200711 shows that 77 per cent of the pupils state that they are never bullied, while three per cent answer that they are bullied several times a week. The analysis shows no significant change in the proportion of pupils who state that they are bullied weekly at school compared with figures from earlier pupil surveys. B. Root causes underlying the problem Just as there are various understandings of what shall be regarded as violence against children, there is also considerable complexity in the understanding of the causes of the violence. These understandings will also partly differ in relation to the different types of violence that children are exposed to. A detailed discussion of such causes is outside the scope of this report. Broadly speaking, it may be said that such causes can be associated with structural conditions in the community conducive to the occurrence of violence against children. Gender, social class and cultural factors are examples of such structural causes. There are also a number of other explanations at the group level, for example systemic theory and social learning theory. Systemic theory posits that the use of violence is partly explained by structural relationships in the family, whereas social learning theory holds that a person who is subjected to violence learns a method for resolving conflicts which is reproduced in the next generation, for example, by the victim of violence in the next round becoming the perpetrator of violence. In addition, there are individual-oriented explanations, such as those associating the use of violence with deviant personality traits of the perpetrator of violence (for example personality disorders, lack of aggression control, etc.). There have been few empirical studies in Norway of the various explanatory models. However, in relation to certain types of violence, the gender orientation is reasonably clear, for example, girls are more vulnerable to sexual abuse than boys, and the perpetrators of such abuse are more often men than women (see Bakketeig 1999, page 24, for an overview of the gender distribution in various scope surveys). Taken as a whole, the patterns in surveys of this form of violence indicate that gender is an important factor in understanding why sexual abuse of children takes place. The national scope survey by NOVA (Stefansen, 2007) shows moreover that the risk of being subjected to gross violence by one"s own parents is associated with living conditions. Young people in immigrant families, in families with poor economy and in families where the mother or father has drug or alcohol problems were more at risk of being subjected to gross violence by parents than other young people. Witnessing of violence and experience of sexual abuse were also associated with corresponding living condition variables. However, since this was a cross-section survey, it does not provide any information on how these living condition variables foster violence and sexual abuse of children. Such knowledge is dependent on more detailed qualitative studies and longitudinal data. Another major factor demonstrated by NOVA"s survey is that exposure to one type of violence increases the risk of exposure to other types of violence. For example, the experience of exposure to partner violence was a risk factor for being subjected to direct violence from 10 We also refer to Dan Olweus, who has played a central role in surveying the scope of bullying. For more information, see http://www.uib.no/psyfa/hemil/ 11 The pupil survey is being carried out for the Norwegian Directorate for Education and Training, and is an Internet-based survey that allows the pupils to assess their own learning environment. The survey is compulsory in the primary and lower secondary school from 7–10 class, and in the first class of the upper secondary school. For other classes, it is voluntary. 11 the mother and particularly from the father. The survey strengthens the assumption that has long been made that, where violence against children is concerned, it is important to focus on preventive work, where different forms of violence are viewed within an overall context. II: PREVENTING VIOLENCE AGAINST CHILDREN: THE SYSTEM IN PLACE A. Legal framework and institutional framework 1. International legal instruments concerning violence against children acceded to by the country. A number of international legal instruments are applied in connection with prevention of violence against children. The general human rights are protected by the European Convention on Human Rights of 1950 as well as by the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights, with additional protocols, both from 1966. The most important convention applied in relation to violence against children is the Convention on the Rights of the Child, where the right of children to be protected from violence, abuse and exploitation is a fundamental right. Both the Convention on the Rights of the Child and the other conventions with their additional protocols are implemented in Norwegian law through the Human Rights Act of 21 May 1999 No. 30. Because children need special protection, the right to protection from violence, abuse and exploitation laid down in the Convention on the Rights of the Child goes further than corresponding rights pursuant to the general human rights. The rights are laid down in the different articles of the Convention on the Rights of the Child. Article 19 of the Convention concerns children"s right not to be subjected to abuse by their parents or anyone else who looks after them. Article 34 protects the right not to be subjected to sexual abuse and articles 35 and 36 regulate the obligation of the signatory states to combat trafficking in children. Other provisions of the Convention on the Rights of the Child may be applied in addition to the provisions referred to here. For example, article 19 must be viewed in connection with article 28, second sentence, concerning discipline in schools, article 37, which prohibits cruel treatment of children, and article 39, which concerns rehabilitation of children subjected to abuse. In addition, in July 2007, a new Council of Europe convention was adopted concerning the protection of children against sexual exploitation and abuse. The Convention contains more specific obligations than the Convention on the Rights of the Child and its additional protocol. The convention was made available for signing on 25 October 2007, and was signed by Norway on the same day. In addition to the above-mentioned conventions, we will also draw attention to the Council of Europe recommendation calling for a Europe-wide ban on corporal punishment of children (Council of Europe 2004). Other relevant international conventions, etc. that have been ratified by Norway are: the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment the UN Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and the UN Convention on Consent to Marriage, Minimum Age for Marriage and Registration of Marriages 12 the Rome Statute of the International Criminal Court ILO Convention No. 138 on the Minimum Age for Employment ILO Convention No. 183 on the Worst Forms of Child Labour the UN Convention against Transnational Organized Crime and its additional protocols, including the Protocol to Prevent, Suppress and Punish Trafficking in Persons Especially Women and Children (often referred to as the "Palermo Protocol"). Norway has also signed – but not yet ratified – the additional protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. In autumn 2007, the Norwegian government is preparing for ratification of this additional protocol. In addition to these conventions, Norway, represented by the Ministry of Education and Research and the Norwegian Directorate for Education and Training, has played a leading role in the establishment of an international OECD network on school bullying and violence, participated in by 22 countries (see Manifesto against Bullying 2006–2008). 2. National legal instruments concerning the various aspects of violence against children (e.g. prohibition of all forms of corporal punishment of children in domestic legislation) Norwegian law has a number of provisions applying to violence against children12. In the Act of 20 June 1891 No. 1 relating to restriction of the application of corporal punishment, it was laid down that "for the furtherance of upbringing, parents and other persons in loco parentis shall be entitled to apply moderate corporal punishment to children under their authority". The provision thus gave parents the right to corporal punishment of their children (and of their employees). This provision was repealed in 1972. However, it was unclear whether the repeal entailed that parents no longer had the right to corporal punishment of their children. Owing to this lack of clarity, section 30 of the Children Act of 8 April 1982 No. 7 was amended in 1987 by the addition of the following sentence: The child must not be exposed to violence or in any other way be treated so as to harm or endanger his or her mental or physical health." The provision thus prohibits the use of violence or other physically or mentally harmful treatment in upbringing of children. Children are also protected from being subjected to violence pursuant to the Penal Code"s provisions concerning bodily assault. Section 228 of the Penal Code is directed against "any person who commits violence against the person of another or otherwise assails him bodily", and protects all persons (including children) against violence. Violence pursuant to section 228 need not involve the use of much force13. In a Supreme Court judgment from 1990, a father was convicted of slapping his 20 month-old son on the mouth so that he was given a swollen lip and a bleeding sore on the inside of the lip (Norwegian Supreme Court Reports 1990, page 1155). Relatively little force is thus required for an act to be deemed violent in the sense used in the section 228 of the Penal Code. Pulling someone by the ear, shaking a person by the shoulders or spanking someone on the seat of his trousers would all be deemed punishable violence pursuant to section 228. The question of parents" use of physical force against children received attention in a ruling by the Supreme Court in 2005 (Norwegian Supreme Court Reports 2005, page 1567). In this case, a stepfather was fined NOK 6000 for taking his two stepsons (9 and 7 years old) up to their room, putting them over his knee and 12 The account under (2) is largely based on an unpublished manuscript by Ragnhild Hennum. 13 For a more thorough account of the lower limit, see Andenæs and Bratholm (1996, page 43 ff.), see also Backer (2006, pages 61–62). 13 giving them three smacks each on the seats of their trousers with the palm of his hand. The Supreme Court deemed the stepfather"s action in isolation to be subject to section 228 of the Penal Code. On the basis of an interpretation of the term violence as used in section 30, third paragraph, of the Children Act and article 19 of the Convention on the Rights of the Child, the Supreme Court found that the stepfather"s action could not be deemed lawful although it was carried out for the purpose of upbringing. However, in the judgment, the statements of the judge delivering the first judgment gave rise to doubt concerning the Norwegian legal position on the question of what is punishable violence against children. For more details concerning this, see below under (3). Norwegian law has a number of provisions directed against sexual abuse of children. Sexual abuses are regulated in various penal provisions dependent on their seriousness and on the age of the children concerned. The Penal Code uses the terms seksuell omgang (sexual activity), seksuell handling (sexual act) and seksuelt krenkende og annen uanstendig atferd (sexually offensive or otherwise indecent behaviour) to denote the sexual abuses. The serious forms of sexual abuse – sexual activity – are punishable pursuant to section 195 of the Penal Code (children under 14 years of age) and section 196 (children between 14 and 16). The punishment prescribed by section 195 of the Penal Code for sexual activity with children under 14 years of age is imprisonment for a term not exceeding 10 years. In the case of sexual intercourse, a penalty of imprisonment for not less than two years shall be imposed, and in such case the maximum sentence is raised to 15 years (cf. section 17 of the Penal Code). In section 195, second paragraph, it is provided that imprisonment for a term not exceeding 21 years may be imposed in the presence of certain aggravating circumstances. The extended penalty scale may, inter alia, be applied if the injured party (the victim) dies or sustains serious injury to body or health or if the act is committed against a child under 10 years of age and there have been repeated assaults. Whether or not the injured party (the victim) consents to the sexual acts is irrelevant to their punishability. The perpetrator shall be punished even if the injured party has consented. An issue that may arise in this type of case is that the perpetrator claims that he thought the child was older than it was in reality. If the perpetrator cannot be blamed for not knowing that the injured party was under 16 years of age, he may claim that he thought the injured party was over 16. The assessment shall be strict (this follows from a Supreme Court judgment from 2005 – Norwegian Supreme Court Reports 2005, page 833). Pursuant to section 195, final paragraph, punishment may be remitted if those who have committed the sexual act are about equal as regards age and development. Considerable age differences between the parties are not tolerated. In accordance with legal usage (see for example Norwegian Supreme Court Reports 1990, page 1217, and Norwegian Supreme Court Reports 1994, page 1000) an age difference of just over four years is on the borderline for what can be accepted. Section 196 of the Penal Code regulates sexual activity with a child who is under 16 years of age (i.e. between 14 and 16 years of age). Pursuant to this section, there is no minimum penalty for sexual intercourse. This thus differs in relation to abuse of a person less than 14 years of age. The consent of the injured party is still irrelevant to the punish ability of the offence. The second paragraph of the provision refers to a number of aggravating circumstances qualifying for a prison term not exceeding 15 years. The circumstances causing extension of the penalty scale are the same as those pursuant to section 195 (see above). Section 196 of the Penal Code contains the same rules as section 195 concerning mistake as regards age and remission of punishment if those who have committed the sexual act are about equal as regards age and development (see above). 14 The term seksuell omgang (sexual activity) is delimited by seksuell handling (sexual act), which includes the less serious forms of sexual act, such as fondling. The punishment for committing sexual acts with children under 16 years of age is imprisonment for a term not exceeding three years. The fourth paragraph of the provision lists a number of aggravating circumstances that qualify for imprisonment for a term not exceeding 6 years. When assessing whether there are aggravating circumstances qualifying for use of the extended penalty scale, particular emphasis shall be placed on the duration of the relationship, whether the act constitutes abuse of a familial relationship, care relationship, position, or relationship of dependence or close trust, and whether the act has been committed in a particularly painful or offensive manner. The third paragraph of the provision states that any person who misleads a child under 16 years of age to behave in a sexually offensive or otherwise indecent manner, as referred to in section 201, shall be liable to imprisonment for a term not exceeding three years. Section 201 of the Penal Code imposes penalties persons who by word or deed behave in a sexually offensive or otherwise indecent manner. The sexually offensive or indecent behaviour is thus punishable when it is perpetrated in the presence of or towards children under 16 years of age (the above alternative includes both letter and telephone). The term sexually offensive or indecent behaviour includes a number of offences. The most usual is perhaps indecent exposure, but voyeurism is also included. Profanity and offensive language may also in certain cases fall within the scope of the provision. There is uncertainty concerning the scope of application of section 201 in protecting children from being subjected to offensive language over the telephone, obscene/sexual text messages and obscene/sexual messages on Internet chat channels. Here there is a lack of legal usage to clarify the scope of the provision. Showing pornographic films for children under 16 years of age or engaging in sexual intercourse in the presence of children under 16 years of age would fall within the scope. Sections 197–199 of the Penal Code apply to sexual activity with close relatives. Sexual activity with close relatives is prohibited regardless of the age of the parties. In relation to sexual abuse of children, the provisions that apply to sexual relationships with relatives only result in more severe penalties. If, for example, a father commits sexual abuse of his 13 year- old daughter, the age aspect of the offence will be judged pursuant to section 195 concerning sexual abuse of a person under 14 years of age while the familial aspect of the offence will fall under section 197, which prescribes penalties for persons who engage in sexual activity with a person in direct line of descent. There are three different provisions in section 19 of the Penal Code that apply to sexual activity between relatives. Firstly, section 197 of the Penal Code prescribes penalties for persons who engage in sexual activity with a relative in direct line of descent (children, grandchildren, etc.). The punishment is imprisonment for a term not exceeding 5 years. Both biological children and adopted descendants are regarded as relatives in direct line of descent. Only the most serious forms of sexual act (sexual activity) are punishable pursuant to this provision. Section 198 of the Penal Code prescribes penalties for persons who engage in sexual intercourse with a brother or sister. The penalty is imprisonment for a term not exceeding one year. This provision does not apply to any form of sexual activity – only sexual intercourse is punishable. The second paragraph of the provision provides that no penalty shall be imposed on persons under 18 years of age. Section 199 of the Penal Code applies to what may be referred to as social relatives. The provision prescribes penalties for engaging in sexual activity with a foster child, a child in his 15 care, a stepchild or any other person under 18 years of age who is under his care, or subject to his authority or supervision. The provision is thus directed against anyone who has exploited a care relationship to commit sexual abuse. The prescribed penalty is imprisonment for a term not exceeding 5 years. In addition to these provisions applying to sexual abuse of children, the legislation contains a number of provisions that aim to prevent sexual abuse of children. In order to protect children from sexual abuse, a number of Acts provide that persons who are to work with children must present a police certificate14 in order to document that they have not been convicted for sexual abuse of children. For example, section 6-10 of the Child Welfare Act contains provisions concerning presentation of a police certificate by persons to be employed by the Child Welfare Service. This provision gives the Child Welfare Service the authority to require a police certificate from personal support contacts, child welfare officers, etc. Persons who are to be approved as foster parents shall always present police certificates. Provisions corresponding to that of the Child Welfare Act are found in a number of other Acts, for example section 8-10 of the Social Services Act and section 20a of the Health Personnel Act. Section 203 of the Penal Code lays down a prohibition against the purchase of sexual services from persons under the age of 18. The provision was added to the Act as part of amendments made in August 2000. On adoption of the amendments it was argued that prostitution was particularly harmful for children. The Ministry pointed out that, although there was no obligation under international law to prohibit the purchase of sex from persons under 18 years of age, such a prohibition was within the spirit of the Convention on the Rights of the Child. Another factor in favour of criminalization was that all the other Nordic countries had criminalized the purchase of sex from persons less than 18 years of age (cf. Proposition No. 28 to the Odelsting (1999–2000)). Children are also protected against sexual exploitation by the provision on child pornography. Section 204a of the Penal Code totally prohibits any dealings with child pornography. Pursuant to the provision, depictions of sexual abuse or depictions that sexualize children shall be deemed child pornography. Child means any person who is or who appears to be under 18 years of age. The penalty is fines or imprisonment for a term not exceeding three years. In April 2007, a new provision was added to section 201a of the Penal Code. The provision applies to what is referred to as "grooming". That is to say, preparation for sexual abuse. Pursuant to this provision, a person who has arranged a meeting with a child under 16 years of age in order to commit sexual abuse of the child, and has come to the meeting place or to a place from where the meeting place can be observed shall be punishable for "grooming". The penalty is fines or imprisonment for a term not exceeding one year. The purpose of this provision is to be able to arrest persons who intend to commit sexual abuse of children before the abuse occurs. This amendment is further commented below under II (A) (3). In addition to the outlined provisions, Norwegian legislation also contains prohibition of female genital mutilation, cf. the Act relating to prohibition of female genital mutilation of 15 December 1995 No. 74. The Act was tightened in 2004 in order to strengthen the protection against such acts. Norwegian criminal legislation also prohibits forced marriage (cf. section 14 The arrangement involving police certificates for persons who work with children and young people has been reviewed by an interministerial working group chaired by the Ministry of Children and Equality. 16 222 of the Penal Code). The Child Welfare Act of 17 July 1992 No. 100 also protects children against violence and abuse in the home. Sexual harassment is explicitly addressed in the Act of 9 June 1978 No. 45 relating to gender equality, section 8a: "No person may subject another person to sexual harassment. The term "sexual harassment" shall mean unwanted sexual attention that is offensive to the object of such attention. Sexual harassment is considered to be differential treatment on account of gender. The employer and management of organizations or educational institutions shall be responsible for preventing and seeking to preclude the occurrence of sexual harassment within their sphere of responsibility. The Gender Equality Ombud and the Gender Equality Board of Appeals shall enforce the provision in the third paragraph pursuant to the provisions of sections 12 and 13." Section 1.2, sixth paragraph, of the Education Act states that "All persons associated with schools or with training establishments shall make efforts to ensure that pupils, apprentices and trainees are not injured or exposed to offensive words or actions." In November 2002, a number of provisions in the Education Act were amended, including those relating to the psychosocial environment, cf. Proposition No. 72 (2001–2002) to the Odelsting. The new provisions apply to the pupils" learning environment: all primary and secondary schools are to have a physical and psychosocial environment that promotes pupils" health, well-being and learning. The amendments came into force in April 2003. If a child is subjected to violence in one of the institutions regulated by the Child Welfare Act, chapter 5 becomes applicable. Section 5-9 regulates the rights of a child while he or she is in an institution. It is not permitted to punish a child physically or to lock the child in a room on his or her own or employ similar coercive measures unless authorized by regulations issued by the Ministry of Children and Family Affairs. The County Governor oversees that institutions are run in accordance with the Child Welfare Act. If the County Governor considers that the institution is not being properly run, he or she may order that the conditions be rectified or that the institution be closed down, cf. section 5-7. In 2006 amendments to the Children Act also came into force (cf. Act of 8 April 1981 No. 7) in order to help ensure that children receive better protection in child custody cases where violence and abuse are suspected. Section 48 of the Children Act provides that decisions on parental responsibility, on where the child shall permanently reside and on access and procedure in such matters shall first and foremost have regard for the best interests of the child. When making such decisions, account shall be taken of the fact that the child must not be subjected to violence or in any other way treated in such a manner as to impair or endanger his or her physical or mental health. 3. Problems encountered in attempts to improve the application of existing texts and/or supplementing or reforming the national legal framework Under this item, we have chosen to draw attention to experience of two areas. The first of these concerns the lack of clarity of the legal position associated with the scope of the prohibition against violence against children. The second concerns penal prohibition against what is termed "grooming". The lack of clarity of the Norwegian legal position is due to a ruling by the Supreme Court in 2005 (cf. Norwegian Supreme Court Reports 2005 page 1567) referred to above under II (A) (2). Statements made by the first judge to deliver judgment in this case gave rise to a lack of clarity concerning the Norwegian legal position associated with the prohibition against corporal punishment of children. In paragraph 24 of the ruling, the first judge to deliver 17 judgment stated "…that, although the parents" right to practise corporal punishment has been repealed, section 228, first paragraph, of the Penal Code will not apply if parents, for the purpose of upbringing, give their children light slaps, cf. Bratholm/Matningsdal (eds.): The Penal Code with comments, Part II (1995), page 551. When deciding what may be permitted, emphasis must be placed on the degree of force, the degree of spontaneity and the character of violation." The first judge stressed in the same paragraph that this view must be consistent with the Convention on the Rights of the Child. This interpretation is controversial. The ruling has given rise to a need for clarification of the legal position either through legal usage or by means of a clarification of the legislation. It is possible that such a clarification will be provided in connection with the adoption of the specific part of the new Penal Code (The Penal Code of 20 May 2005). In connection with the ruling of the Supreme Court in 2005, the Commissioner for Children wrote to the Minister of Justice requesting a clarification with regard to parents" right to corporal punishment of children in Norway. In his reply of 4 January 2006, the Minister of Justice wrote that: "the Ministry is in the process of drafting a proposal for the specific part of the new Penal Code. New provisions against violence will be drafted, and section 228 of the Penal Code is among the provisions that will be revised. In this connection, the Ministry will consider whether there is a need to clarify and, if appropriate, to strengthen children"s protection from corporal punishment." In November 2007, a Bill was submitted15 concerning the explicit provision in the Children Act that all forms of corporal punishment of children are prohibited. There now appears to be a majority in the Storting in favour of an amendment of the Children Act clearly stating that all corporal punishment is prohibited (cf.http://www.barneombudet.no/cgi-bin/barneombudet/imaker?id=17840). The other context we wish to draw attention to is the introduction of the penal provision concerning "grooming" cf. section 201a and section 201, second paragraph, of the Penal Code. Electronic media, such as the Internet, are today an integral part of the everyday lives of children and young people and where abuse of children occurs. An important measure in this connection is the introduction of the so-called "grooming" section of the Penal Code, which came into force from 2007. Its purpose is to combat adults who arrange to meet children in connection with plans for sexual abuse, thereby enabling the police and prosecuting authority more easily to intervene early and prevent abuse. During the consultation round, the majority of commenting bodies responded positively to the provision. However, attention was drawn by some quarters to the difficulty of proving that a criminal offence had taken place, that there was a risk of many acquittals and thus reason for concern that the provision might become a purely symbolic provision. Professor Erling Husabø (2006) took a critical view of criminalizing intention before a criminal offence had taken place, and also pointed out the major evidence problems associated with the provision. 4. Role and mandate of the various governmental and non-governmental organisations in the data collection, reporting, prevention and protection systems (ministries, agencies, care and support services, scientific community, etc.). This is dealt with below under II. 15 (See Private Member"s Bill No. 31 (2007-2008), Dok.nr.8:31 (2007-2008) at www.Stortinget.no). 18 B. Policymaking 1. Role and mandate of the various governmental and non-governmental organisations in the data collection, reporting, prevention and protection (ministries, agencies, care and support services, scientific community, etc.) Involvement of stakeholders and how these sectors are involved in the planning process (Consultations, intersectoral advisory committees, working group, etc.) National and local strategies to prevent violence against children are designed in close cooperation between the different levels of government (state, county and municipality), specialized institutions, NGOs and interest organizations. In the following, we provide an overview of the most central agencies and organizations and, in this connection, present their role in shaping policy in this area in relation to data collection, reporting, prevention and protection of children from violence and abuse. Some of the preventive measures will be presented under (C). The distribution of responsibilities and tasks places considerable demands on cooperation both within and between the different levels of government and in relation to the NGOs. State level The Ministry of Justice coordinates national policies against violence. The ministry of Children and Equality coordinates national policies for children and young people. An effective fight against violence requires close cooperation with other central government authorities and in meeting the need for coordination at the central government level. An interministerial working group has been set up, consisting of representatives of the Ministries of Health and Care Services, Labour and Social Affairs, Children and Equality, and Justice and the Police. In simple terms, policies for combating violence against children are developed through dialogue between the Ministry of Justice and the Ministry of Children and Equality, other ministries and subordinate government agencies. The following parliamentary committees address violence against children: the Standing Committee on Justice, which is responsible for the Penal Code, and the Standing Committee on Family, Cultural Affairs and Government Administration, which is responsible for matters relating to families, children and youth. There are a number of national strategies and action plans for addressing violence, especially violence against children, some of which are mentioned above, (see I (A) (1)). Examples are: National action plan against domestic violence "Turning Point" (2008–2011) National plan of action against female genital mutilation (2008–2011) National action programme to prevent forced marriage (2008–2011) National programme to prevent harassment in schools (2006–2008) National action plan to address violence and sexual abuse of children (2005–2009) National action plan "Stop Trafficking" (2006–2009) In the work on Report No. 40 to the Storting (2001–2002) relating to child and youth welfare, the public authorities, specialists and NGOs argued in support of strengthening these efforts in relation to children and young people exposed to abuse, and this resulted in the "Strategy for combating sexual and physical abuse of children" (2005–2009), which addresses legal usage, treatment provision, follow-up and competence. Another important document is the 19 Government"s action plan "Domestic violence" (2004–2007) which was prepared in cooperation between the Ministry of Children and Family Affairs, the Ministry of Health, the Ministry of Justice and the Ministry of Health and Social Affairs. The four objectives of the plan are: to improve the level of cooperation and knowledge in the support services to increase awareness of domestic violence and prevent it through changes in attitude to give victims of domestic violence adequate help, protection and support to break down the spiral of violence by strengthening treatment programmes for perpetrators This plan of action consists of 30 measures within these four areas, with indications of when they are to be carried out and which agencies shall be responsible for implementing the individual measures. Several of the measures are referred to in this report. The Ministry of Justice and the Police has recently launched a new action plan against domestic violence (2008–2011) "Turning Point". This plan involves 50 measures in seven main areas. Besides the four main areas included in the previous plan16 (cf. above), it is proposed that victims of domestic violence shall be offered an opportunity for facilitated encounters with the perpetrator (so-called restorative justice), and that research and development work shall be strengthened and continued. In addition, the plan brings efforts to increase awareness of violence to the fore as an independent main area. Municipal level The general preventive work in relation to children and youth is primarily a municipal responsibility. The state assists the municipalities in this work and, by strengthening the municipal economy, the Government has wished to make provisions to enable a keener focus on prevention. The Child Welfare Service is the agency that has the chief responsibility for keeping track and intervening where children are subjected to violence and abuse. Section 1-1 of the Child Welfare Act states that one of the purposes of the Act is: "…to ensure that children and young people who live in conditions which may be detrimental to their health and development receive the necessary assistance and care at the right time." Section 3-1 of the Act, which concerns the preventive activities of the Child Welfare Service, states further that the municipality shall keep a close eye on the conditions under which children live, and is 16 In other words, one sees that the action plan is partly an extension of earlier priority areas and partly a presentation of new areas. The action plans thus partly serve to maintain the continuity of the work. Measures assessed as successful are continued. Certain measures will also need to be assessed over a longer period than the time frame for the action plan before their suitability can be judged. In addition, new measures are incorporated, for example, following input from NGOs or other organizations or where proposals arise from studies carried out by various committees. The introduction of new action plans in the different areas may also be a consequence of changes of government, since a new government will wish to communicate its policy through the action plan. As part of the interministerial work on the drafting of a new action plan, an assessment will be made of what shall be continued in the new plan. However, beyond this, no systematic assessment of the various plans is available unless this is specifically included as an item of the plan, cf. for example the new action plan on female genital mutilation. Some of the measures in the action plans will also be assessed individually. No systematic reporting is made to the Storting specifically in association with the various action plans, but both description of problem areas and the action plans as such is included in the annual report submitted by the Government in connection with the fiscal budget cf. for example Proposition No. (2007-2008) to the Storting for the budgetary year 2008, Ministry of Children and Equality. 20 responsible for framing measures to safeguard against inadequate care and behavioural problems. The provision assigns the Child Welfare Service particular responsibility for bringing to light inadequate care, behavioural, social and emotional problems at a sufficiently early stage to avoid lasting problems, and for instituting measures to this end. In order that it shall be able to perform this duty of protecting particularly vulnerable children, the Act gives the Child Welfare Service a number of responsibilities and instruments that we will return to in (C). A number of other agencies also have important roles in protecting children and young people from violence and abuse. These include general practitioners, child health clinics and the school health service, the dental health service, child and adolescent psychiatry, day care centres and schools. Child health clinics come into contact with the majority of children through health check-ups during the children"s first years of life. Very many children attend day care facilities and all children attend school (10-year compulsory school). Because these institutions come into contact with very many children, they play an important role in preventing abuse by detecting such acts as part of their normal activities. In order that the Child Welfare Service shall be ensured information concerning children subjected to failure of care or abuse, section 6-4, second and third paragraph, and section 6-4a of the Child Welfare Act contain provisions obliging the public authorities to report such cases. Section 6-4, second paragraph, states that the public authorities, on their own initiative, without regard to the duty of confidentiality, shall disclose information to the municipal child welfare service when there is reason to believe that a child is being mistreated at home or is exposed to other serious failure of parental care or when a child has shown persistent, serious behavioural problems. It follows from the provision that organizations and private entities that perform tasks for the state, county authority or municipality are considered on a par with public authorities in this connection. The provision also obliges the public authorities to disclose such information when ordered to do so by agencies which are responsible for implementation of the Child Welfare Act. The duty of disclosure to the Child Welfare Service is also laid down in other legislation. The third paragraph of the provision obliges professional practitioners pursuant to the Health Personnel Act, the Mental Health Care Act, the Municipal Health Service Act, the Family Counselling Office Act and the Independent Schools Act to disclose information pursuant to the provisions of the second paragraph. A teacher or medical practitioner who receives information giving reason to believe that a child is exposed to abuse or serious failure of care or that the child has shown persistent, serious behavioural problems is obliged to disclose this information to the Child Welfare Service. In addition to the provisions concerning the duty to disclose information, section 139 of the Penal Code contains a provision concerning the duty to try to prevent certain punishable acts. This provision applies not only to professionals, but in principle everyone. Normally, such preventive action takes the form of a report to the police. In view of the number of actors involved, there is a need for sound structures to support the municipal and intermunicipal cooperation in the work on prevention of violence against children. The municipalities are also able to obtain expert assistance and services from various actors at the regional level. These include the state child welfare services in the regions and the newly established regional resource centres for violence, traumatic stress and suicide prevention. These are major contributors to policy formulation in the work on children exposed to violence. 21 Regional level: Professional teams In 2004, the state took over responsibility from the county authorities for operating the family counselling offices, child welfare institutions and foster homes and, on 1 January 2004, the Norwegian Directorate for Children, Youth and Family Affairs was established. Administration is organized in five regions with a broad range of specialist units. The main reason for transfer of responsibility for the Child Welfare Service from the county authorities to the state was to be able to increase the competence and knowledge-based guidance provided to the municipal Child Welfare Service. Twenty-six professional teams were established to provide expert assistance to the municipal Child Welfare Service in difficult child welfare cases, for investigating the cases, for use of support measures and for placement outside the home. One of the measures in the Government"s action plan "Domestic Violence" (2004–2007)" is to strengthen competence on violence issues in the professional teams in the state family counselling offices. Website: www.bufetat.no Regional resource centres for violence, traumatic stress and suicide prevention (RVTS) The municipalities will also be able to obtain competence from the newly established resource centres for violence, traumatic stress and suicide prevention. These centres are organized in five health regions in Norway. The purpose of the regional centres is to ensure better and more integrated services. The centres play an important role in informing and, not least, providing direct guidance to the local public services. In addition, they will establish and operate the network between relevant collaborating agencies in the region. These institutions have a special responsibility for assisting the local public services in their work on cases where children are subjected to serious physical abuse. The centres will coordinate guidance functions in relation to abuse cases. Website. www.nktvs.no Coordination of guidance and consultation facilities provided respectively by the child welfare regions and the health regions is the responsibility of the central government authorities at the ministerial and directorate levels. The objective is to develop complementary facilities adapted to the needs of families that public services in the regions and municipalities will come into contact with. Consideration will be given to how cooperation between regional state child welfare authorities, the regional resource centres for violence, traumatic stress and suicide prevention, the family counselling offices and local guidance bodies best can be formalized (the Government"s action plan "Domestic Violence" (2004–2007)"). Scientific community The Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS) was established on 1 January 2004. The purpose of this centre is to strengthen research, education and guidance for the public services in the field of violence and trauma. The centre has a separate section that deals with violence, family violence and sexual abuse. The centre plays a major role in the Government"s endeavours to improve the level of knowledge about domestic violence with regard to children, women and perpetrators. In 2004, several smaller national specialized institutions in the field of violence and trauma were incorporated into the newly established knowledge centre. The establishment of a national knowledge centre reflects the public authorities" prioritization of the field of violence against children, including the need to raise competence and improve the treatment provision for persons affected by such acts. The 22 centre will contribute to the development of knowledge concerning efficient measures and methods of treatment for children exposed to violence. The treatment provision will be improved as a stage in the work on strengthening the protection of mental health for children and young people in cooperation with clinical institutions and regional resource centres. Research into violence and sexual abuse of children is also part of the activities of a number of research institutes and other institutions. In the following, we mention some of these, but the account is far from exhaustive. The research into violence and sexual abuse is being conducted at regional centres for child and adolescent mental health. These centres also run courses on violence and sexual abuse for public services. For example, the regional centres in eastern and southern Norway, in cooperation with other agencies, have developed educational provision concerning children who live with domestic violence. In Norway, there are also development centres for the Child Welfare Service, which carry out relevant research. NOVA - Norwegian Social Research covers a broad field of social research where violence and sexual abuse of children are one of several areas of the institute"s research activity. NOVA also has major competence in areas such as migration, living conditions/welfare research and persons with disabilities, all of which are relevant for issues associated with violence against and abuse of children. A number of research institutes also focus on issues of relevance to violence against and abuse of children, cf. for example the Institute for Social Research, the Nordic Institute for Women"s Studies and Gender Research (NIKK) and the Institute for Applied Social Science FAFO. The Cognitive Developmental Research Unit (EKUP) at the University of Oslo is a laboratory at the Department of Psychology. The intention of forming EKUP was to establish a laboratory at the University of Oslo that is goal-oriented and that serves to coordinate and strengthen the research area of children"s psychological development. The unit was founded in 2006. One of EKUP"s focus areas is the cognitive and neuropsychological aspects of the development of the brain associated with abuse and neglect, sexual abuse, violence against children and situations where children witness violence and abuse. The Institute of Forensic Medicine at Ullevål University Hospital, the child welfare service and the administration of justice are major collaborators in relation to this area. For more details of research projects in this field, contact the Norwegian Research Council, Programme on Welfare Research, at www.program.forskningsradet.no/vfo/english.php3 or the Norwegian Centre for Violence and Traumatic Stress Studies, www.nkvts.no. b) Non-governmental sectors and independent institutions In the development of strategies for prevention of violence against children, an important role is played by independent institutions, NGOs and interest organizations. Some of these are mentioned in the following. Norway was the first country in the world to appoint a Commissioner for Children. The Commissioner for Children plays a central role in fostering the interests of children in society and in monitoring the conditions under which children grow up. Either on his own initiative or as a commenting body, the Commissioner safeguards children"s interests in connection with planning and investigations in all fields. The Commissioner is also responsible for monitoring compliance with legislation protecting children"s interests and for proposing measures to strengthen children"s security under the law. Through legislative amendments in spring 1998, the Commissioner for Children was also given a clear mandate to monitor compliance of Norwegian legal and administrative practice with Norway"s obligations pursuant to the UN Convention on the Rights of the Child. In this way, the Commissioner for Children plays a 23 central role in preventing and combating violence against and abuse of children (cf. the Act of 6 March 1981 relating to the Commissioner for Children). NGOs are important contributors to the shaping of policy for detecting and preventing violence against children, both as commenting bodies to the ministries and, not least, through their own work. Most NGOs that work on abuse of children and young people receive state support. The various players work on prevention of sexual abuse from different viewpoints. As regards physical abuse of children, the NGOs have shown less interest (Strategy for combating sexual and physical abuse of children 2005–2009). Some of the organizations, such as Norwegian People"s Aid, the Red Cross, Norwegian Save the Children, the Norwegian Youth Council and other NGOs, operate projects aimed at providing new knowledge through surveys, dissemination of information, e.g. by assisting in the production of films and teaching materials on violence against and abuse of children, operating telephone help lines, etc. Norwegian Save the Children has worked on issues associated with violence and abuse since the beginning of the 1990s. The organization works to achieve the participation of children and young people and to increase insight into children"s rights and living conditions through the development of knowledge, and participates at national and international levels in efforts to support children"s rights. Norwegian Save the Children is a member of the global network ECPAT, which works to end child prostitution, child pornography and trafficking in children for sexual purposes (see http://www.ecpat.no). The Forum for the Convention on the Rights of the Child (FBB) was founded in 1994, and is a network for organizations, institutions and individuals who are concerned about children"s rights nationally and internationally. A major task that the FBB has been involved in is the work on the Supplementary Report to the UN Committee on the Rights of the Child (Forum for the Convention on the Rights of the Child, 2004). In connection with the UN"s global study on violence against children, the FBB produced a supplementary report with input from a number of organizations (Forum for the Convention on the Rights of the Child, 2006). In addition to the many NGOs, there are also a number of interest organizations that contribute consultative comments, such as the Association for Support to Sexually Abused Children and the Norwegian Association for Child-Care Children. These interest organizations operate their own measures, such as discussion groups, talks by invited speakers and dissemination of information in various arenas. The cooperation between public authorities, NGOs and interest organizations is intended to ensure democratic participation in the community. Children"s own participation in the work on preventing violence against children. A central issue regarding prevention of violence against children is the extent to which children and young people themselves participate in the design of preventive strategies. Important bodies for participation in the municipalities by children and young people are the youth councils established in most of Norway"s municipalities. However, no survey has been made of whether and to what extent children and young people participate in the municipal decision processes concerning prevention of violence. Article 12 of the Convention on the Rights of the Child states that children and young people shall be given the right to express views and be given the opportunity to be heard. The Forum for the Convention on the Rights of the Child took the initiative to circulate the Convention on the Rights of the Child for children"s comments in connection with Norway"s second report to the UN Committee on the Rights of the Child. This resulted in the report "Vi ble hørt. Barnehøring 1998" ["We were heard. Children"s Consultative Round 1998"] (Norwegian Youth Council 1999). When the work on the third report was begun in 2002, the Commissioner for Children and the Forum for 24 the Convention on the Rights of the Child once more took the initiative to gather the opinions of children and young people, and this time the views of the children and young people were summarized in the report "Livet før 18" ["Life before 18"] (Transformation Factory, 2003). Norway will send its fourth report to the UN Committee on the Rights of the Child in February 2008, and this time children and young people from eight municipalities have contributed input on growing up in Norway (Sandbæk and Einarsson, forthcoming) All three reports also contain constructive contributions and input on improvement of the conditions under which children grow up that often differs from that provided by adults. It is challenging to find ways of ensuring that the views of children and young people are heard and given due attention in the work on appropriate strategies for preventing violence against children. 2. Is there an agency taking a lead in setting the agenda for the eradication of violence and coordinating the multisectoral involvement of other stakeholders? As mentioned above, a number of ministries are involved in the work on preventing violence against children. We refer in this connection to the "Oslo principles" which refer to an "Integrated approach in order to ensure effectiveness and efficiency". The Ministry of Children and Equality and the Ministry of Justice and the Police share a coordinative responsibility for the design of policy in this field, while the responsibility for implementation lies in the various ministries. The Ministry of Children and Equality has coordinative responsibility in the field of violence against children while the Ministry of Justice and the Police has coordinative responsibility in the field of domestic violence. C. Prevention strategies and their implementation 1. Prevention mechanisms Preventive measures must be knowledge-based Knowledge of the reasons for abuse of children and how such behaviour can be stopped is of fundamental importance when designing preventive measures. However, there is no simple explanation for why someone abuses children. The reasons may lie in individual factors associated with the perpetrator, in family conditions, in structural, social factors or in the situation in which the abuse occurs (cf. Strategy for combating sexual and physical abuse of children (2005–2009)). It is the Government"s objective that the preventive measures implemented shall be knowledge-based. Children and young people should not be subjected to measures that are not known to work or that may at worst be harmful. A diversity of approaches is needed. However, it is important that the effect or probability of effect is investigated or documented and that the increased use of measures with documented effect is encouraged. Norway bases help to children subjected to violence and prevention of violence against children on the following overall strategy. This consists of three parts: (1) Ensuring that children exposed to violence receive satisfactory treatment, among other ways, by developing methods of treatment, (2) increasing the risk of detection by providing competence to front- line services and (3) informing the public about the harmful effects of violence so that such acts are not tolerated and that more cases are reported to the relevant public authorities. Alternative to Violence (ATV) and the Centre for Crisis Psychology have professional responsibility in cooperation with the Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS) (for a more detailed description of the project, see below under (2)). In 25 addition, NKTVS, in cooperation with the regional resource centres for violence, traumatic stress and suicide prevention (RVTS) will help in ensuring the development of systematic knowledge concerning, among other things, children and young people who are exposed to physical and sexual abuse. They will also develop knowledge of efficient measures and methods of treatment in cooperation with relevant resource centres and clinical institutions (cf. Strategy for combating sexual and physical abuse of children for 2005–2009 and the Government"s action plan "Domestic Violence" (2004–2007)". Preventive measures can be directed towards children and young people, towards adults, towards the general public and towards specific risk groups. Below, we give some examples of measures in relation to the above-mentioned target groups. We refer otherwise to the Ministry of Children and Family Affairs" circular Q- 25/2005 "Barnevernet og det forebyggende arbeidet for barn og unge og deres familier" ("The Child Welfare Service and preventive work for children and young people and their families") and the Ministry of Children and Equality circular Q- 16/2007 "Forebyggende innsats for barn og unge" ("Preventive measures for children and young people"). Preventive measures directed towards the general public. Courses for couples on how to live together are a primary preventive measure that, according to the international literature, are assumed to have preventive effect in relation to violence. This particularly applies to courses chiefly aimed at training communication skills and conflict handling. "PREP" is an example of such courses. "Godt samliv" (Well-functioning Family Life), a programme of courses for first-time parents on how to live together, is also thought to be a valuable preventive measure in this area. According to cohabitation research, this is a phase that is particularly vulnerable for the relationship, and it is of major importance for the parental function to strengthen the quality of life together and prevent unnecessary conflicts and breakdown of the partnership. "Programme for parental guidance" is a consciousness-raising programme designed for all parents with children from 0–18. The parental guidance programme is based on the International Child Development Programme. The programme is based on a humanistic tradition where an empathetic interpretative attitude to the child is an important element. The negative effect of corporal punishment on children"s psychosocial development is a topic combined with alternative strategies for setting limits for children. The parental guidance programme also has a special course for families belonging to ethnic minorities, among other reasons, because views on the use of violence in child rearing vary between different countries. Norwegian legislation is presented in this connection, and the ground is laid for dialogue on alternative ways of setting limits. Materials associated with the parental guidance programme have been translated into a number of languages. The dialogue is to be founded on the values of the Convention on the Rights of the Child. Owing to language barriers and differing traditions, special measures have been designed for this target group. The Norwegian Centre on Violence and Traumatic Stress (NKVTS) is working on a survey of existing parental guidance programmes in Norway and the Nordic countries and corresponding materials developed with regard to families of refugee and immigrant background. In addition, NKVTS will gather and systematize experience associated with the use of such programmes. This includes a systematization carried out in cooperation with RVTS–ØST (regional resource centre for violence, traumatic stress and suicide prevention) of experience on the basis of five groups in the municipality of Bærum as a stage in trials of International Child Development Programmes for minority families. 26 Preventive measures for specific risk groups. As mentioned above, the programme for parental guidance is a primary preventive measure for all families. However, new variants of the programme are continually being developed and adapted to different risk groups. This applies, for example, to families that receive help from the Child Welfare Service and to prison inmates. Work is also being done on adapting the programme better to families with children with disabilities. The family counselling project "What about us?" is a course that raises the challenges that these parents meet. Strain on the relationship, own reactions, feelings and relations with friends and work are some of the topics that are raised. Special courses are also held for single parents who have children with disabilities. For many of the children who come to Norway as refugees, it is the family that provides a feeling of security. At the same time, the families have experience, resources and abilities for dealing with difficult experiences. Several interministerial working groups that have assessed the situation for children in state reception centres for asylum-seekers have submitted proposals for measures that can strengthen the parents" care skills. Work is also being carried out on a knowledge survey of how public services can approach ethnic minority parents concerning the use of violence in child rearing and on the consequences for children of exposure to domestic violence. Home-Start Home-Start in Norway now has 20 local groups where volunteers provide support to families. The aim is to provide preventive measures for young families in difficult circumstances. The purpose is to prevent crises or breakdown of families which in the next round may lead to difficult care situations. Preventive measures directed towards children and young people. Preventive measures directed towards children have been disputed because it is not certain that children are able to make use of the knowledge they obtain through the various programmes. In Norway (mainly during the 1980s and 90s), programmes such as "Trygg og Sterk" ("Secure and Strong") and the training package "Det er min kropp" ("It"s MY body") have been tried out, both of them directed at the child population in general. The purpose was to teach children to protect themselves from sexual abuse through "empowerment" techniques. No clearly positive effect of such programmes has been documented through research (Førland and Mossige, 1993). The objection has been made that such programmes may, among other things, give children a wrong impression that it is their own responsibility if they are subjected to sexual abuse, and that children become anxious about and generally suspicious of adults. A guidance programme has been produced for day care centres and child health clinics on how one can strengthen small children"s independence and mastery. The focus is on ownership of one"s own body and sexuality, and the programme was begun in 2001. Easily accessible information has also been made available to children and young people, where one can get help in a situation involving violence: www.unghelse.no. On the net portal www.ung.no, which is operated by the Norwegian Directorate for Children, Youth and Family Affairs, information is available on sexual abuse with links to other websites giving further information. The Norwegian Directorate for Education and Training has developed information booklets on sexual relations and sexuality which are sent each year to all pupils in the 10th grade. These booklets stress the importance of setting limits and of sexual health. Booklets are also available for teachers and parents. The booklet is available in 15 different languages. The 27 Norwegian Children and Youth Council (LNU) has carried out the project "Trygg" ("Secure"), which has produced various information and guidance materials on the topics of young people and sexuality, limits and exceeding limits. The objective is to promote dialogue, consciousness raising and a low threshold in order to raise difficult topics in the organizations (Norwegian Youth Council 2003). In 2004, support was given for three projects for preventing and dealing with bullying in recreational institutions. These were the Norwegian Confederation of Youth Clubs ("Campaign against Bullying"), Norwegian Federation of Organizations of Disabled People, Youth ("Youth teaches Youth") and the Norwegian 4H organization ("Mobbestopp"). The Government is continuing its initiative against bullying by the Manifesto against Bullying 2006–2008, a handbook on bullying in recreational institutions aimed at leaders of voluntary organizations for children and youth and recreational institutions, was issued in 2006. Further efforts were given priority here. In addition, attention was directed towards combating bullying and harassment via electronic media. The Manifesto against Bullying also attaches importance to the work on preventing harassment and violations on account of gender and sexual orientation. All Different – All Equal is the Council of Europe campaign for and by young people taking place during the period from June 2006 to October 2007. The main focuses are diversity, human rights and participation. In Norway, emphasis is also being placed on prejudice and discrimination. Through a separate grant scheme, funds are allocated to young people who wish to carry out local activities. The secretariat for the campaign is at the Norwegian Children and Youth Council (LNU). Other examples of preventive work The project Sinna Mann (Angry Man) is an animated short film for children (and adults). The film focuses on domestic violence, and its purpose is to show up the powerlessness of the adults and the anxiety, shame and guilt feelings of the child. The film is to be used in discussions about domestic violence with children and adults, and production is expected to be completed during the course of 2008. An educational film about the procedures in cases concerning sexual abuse. The purpose of the film is to give adults who are anxious about or who suspect sexual abuse of children a better basis for giving help and protection to children exposed to abuse. The target group is employees at schools, day care centres and public services such as the Child Welfare Service and the primary and specialist health service. "The Difficult Interview: Interviewing Children as a Method of Child Welfare Activity." This project is being carried out in cooperation between NKVTS, RVTS-ØST, the Department of Special Needs Education at the University of Oslo and the child welfare authorities of a district of Oslo, and is managed by Åse Langballe. It is based on a communication model used in legal contexts (Gamst and Langballe 2004), where the method has been adapted and implemented by the child welfare authorities. The objective is to assess the training of child welfare consultants and the efficiency of the method, and to carry out content analysis of the interviews. An educational film on the method is to be produced with a view to the implementation of the method by the child welfare authorities (cf. also the educational package: "Se min kjole – Oda i dommeravhør", which is educational material directed primarily at the police and prosecuting authorities in the training of interviewers, cf. Davik, Gamst and Langballe 2007). 28 2. Intervention mechanisms Detecting and helping children exposed to physical and mental violence, who witness violence or are exposed to sexual abuse requires a diversity of measures from various agencies. The provision for helping this group of children and young people is mainly found in the general public services. As mentioned above, the Child Welfare Service is the public agency mainly responsible for intervening when children are exposed to violence and abuse. Section 4-4 of the Child Welfare Act lists a number of support measures17 that the Child Welfare Service can employ when specially needed by a child, owing to circumstances in the home or for other reasons. The fundamental principle adopted by the Act is that children shall grow up with their biological parents. This principle entails that children shall primarily be helped in the home. Support measures can be implemented for the child and the family, for example, by appointing a personal support contact or respite family or by means of relief measures in the home, etc. The Child Welfare Service has thus a number of instruments that can be used in order to attempt to create satisfactory conditions for the child in the home. The Act also enables measures to be implemented against the wishes of the parents and the children. In recent years, the Child Welfare Service has adopted new and well documented methods in community-based measures such as Parent Management Training Oregon (PMTO) and Multisystemic Therapy (MST). If satisfactory conditions for the child cannot be created by means of support measures, section 4-12 of the Child Welfare Act enables the County Welfare Board to decide that the Child Welfare Service shall take over responsibility for the care of the child. One of the grounds for taking a child into care is: "if the child is mistreated or exposed to other serious abuse at home" cf. section 4-12 (c) of the Child Welfare Act. Pursuant to the second paragraph of the provision, such a care order may only be made when "required by the child"s current situation." In addition, taking the child into care must be the measure that is in the child"s best interests, cf. section 4-1. The municipal Child Welfare Service can obtain expert assistance when investigating difficult child welfare cases, including cases involving a suspicion of physical and sexual abuse. Children residing in institutions are particularly vulnerable to abuse. It is important that the employees receive adequate training in detecting violence and abuse. A survey has been conducted of routines in connection with suspicion of violence and abuse by employees of child welfare institutions, reception centres for asylum-seekers and homes for children with disabilities. The survey was completed in April 2007. In June 2007, the Norwegian Directorate for Children, Youth and Family Affairs drafted routines for state child welfare institutions in connection with suspicions of physical or sexual or excessive behaviour against children and young people. In addition, a system for training and guidance of foster parents is under development for persons who look after children who have been subjected to physical and/or sexual abuse. Emergency child welfare units All Norwegian municipalities have a Child Welfare Service that can be contacted during office hours. Emergency child welfare units have emergency preparedness in the evenings and at weekends. Emergency child welfare units work in accordance with the Child Welfare Act. The availability of emergency child welfare services varies from municipality to municipality. 17 For a presentation of these, see Sandberg 2000, page 300 ff. 29 We currently know too little about the degree of coverage of emergency child welfare units or other emergency preparedness in Norway and whether it may be deemed adequate. An evaluation and review of emergency child welfare arrangements under the auspices of NOVA - Norwegian Social Research will be completed in 2008. A website has been established with a list of all emergency child welfare units in Norway. The website is operated in cooperation between the Ministry of Children and Equality and Kristiansand municipality: www.barnevernvakt.no. The family counselling offices in Bufetat. The family counselling offices have for many years worked with families where violence has been involved. Throughout the years, the family counselling offices have therefore built up considerable competence in this field. Many offices have taken the initiative to establish local models for multiprofessional cooperation, for example, in child welfare, women"s shelters, the police, municipal health services, mental health care, educational and psychological counselling service, etc., in order to be able to offer the best possible professional help. The family counselling offices have also held multiprofessional courses and training measures in order to strengthen local competence. The family counselling offices offer individual therapy for abused women, children and siblings, trauma treatment of children and siblings who have witnessed or been exposed to violence, and groups for children and mother-child conversations. Through their therapeutic work, mediation and cooperation with parents, the family counselling offices reach many families with violence problems that are not reached by other public services. The family counselling offices currently work with approximately 30 000 families. On the basis of a sample of cases at a large family counselling office, it is assumed that, in approximately 20 per cent of cases, violence is involved. According to cautious estimates, this means that the family counselling offices annually have contact with 5–6000 families that have problems with violence. It is therefore of strategic importance that the family counselling offices" potential for working in this field be strengthened. Website: www.bufetat.no Women"s shelters The women"s shelters have for many years been the most important low-threshold care facility for abused women and their children (Official Norwegian Report NOU 2003:31). There are currently 53 women"s shelters organized in two separate organizations, the Norwegian Federation of Women"s Shelters and the Secretariat of the Shelter Movement. Shelters for battered women and their children provide a safe refuge for women who have experienced physical and/or psychological abuse. Shelters work on the principle of helping people to help themselves. The shelters provide a safe refuge, support and counselling, help with the social services, doctors, lawyers, housing authorities and other services and a meeting ground where battered women can meet others in a similar situation. As a stage in the development of the facilities provided by women"s shelters strengthening their contribution to the work on establishing cooperative intermunicipal solutions, the administration of state support has been transferred to the state Child Welfare Service. The acknowledgement that children who witness violence need protection and help has resulted in increased attention for children at women"s shelters in recent years. A special provision has been included in section 6-4a of the Child Welfare Act, imposing on employees of private women"s shelters whose operating costs are covered by the public authorities an obligation to disclose information as referred to in section 6-4, second paragraph. This provision was added by the Act of 20 January 2006, because it was previously uncertain to 30 what extent employees of private women"s shelters were subject to the obligation to disclose information18 pursuant to section 6-4. As a stage in the Government"s action plan "Domestic Violence" (2004–2007), a regional pilot project has been implemented to try out models for cooperation and routines between women"s shelters, family counselling and child welfare with a view to strengthening facilities for children at women"s shelters. The project will result in production of an electronic handbook for the use of these institutions. In 2005, the Secretariat of the Shelter Movement developed a guide with a view to raising the competence of persons who assist abused women and children at women"s shelters (Bentsen 2005). As a stage in the follow-up of measure 36d of "Turning Point" - Action Plan against Domestic Violence (2008– 2011), NKVTS has been assigned responsibility for making a survey of the various groups of children and adolescents at women"s shelters in relation to the situation and challenges and the need for information, assistance and follow-up. Women"s shelters 2003 – Statistics with Comments (Jonassen 2004) gives a presentation of user background and the work of the women"s shelters. The two women"s shelter organizations (the Norwegian Federation of Crisis Centres and the Secretariat of the Shelter Movement), the Ministry of Children and Equality and the Norwegian Centre for Violence and Traumatic Stress Studies (NKTVS) have produced a new joint registration form for shelter activities. The statistics are analysed by the NKTVS. Websites: www.krisesentersekretariatet.com and www.norskkrisesenterforbund.no The Support Centre against Incest The Support Centre against Incest is a low-threshold provision for people who have been subjected to sexual abuse and their families. There are currently 18 support centres in Norway. The centres are primarily a day-time provision for adults who have been subjected to sexual abuse and to their children. However, several of the support centres also provide facilities for children and young people. The purpose of the centres is to provide guidance and support to users based on the principle of self-help. Many of them also carry out preventive work in the form of information and guidance to other agencies that work in the field. From 2006, the support centres are financed in the same way as the women"s shelters with full state support, of which 20 per cent is provided by municipalities or health enterprises and the remaining 80 per cent is provided directly by the state. Felleskap mot seksuelle overgrep (Community against Sexual Abuse) is an umbrella organization that aims to develop quality and professional knowledge across the public facilities. Fifteen of the 18 centres are members. Website: www.sentermotincest.no Family violence coordinator The police play a central role in protecting children from violence and abuse. In 2002, in order to enable the police service to provide victims of violence with a well integrated, consistent and high quality service, family violence coordinators were established in each of Norway"s 27 police districts. The work of the police in family violence cases is part of the total activities of the police service in reducing violent crime. The handbook "Politiets behandling av familievoldssaker" (2002) ["Police handling of family violence cases"] is one of several initiatives for improving police work in this area. The family violence coordinator will work to combat both violence against women and physical and sexual abuse of children within the family. The scheme will ensure more rapid intervention and better follow-up in rape cases, 18 For a more detailed discussion of this, see Official Norwegian Report NOU 2003: 31 "The Right to a Life without Violence". 31 reduce the threshold for contacting the police, and help in assessing the need for protection and referral to support measures. An important responsibility of the family violence coordinator is to establish good routines for cooperation with other agencies, institutions and organizations that assist victims of violence. Health enterprises: It is important that children and adolescents are ensured satisfactory medical treatment and that traces of physical or sexual abuse are documented as soon as possible after the abuse occurs. Responsibility for this is shared between seven health enterprises in the eastern region, eight in the southern region, five in the western region, five in the central region and five in the northern region. The hospitals" Section for Social Paediatrics has specialist expertise in somatic examination of children where there is a suspicion of sexual abuse. International classifications have been developed to aid in diagnosing sexual abuse, and these are regularly revised (cf. Myhre, Borgen and Ormstad 2006). Rape clinics A rape clinic is an emergency room for rape victims19. At the clinic, medical and forensic examinations are carried out and there is sometimes also psychosocial follow-up. There are currently rape clinics20 at 20 places in Norway. Some rape clinics are attached to municipal accident and emergency units and others to gynaecology departments at hospitals. In cooperation with a broadly composed working group, the Norwegian Directorate for Health and Social Welfare has produced a guide to help ensure that persons subjected to sexual abuse and domestic violence receive the necessary medical and psychiatric assistance. In addition, the guide is intended to help in ensuring that the securing of evidence and documentation of injuries are of a high enough quality to provide an adequate basis for the police investigation, trial, and assessment of criminal injuries compensation. The guide is also intended to ensure that equivalent facilities are provided throughout the country, both immediately after the abuse and during the follow-up (cf. Overgrepsmottak, Veileder for helsetjenesten [Rape Clinics, Guide for the Health Service) 2007]. DIXI Resource Centre DIXI Resource Centre provides help to rape victims and their families, disseminates information on delayed injuries and carries out consciousness-raising. In addition to individual discussions with rape victims and their families, the centre also offers self-help groups for rape victims. DIXI also provides free legal services. Website: www.dixi.no Counselling Offices for Victims of Crime The Counselling Offices for Victims of Crime provide advice, support and practical guidance for persons who have been subjected to crime. The first office was established in 1996 and there are now counselling offices in all of the health regions. The offices are administered by the local police and the professional activities are coordinated by the Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS). Website: www.kriminalitetsofre.no Child and adolescent psychiatry outpatients" clinics 19 Atle Dyregrov at the Centre for Crisis Psychology has written a guide for the families of rape victims (see www.bld.dep.no). 20 For a list of rape clinics, see the website: www.dixi.no. 32 Child and adolescent psychiatry outpatients" clinics are an important part of the treatment provision available to children who are subjected to violence and sexual abuse. The primary tasks of these outpatients" clinics are examination and treatment. Certain Norwegian outpatients" clinics in mental health care for children and young people have experienced therapists who work with children and young people who have been subjected to sexual abuse. Alternative to Violence Alternative to Violence (ATV), is a research and treatment centre that offers professional treatment to violent offenders and people who have witnessed or been exposed to violence in close relationships. ATV was established in 1987, the first centre in Europe for male batterers. Special programmes for children witnessing violence have been implemented since 1999. As previously mentioned (cf. above under II (C) (1)) the project "Treatment of children experiencing violence in their family" (2004–2009) is being carried out in cooperation between Alternative to Violence (ATV) in Oslo and Telemark and the Centre for Crisis Psychology in Bergen. The project will (1) develop methods of treatment for children who have been subjected to violence, (2) disseminate competence to all treatment facilities, (3) provide information and training to the local public services so that they can detect children who have been subjected to violence and (4) raise public awareness of children who have been subjected to violence. Competence development has been set in motion in the family counselling offices, child welfare offices, women"s shelters and the police by means of courses/seminars, guidance, methodological development and publications. Materials have been produced for discussions with parents and children at women"s shelters. In addition, teaching materials have been produced to provide a professional basis for work with children experiencing domestic violence. In further work on the project (2006–2009), emphasis will be placed on strengthening competence in the Child Welfare Service. An account of the Norwegian treatment provision for perpetrators of violence is given below under (3). Website: www.atv-stiftelsen.no The Church"s Resource Centre against Violence and Sexual Abuse is a diaconal activity whose intention is to help repair damage to individuals following abuse and prevent further damage. The centre was established in 1996, and is a private foundation. For more information, see website: www.kirkens-ressurssenter.no Telephone help lines In Norway there are a number of telephone help lines where children and young people can receive help or information in connection with violence and abuse. A number of these telephones are associated with the activities of agencies or organizations such as the Commissioner for Children, the Red Cross Telephone for Children and Young People, the Norwegian Association for Child-Care Children and Landsforeningen for voldsofre (Norwegian Victim Support). Others are independent telephone help lines either directed towards a specific type of issue, for example the Tips Telephone against Sexual Abuse of Children and the telephone help line on forced marriage (Oslo Red Cross International Centre – ORKIS). Some have a broader user group, for example the help line for young people on sexual relations and sexuality (The Centre for Young People"s Health, Sexual Relations and Sexuality – SUSS). The Norwegian Forum for the Convention on the Rights of the Child has proposed the establishment of a single, 24-hour nationwide telephone number for children to ring if they are exposed to violence in the broad sense of the word. Establishment of a (six-digit) telephone 33 help line for children is also included in the EU strategy on children"s rights from 2006. The Commissioner for Children has on several occasions recommended the establishment of a telephone alarm number similar to that found in Iceland. As a stage in the Action plan against domestic violence 2008–2011 "Turning Point", a 24-hour free alarm telephone is to be set up for children and adolescents exposed to various forms of violence. The alarm telephone will also be available to adults. An evaluation is being conducted of telephone help lines and websites as preventive measures against physical abuse of children (Ford 2007). 3. Deterrence mechanisms Treatment provision for perpetrators of violence In Norway, it was not until the 1980s that efforts were targeted to planning the development of separate treatment facilities for persons convicted of violence and sex offences under the auspices of the mental health service (Friestad 2005). Development of treatment provision for persons who commit violence and abuse was also included in the general initiative to combat domestic violence. One of the measures of the Government"s action plan "Violence against women" that was launched in 1999 was to establish a research project in order to systematize and process information concerning the various treatments for men with violence problems. As a stage in this plan, a survey was made of treatment experience and the status of current knowledge (cf. Menns vold mot kvinner. Behandlingserfaringer og kunnskapsstatus [Men"s violence against women. Treatment experience and the status of current knowledge] 2002). Treatment provision for perpetrators of violence was also a topic of the report of the Commission on Violence Against Women, where one of the main points was the importance of making the perpetrators of violence responsible for their actions. This is important because measures in this field have traditionally been directed towards the victim of violence (Official Norwegian Report NOU 2003:13). Today, there are several bodies, both public and private, that provide help and treatment to men who commit domestic violence. Help is provided by family counselling offices, mental health care, the prison and probation service and private institutions. Although most provisions are primarily aimed at men as perpetrators of violence, some the measures are also offered to women and young people as perpetrators of violence and to children as witnesses of violence (see http://www.atv-stiftelsen.no/). Among the most important treatment provision are Alternative to Violence21, the Institute for Clinical Sexology and Therapy and the Anger Management Project.22 The Anger Management Project was started in 1998, and is a policlinical treatment provision for violent cohabiting men. The project is located at Brøset Regional Security Department and Competence Centre in Trondheim. The treatment includes group therapy, and is based on cognitive theory and treatment philosophy (Haugan and Nøttestad 2002). In 2004, a pilot project involving persons convicted of sexual abuse was 21 One of the measures of the action plan ("Domestic Violence 2004–2007") is an evaluation of the treatment methods of Alternative to Violence in order to measure their effect with a view to systematization and dissemination of the treatment methods. The evaluation is being conducted by NKVTS. Two projects are in progress in connection with this. "Voldsutøvelse og voldserfaringer, samt behandlingsforløp, i et utvalg menn i behandling for partnervold 2006–2007" ["Perpetration and experience of violence and the progress of treatment in a sample of men being treated for partner violence 2006–2007"] (Askeland and Råkil) and "Voldsutøvelse og voldserfaringer i et utvalg menn i behandling for vold i nære relasjoner 2004-2007" ["Perpetration and experience of violence in a sample of men being treated for domestic violence 2004-2007"] (Askeland and Evang). See http://www.nkvts.no/ 22 In accordance with the Government"s action plan "Domestic Violence 2004–2007", work is being carried out on dissemination of this and other treatment provision. 34 started at Brøset regional Security Department and Competence Centre in Trondheim. The project involved a combination of hormone treatment and cognitive treatment, and participation by offenders was voluntary. Bergen Central Prison has a treatment programme for persons convicted of sex offences (see Friestad 2005). From 2005, a treatment programme for sex offenders was also established at Ila Prison Service, Custody and Supervision Unit. In the health service, measures have also been implemented to improve knowledge about young offenders and the need for help and treatment measures in cooperation with several clinical institutions that work with this group of offenders. The Norwegian Directorate for Health and Social Welfare is funding a five-year project (2005–2009) at Betanien Outpatients Clinic for Children and Young People for development and testing of new treatment programmes. The Norwegian Government considers it important to have a broad diverse treatment provision based on the needs of the various groups of persons who commit violence and abuse (e.g. adults, young people and people belonging to ethnic minorities, both men and women). In this connection, it is important to offer help to persons who have committed such acts, but it is also important to reach those who need help but have not yet committed violence or abuse. Other major challenges in this field of treatment include ensuring documentation of the treatments provided (see Friestad 2005) and external assessments of the various treatment models23. A further challenge involves ensuring that such treatment provision is placed on a better footing, and improving the geographical distribution of the treatment provision so that perpetrators of violence and offenders can be reached as early as possible. This is consistent with the Government"s proposals in Report No. 29 to the Storting (2002–2003), where it is stated that the Government will increase the scope and quality of treatment provisions for persons who commit violence and abuse. Investigation and punishment of violence against and abuse of children The police and judicial system play an important role in preventing violence against and abuse of children. By putting a stop to situations involving violence or abuse and by punishing persons who commit violence against and abuse of children, they communicate to the public that these acts are unacceptable. In Norway, the police is one of the agencies that has been in the forefront of work on domestic violence. According to the Government"s action plan "Domestic Violence" (2004–2007)", the appointment of police violence coordinators has resulted in an increase in the number of cases of domestic violence reported. However, experience so far indicates that some family violence coordinators find that other agencies are reluctant to continue following up cases when police measures have been exhausted. This shows the importance of establishing effective cooperative networks and routines across all central services and agencies involved in these cases. Ensuring a multiprofessional approach to work in this field has been one of the main objectives of the Norwegian Government"s action plan "Domestic Violence" (2004–2007). In Norway, there are a number of preventive instruments that can be utilized in such cases. These are primarily measures aimed at the person exposed to abuse. These measures also have major consequences for the children in the family. In domestic violence cases, custody (perpetrator), ban on visiting, personal violence alarm systems, use of secret addresses and change of identity (all victim-oriented) measures can be employed for prevention of further 23 Internal assessments and outlines of the various treatment provisions have been made and continue to be made. For example, John Nikolaisen, who works as a researcher at NKVTS and in a clinical post at the Institute of Clinical Sexology (IKST), has made a summary of the characteristics of children and adolescents who have committed acts of sexual abuse and have received treatment at IKST. This is intended to form the basis of a larger study providing a broader basis for describing the effect of the treatment measures aimed at this group. 35 violence. These measures have a number of implications for the children, primarily by helping to prevent violence against the mother and preventing the children from witnessing further violence. An evaluation of personal violence alarms showed that such alarms helped to improve freedom of movement for victims of violence, which also gave greater freedom to the children (Bakketeig 2006). However, the use of secret addresses often involves a break with home, family and friends for mothers exposed to violence and their children. The measure thus often results in increased isolation and loneliness (Eidheim 2007). A pilot project will be carried out involving electronic marking of perpetrators of violence. This measure was originally proposed by the Commission on Violence Against Women in Official Norwegian Report NOU 2003:31 in order to address the need to hold perpetrators of violence responsible for their actions. It was pointed out that the existing protective measures have too great an impact on the victims of violence and abuse. The fact that measures directed against perpetrators of violence are being developed may thus indicate an increased willingness in Norway to shift the focus from what may be referred to as victim-oriented measures to measures directed against the perpetrator. However, there is a need for increased knowledge of what implications the existing protective and preventive measures have for children affected by such measures. An issue that has been raised in connection with physical abuse of children is how improvements can be made in detecting abuse of the smallest children. When they suspect unnatural causes of death, doctors are obliged24 to notify the police. In order to improve the security under the law of the smallest children, obligatory death location investigations shall be carried out under the auspices of the health service (cf. Action plan against domestic violence 2008–2011 "Turning Point", cf. also Dødsstedsundersøkelser ved plutselig uventet barnedød [Death Location Investigation on Sudden and Unexpected Death of a Child], 2006. Death location investigations fall under criminal law procedure, and their main purpose is to establish the cause of death. This is a difficult area because the consequences of making erroneous assessment are very great. If one fails to detect that a small child has died as a result of abuse, there is a risk that other children in the family may be subjected to abuse resulting in death. However, if one erroneously believes that a child has died as a result of abuse; one subjects the parents to a dreadful strain in an already extremely difficult situation. Generally speaking, there is a need for increased focus on detection of physical abuse of children in general and of the smallest children in particular. Work is being carried out on development of routines for registration and documentation of cases where there are suspicions of physical abuse of children admitted to hospitals. The National Criminal Investigation Service (NCIS) has chosen a comprehensive approach towards investigation of child sexual abuse in real life and on the Internet. The unit investigates child sexual abusive material focusing on identifying and rescuing victims of abuse. The NCIS works closely with other stakeholders, both nationally and internationally on developing methods for effectively combating this criminal activity on the Internet. The NCIS has also an ongoing cooperation with the main Internet providers in Norway on blocking out of sites depicting child sexual abuse of children. The NCIS is responsible for a European Police Chiefs Task Force initiative implementing similar blocking technology in the European countries. The responsibilities of the NCIS include providing technical and tactical investigation assistance to Norway"s 27 police districts. This includes leadership of 24 Cf. Section 36, third and fourth paragraph, of the Health Personnel Act and the Regulations of 21 December 2000 No. 1378. 36 investigations and implementation of specific steps in investigations, such as police examinations and judicial examinations out of court in sexual abuse cases. The NCIS cooperates in relation to projects associated with prevention of Internet-related abuse, such as "Safety", "Awareness", "Facts and Tools" (SAFT). This must be viewed in connection with the Ministry of Children and Equality"s responsibility for "Action plan – children, young people and the Internet" (2001). The project receives funding from the EU project Safer Internet Action Plan. The cooperation with the NCIS has included combating of pictures of children being abused, child pornography and measures to prevent children via the Internet meeting offenders in reality. As an extension of this, on the basis of a proposal submitted by a commission on prevention of Internet-related abuse of children (Faremo 2007), there are plans to establish a special "police station" on the Internet with a view to preventing Internet-related abuse. Here, it is intended, by means of regular "patrols", to prevent and investigate criminal offences. Cases concerning sexual abuse of children raise particular challenges for the criminal justice system (see Hennum 1999 and Bakketeig 1999). In such cases, there is very often little evidence, and the testimonies of the child and the accused often provide the main evidence. At the same time, the criminal justice system is not a child-friendly arena, and this has significance for the safeguarding of children"s security under the law. Children under the age of 14 are examined in a separate interview and not at the court hearing if this is considered to be in the interest of the child or for other reasons. A judge is responsible for the examination, but he/she may decide that the child should be examined by an appointed expert. In most cases, a specially trained police officer conducts the examination. The examination is supervised by a judge, and both the defence lawyer and the counsel for the prosecution may be present. They may also pose questions to the child via the police officer. In general, these rules apply to children between the ages of 6 and 14. A judge may decide that, because of the witness"s age or other special circumstances, the witness is to be placed under observation instead of or prior to an examination by a police officer. In practice, children under the age of 6 are placed under observation. Observations are conducted by experts in child psychiatry or psychology. In general, the judge, the defence lawyer and the counsel for the prosecution are not present during the observation. Both examinations and observations are recorded on video, which is shown at the court hearing. Suspicion of sexual abuse or other violence gives rise to the need for contact with many different bodies, entailing that the child often has to tell his or her story many times. This is a strain for the child, and involves a risk of damage to evidence. In order to ensure better safeguards for the child, so-called "Barnehus" (Children"s Houses) are being established, inspired by a model from Iceland. This arrangement involves giving the child a single place to relate to, in that several relevant functions are gathered in one place. The arrangement includes interviewing, medical examination and treatment of children who have been subjected to sexual abuse or violence or have witnessed domestic violence. The measure gives children better integrated facilities, better security under the law, provides safeguards, and ensures multiprofessional cooperation and sound competence. A pilot project was implemented in 2007, and Children"s Houses have been established in Bergen and Hamar. During the course of 2008, Children"s Houses are to be established in all regions so that the scheme will be nation-wide (cf. Action plan against domestic violence 2008–2011. "Turning Point"). 37 An educational package has been developed for judges, lawyers, and the police with a view to ensuring better safeguards for children who may have been subjected to violence and abuse. This is intended to be used when interviewing children subjected to abuse and for improving communication between the children and those examining them (Davik, Gamst and Langballe 2007). A particular challenge for the criminal justice system has been the low proportion of convictions in rape cases. This is a major challenge since surveys show that a disturbingly high proportion of Norwegian girls are subjected to unwanted sexual acts. NOVA"s self-report study among pupils in their final year of the upper secondary school shows that 12 per cent of the girls state that they have experienced an unwanted sexual incident in the form of sexual intercourse. Furthermore, 10 per cent of all girls report an unwanted sexual incident involving restraint. The survey further shows that a significant proportion of unwanted sexual incidents occur between a victim and a perpetrator who are both in early youth or teens. The largest group of perpetrators of abuse consists of friends, boyfriends or acquaintances (Mossige 2007). In 2006, a total of 974 rapes and attempted rapes were reported25, and there are probably considerable grey figures. Health Service provisions for rape victims vary in quality, content and organization from place to place in Norway. Surveys show that some groups rarely seek help from public services, that the risk of rape is particularly high for teenagers and that it increases with the use of drugs. This was part of the background for the appointment by the Government of a Commission on Rape in September 2006, which submitted its recommendations in January 2008. The Commission proposed among other things the establishment of a central, national special police unit with responsibility for investigating sexualized violence (SEPOL). In addition, it proposed that a sexual abuse team be established in each police district including investigators, a lawyer and other personnel with specialist competence in sexual abuse (cf. From Words to Action. Combating Rape Requires Action 2008). D. Capacity development 1. Training programs The development of competence in the area of violence against children is a priority area for national policy. This is stated, among other places, in the Government"s action plan "Domestic Violence" (2004–2007). The action plan treats competence raising and coordination of care facilities as overriding objectives, and includes measures for strengthening of competence regarding violence and violence victim issues in agencies responsible for assisting women and children subjected to violence and offenders. At the same time, there is still a major need for continued effort. Øverlien and Sogn (2007) have surveyed whether and to what extent the last class of students in a selection of child welfare officer, pre-school teacher and general teacher programmes have received instruction on the Convention on the Rights of the Child, physical and sexual abuse and methodology for interviewing children. The report documents that teachers, pre-school teachers and child welfare officers do not receive adequate instruction on these topics. The review contains a description of the current course provision, a specification of the academic content that such courses should focus on and the necessary framework conditions for implementation of such knowledge. The courses should include such topics as vulnerability, risk factors and protective factors, prevention and treatment, ethical challenges 25 See Crime Statistics: Offences reported, by type of offence. 1993–2006. Statistics Norway. 38 and user rights, violence, family violence and sexual abuse both generally and specifically directed against children and young people. The national curriculum regulations for the various professional training programmes form an important premise for implementation of knowledge of domestic violence. The authors recommend that the field of domestic violence be implemented as an obligatory discipline in established subjects and in all basic training courses. Sogn (2007) has drafted a proposal for an implementation plan in order to strengthen the various basic, advanced and specialist courses with regard to knowledge of domestic violence. 2 "Surveillance system" – systematic data collection on violence The child welfare statistics produced by Statistics Norway contain information concerning children who receive assistance from the Child Welfare Service owing to sexual abuse, physical abuse or mental abuse. From 2007, the child welfare statistics will also register when children receive assistance owing to exposure to domestic violence. The statistics contain information on the children"s age and sex. Statistics Norway"s child welfare statistics enable analyses of which full use has not yet been made. The data can be coupled to data concerning properties of residences (town/country), properties of households and families, parents" education, income and national background (parents/children). Statistics Norway"s crime statistics contain information on the age of victims of reported crimes. Beyond this, the ordinary statistics published to date contain little information on the various types of violence that persons under 18 years of age are exposed to. The exception is certain sex crimes (and corresponding statistical variables) where the age of the victim is the ground for defining the act as criminal. Statistics Norway"s family counselling statistics and health statistics contain no information on violence against children. Many paediatricians have wished to be able to register cases of child abuse in a separate hospital register. Separate registers have been established at some hospitals, such as the newly established Trauma Register at Ullevål University Hospital in Oslo and at St. Olavs Hospital in Trondheim. Such registers give the department and the hospital a good overview of practice, the types of injuries that are reported and which patients repeated reports have been made about (cf. Sexual and physical abuse of children. Project plan for section for children and adolescents, NKVTS, 2007. 3. Researching violence – investigation of risk factors associated with violence Little national research has been conducted on risk factors associated with committing violence against children. However, the above-mentioned national self-report survey (cf. I (A)) throws light on risk factors26 associated with exposure to physical violence, witnessing violence and exposure to sexual abuse (Mossige 2007). The self-report survey directed at young people in six counties of Norway, correlation between self-reported violence and sexual abuse and socio-economic, geographical and individual conditions (cf. Schou, Dyb and Graff- Iversen 2007). In addition, the Nordic-Baltic study of sexual abuse throws further light on risk factors associated with committing sexual abuse (see Abrahamsen and Mossige 2007). 26 Risk factors must not be confused with causal factors. Risk factors are "factors that influence the probability of an outcome" (Mossige 2007, page 102). 39 4. Sustainability It can be seen from the budgets of the various ministries that prevention and combating of violence against and abuse of children are major priority areas at the national level in Norway. Action plans, strategic plans and circulars show that this focus includes regional and municipal levels. At the same time, as is shown in the introduction to this account, the focus on various types of violence against children tends to fluctuate. It is therefore important to place knowledge of the various forms of violence against children at all levels of organization, resources and knowledge. This is important if we are to avoid vulnerable systems and the loss of established knowledge owing to the replacement of competent personnel. This has previously been seen in the field of sexual abuse of children. Working with violence against children involves considerable strain on the personnel involved, which underlines the need to attach considerable importance to strategies associated with this field. An example of an initiative that contributes to this is the forum for medical professionals at the Norwegian Centre on Violence and Traumatic Stress. This is a twice-yearly gathering of paediatricians, forensic pathologists, gynaecologists and nurses from Norway and the Nordic countries who perform or are interested in medical examinations of children and adolescents where there is a suspicion of abuse (physical, sexual or emotional) or of gross deficit of parental care. The forum works on quality assurance of diagnosis and procedures and on exchanging knowledge and experience, thus contributing to both competence building and competence development. In this respect, the forum serves an important purpose in increasing medical competence and in making it more robust across national borders. III. FRAMEWORK FOR CHANGE – Conclusions and recommendations What could and should be done by the various sectors – this section includes the outcomes from the consultation and national seminar. In the following, we present the most important priority areas and recommendations for the work ahead on preventing violence against and abuse of children and adolescents in Norway. In addition to the preceding chapters of the report, this presentation is based on input from a seminar that was held on 3 December 2007 in Oslo. The seminar was opened by the Council of Europe representative, who was present throughout. A number of central organizations, research institutions and municipal child welfare authorities were represented. These took an active and constructive part in the dialogue with several ministries and directorates (see the enclosed programme and list of invited participants). A. The System's achievements and inadequacies. Organization Maintaining a focus on all forms of violence The account shows that considerable competence has been developed in various types of violence affecting children and adolescents. The current preventive work on violence against and abuse of children and adolescents is characterized by a broad approach. At the social level too, increased attention has been devoted to children subjected to various forms of violence. This is an advantage since it indicates an increased probability of reaching children in various situations involving violence and abuse. At the same time, the development of the awareness of various forms of violence against and abuse of children indicated that, when one form violence against children receives public attention, other forms of violence are in danger of not being focused on. Reduced focus involves a risk that fewer cases will be detected and that existing knowledge is not further developed or is lost. This is a challenge to preservation of 40 the knowledge concerning violence against children and to safeguarding of the "sustainability" of the work carried out in the field. Retaining the focus at the national, regional and local levels on all forms of violence against children is therefore a major national goal of violence prevention work. Coordination across professions and organizational systems A number of organizational changes in the Norwegian system (cf. establishment of health regions, regional centres for child and adolescent mental health, Bufetat and professional teams, regional resource centres for violence, traumatic stress and suicide prevention) in recent years reflect a development towards gathering competence in larger units. This is made necessary by the fact that Norway is a long and narrow country with towns and villages of varying size and composition of population. Some regions have very little experience of various types of violence issues, while others have a broader experience. Another challenge has been the low level of exchange of knowledge between various fields involved in bodies that come into contact with children subjected to violence. Through the establishment of larger units with responsibility for a greater number of different fields, the organizational conditions will more easily facilitate interdisciplinary cooperation, thereby reducing the risk of fragmentation of knowledge. This is important because improved coordination results in improved provision. Organization across agencies and professional boundaries helps to consolidate provision for victims of violence, improves the coordination of facilities and increases the potential for equivalent provision throughout Norway for children subjected to violence. Despite the advantages created by these organizational changes, there are still challenges with regard to exchange of competence and professional cooperation across the organizational structures. Although the units have become larger, these structures function to a certain extent as parallel systems. For example, health regions have been established where the Ministry of Health and Care Services has the overall responsibility and where the Directorate for Health and Social Welfare has responsibility for the work at the regional level. The field of child and family care is organized in regional units (Bufetat) where the Ministry of Children and Equality has the overall political responsibility. Here, the Directorate for Children, Youth and Family Affairs has responsibility for the work at regional level. These partly parallel hierarchical structures provide a challenge for the coordination of work between the various sectors at all administrative levels. At the national level, coordination across policy areas is accomplished by means of groups of senior officials and by means of strategic plans and action plans. These plans supply an important function for the field by providing a direction for violence prevention work at national, regional and local levels. A challenge in the time ahead will involve a review of these plans in order to investigate the degree of correspondence between plans and results and to ensure better coordination between plans developed in neighbouring policy areas. This will be consistent with a knowledge-based approach and result in better coordination of the work. Although there are today formal guidelines, for example for consultation rounds in connection with draft legislation, there is room for a further strengthening of the structure of the cooperation between the authorities and interest groups/NGOs, etc. This is important both out of regard for democratic considerations and in order to ensure the best possible quality and a broad foundation in the national policy in the area. It is not only the overriding structures that may obstruct cooperation. The internal organization of work in the various agencies may also stand in the way of cooperation across professional boundaries. It is not sufficient to coordinate the various units. One must also examine whether 41 production and performance targets in the various agencies promote or inhibit cooperation between the various agencies. If, for example, the production targets for psychological treatment involve treating as many patients as possible within the shortest possible time frame, these targets will not necessarily promote cooperation between the various agencies. A the same time, such cooperation is often necessary for ensuring that individual patients receive the best possible total treatment. However, at the local level, there are examples of measures that help to promote such cooperation. For example, in some places, the child welfare authorities and child and adolescent psychiatry have a more formalized cooperation, where child and adolescent psychiatry has undertaken to be involved at an early stage. At the same time, both agencies receive training from Alternative to Violence, which has specialist competence in the field. Other examples are regular meetings in interdisciplinary teams in child welfare cases, which may be attended by the police in cases where this is indicated. At these meetings, cases are discussed anonymously and, by means of the anonymity, a balance is achieved between the criminal law perspective and regard to ensuring that the child receives help. At the local level, there are also measures that situate services for children at a single location with a view to improving cooperation and detecting problems met by children and adolescents as early as possible. Establishment of so-called "family centres" is an example. A family centre is a low- threshold provision and a meeting place for the various services, such as child welfare, the educational-psychological service, open day care facilities, prenatal examination, child health clinic and family guidance. Many family centres have also established contact with mental health care for children and adolescents and the police. This is a model for working with children and families with children in an interdisciplinary and coordinated manner, where the users have access to several relevant services in one place. There are currently over 55 such centres in Norway. B. Priorities and policymaking 1 Policymaking Maintaining a child-oriented perspective in preventive work It is of major importance that the work on preventing violence against and abuse of children maintains a child-oriented perspective. This is consistent with the UN Convention on the Rights of the Child, which was incorporated into Norwegian law in 2003. A child-oriented perspective involves taking the needs of children as one"s starting point when shaping national policy, and including children in the policy shaping process. In order to achieve this, the children"s own voices must be heard. This consideration is given priority in a number of connections in the national policy and through the work carried out by several organizations. For example, the Office of the Commissioner for Children has an expert panel consisting of young people who state their opinions on issues dealt with by the Commissioner. The organization "Adults for Children" has arranged consultations with a view to discovering children"s own views. However, these are only examples. We must at the same time stress that, although maintenance of a child-oriented perspective is emphasized as a primary consideration, this does not mean that the children themselves are assigned a responsibility for preventing these acts. The responsibility for this shall always lie with the adults. A major challenge in the time ahead will be to devise effective measures directed at the children themselves with a view to maintaining a child-oriented perspective, of which 42 Olweus"s anti-bullying programme in the school is an example. A challenge involved in devising measures directed at the children themselves is that one is in danger of making the children responsible, and one risks creating measures that are not well enough adapted to the children themselves on the basis of their needs and prerequisites. An example of preventive measures that have been criticized on the basis of some of these considerations are programmes designed to prevent sexual abuse of children (cf. part II (C) (1), above). These programmes aimed to give children knowledge of sexual abuse, to teach the children to say no in abuse situations and to report experiences of abuse. In Norway, "Secure and Strong" and "It"s MY body" were the most widely used programmes (Førland and Mossige, 1993). Following a review of such programmes, Førland and Mossige conclude that these programmes have a tendency to place too much of the responsibility on the children themselves, and that this may reinforce feelings of guilt experienced by children subjected to abuse. In order to maintain a child-oriented perspective in the work, there is a need for more research27 based on children"s own experiences of violence and abuse. How do children and adolescents in different age groups experience being subjected to violence and abuse, or witnessing violence, whether isolated incidents or acts of abuse that occur over a period? Direct information from children is necessary in order to be able to give them assistance based on the needs of the child. An example of a measure that has involved children directly in creating a preventive measure against bullying is a project under the auspices of Norwegian Save the Children. The project28 is entitled "NO 1 OUT". In this project, 850 young people shared experiences from Norwegian school life of how it feels to be bullied and how it feels to be the bully. On the basis of ideas from a group of young people from different parts of the country, tools were devised for tackling bullying in the lower secondary school. The work was continued in the game "Ingen utenfor29" ("NO 1 OUT"), which aims, among other things, to develop solidarity based on equality and human rights, for pupils to be able to include others and to be included themselves, and to develop increased pupil participation. The need for a broad approach in work on violence prevention Where both design and implementation are concerned, there is a need for a broad approach in the national work on preventing violence against children. Further efforts in the preventive work will include prevention at all levels, primary, secondary and tertiary prevention (cf. chapter I). The work will furthermore be directed against all forms of violence against children. Although important work directed towards physical and mental abuse of children is already in hand, there is in this connection a need to give these areas greater priority in the total violence prevention work. Besides work on preventing different forms of violence, there is a need for efforts to prevent violence of varying degrees of severity. NOVA"s scope survey of violence experiences of 27 Överlien (2007) has conducted a review of the literature concerning Nordic and international research on children"s exposure to father"s violence against mother. She shows that Anglo-American research has been dominant in this field, adopting psychological or socio-medical approaches, that have almost exclusively been quantitatively oriented from an adult perspective. Nordic research has to a greater extent adopted qualitative approaches, including sociological, pedagogical or social welfare approaches. Överlien calls for more research applying a child perspective, where the child is given a clearer status of social actor and agent. 28 See website: http://txt.no/index.php?option=com_content&task=view&id=595&Itemid=461 29 See website: http://www.reddbarna.no/default.asp?V_ITEM_ID=108 43 young people showed that, in the case of those who reported such experiences, the less serious offences were the most usual (cf. Stefansen 2007). It is important to direct preventive work at less serious offences too in order to avoid the use of less serious offences to legitimate more serious offences. The concept is that "the higher the threshold in the population is for violence of the moderate kind, the more divergent gross violence will be" (cf. Stefansen et al 2007 p. 181). Besides focusing on the gross and systematic violence affecting children, there is therefore reason to strengthen the preventive work directed at isolated or more sporadic offences against children. Furthermore, in the case of conditions in Norway, a broad approach in preventive work involves to a great extent making changes in existing systems. Unlike, for example, the USA, which to a greater extent applies a programme approach, prevention of violence against children in Norway is included as part of the ordinary practice of the various professions involved. An advantage of a programme orientation is that it involves implementing programmes of more limited scope. It is more arduous to make changes to existing systems than to implement a more limited programme. On the other hand, the possibility of ensuring lasting changes is greater when implementation is carried out at system level than when it is carried out at programme level. In Norway too, many of the measures in this field have been project-based measures carried out, for example, through the action plans. However, work is in hand on integrating projects in the ordinary system. The action plan against domestic violence 2008–2011 "Turning Point" (p. 5), states: "We will lift the good experiences out of the time-limited projects into the established services." This is consistent with experience showing that lasting changes require a rooting in both system and management. At the individual level too there is a need for a broad approach. Children who are subjected to violence and abuse should not be viewed in isolation from their relationships to other persons. A child who witnesses that its father is violent towards its mother is exposed to violence. However, the child"s relationship to its mother and father is of central importance to an understanding of the significance of this violence for the child. A help provision that safeguards the child must adopt an approach that takes these relationships into account on the basis of the child"s needs. Both treatment and punishment are central perspectives associated with prevention of violence against children. A broad approach involves balancing these perspectives against each other. For example, regard for ensuring that children subjected to violence and abuse receive rapid treatment might conflict with considerations associated with criminal investigation of the case. In this connection, the risk of damage to evidence is of central importance. However, a child should not have to wait for psychological treatment owing to the risk of damage to evidence. The goal must as far as possible be to attempt to pay regard both to treatment of the child and to the criminal investigation of the case. In cases where these separate considerations cannot both be safeguarded, consideration for the child must take precedence over consideration for the criminal investigation of the case. Preventing and combating violence against and abuse of children is a responsibility for all The state has overall responsibility for ensuring that children have sound and secure conditions for growing up, including protection from violence and abuse. At the same time, violence against and abuse of children occurs in so many different arenas and in so many relations and contexts that, if children are to be ensured efficient protection in their daily lives, all members of society must participate in this work. Every citizen must regard it as his or her duty to help in ensuring that children and adolescents are not subjected to violence. These are also important goals for the national work directed at preventing violence against and abuse of 44 children. Success in this necessitates a general social awareness that children and adolescents are actually subjected to violence and abuse. Achieving this level of awareness is dependent on dissemination of knowledge about the violence that children are subjected to. In addition, it is important to instil a clear and unequivocal intolerance of such acts in the general public. This is an important precondition for ensuring that individual members of the public intervene if they learn of such violence, and is therefore a central point in the national strategy for preventing violence against children (cf. C (1)). There is reason to believe that there is a considerable degree of general resistance to violence against and abuse of children when the child involved is small and the offence is serious. Most people, for example, would condemn the subjection of a small child to sexual abuse. However, the older the children are and the more ambiguous interpretations that can be put forward in connection with the acts, the less general consensus can be expected. If, for example, a 16 year-old girl is subjected to unwanted sexual acts by a person of the same age, there is less distance between an act of abuse and a socially acceptable pattern of behaviour (that mutually consenting adolescents are sexually active with each other). In such cases, attitudes manifest themselves that are traditional in rape cases. For example, that the girl wanted the sexual act, was not clear enough in her resistance or was irresponsible owing to the way she was dressed or the fact that she was intoxicated. It may also be that we believe there to be a greater degree of consensus that acts of violence are socially unacceptable to the Norwegian public than is really the case (cf. Ford, 2007). This applies for example to the use of physical force in upbringing of children. In 2007, several persons of high profile expressed to the media that they themselves had been subjected to or had exercised physical force during upbringing, and that this was not particularly harmful. This was followed by a heated debate about the harmful effects of such acts. With a view to achieving a general zero-tolerance attitude towards violence against and abuse of children, there is a need to strengthen the national attitudinal development in such areas where there is reason to expect a lower degree of consensus that these acts are undesirable. 2. Capacity development Strengthening and preserving knowledge and competence on violence and abuse It is a national goal that the national violence prevention work shall be knowledge-based. This concerns both gathering and systematizing of knowledge (see below for further information on this) but also ensuring that relevant professional groups and the general public have sufficient competence on violence and abuse. As referred to above, competence building is a priority field of national preventive work. However, this work must be extended to apply to more target groups. The goal should be that all professionals who work with children and adolescents should receive instruction on violence and abuse as a part of their compulsory training. Competence on violence and abuse in the child welfare authorities should be raised considerably since this is the agency that has the main responsibility for handling the child"s situation where there is a suspicion of violence and abuse in the family. Knowledge of violence and abuse should also be disseminated to other groups that meet children and adolescents, for example personnel in recreation centres and sports clubs, so that a larger section of civil society is made responsible for the work. Generally speaking, organizations that work on issues associated with children and vulnerable groups should receive training on these issues. In the Red Cross, for example, all personnel are given an educational booklet containing information on violence and on what has to be done if violence and abuse is 45 discovered (cf. Et av fem barn har en vond hemmelighet. Tør du å lytte? [One of five children has a painful secret. Dare you listen?] 2007). Such training should be part of a national strategy with a view to maintaining the competence of everyone who meets children and adolescents in the course of his or her work. Increased competence on violence and abuse includes increased knowledge of the different types of violence and abuse to which children and adolescents are subjected, the signs and symptoms that may be expressed, mechanisms that inhibit disclosure (for example, isolation, shame and feelings of guilt) and how one can talk to children and adolescents about violence and abuse. There is also a need for specific information concerning what the individual employee shall do if he or she learns of violence, and a need for increased awareness that children can be subjected to several types of violence at a time. For example, that a child is bullied at school and is also subjected to abuse at home. In other words, the different forms of violence must be viewed in relation to each other. Ensuring increased detection of abuse There is a need to continue efforts to detect more cases of violence against and abuse of children. As referred to above (cf. B (1)), the public authorities are obliged to report to the child welfare authorities violence and abuse to which children are subjected. At the same time, practice indicates that not all professional groups make such reports. This may be due to a lack of competence in detection of violence and abuse (see above), but may also be due to a lack of certainty about what one can do in such situations. Competence building must therefore include knowledge not only of violence but also of the options open to one when violence is detected. An example of a measure that strengthens the likelihood that a matter will be referred to the correct agency is an arrangement involving checklists such as that introduced for the police in cases involving domestic violence (cf. Police handling of family violence cases, 2002). A key area involves the provision of security to the various professional groups concerning the limits of the duty of confidentiality within the different professional areas and concerning the point where the duty of disclosure begins to apply for the different professions. In addition, there is a need for a support facility that can be called upon when an individual professional practitioner is in a situation where action and a referral are required. In this connection, it is also important that the agency to which the matter is reported responds to the reporting agency as far as possible within the provisions for the duty of confidentiality (cf. the provisions of section 11a, second paragraph, of the Public Administration Act concerning provisional replies. In other words, there is a need to remove obstacles in the system against disclosure of violence and abuse. There is much to indicate that these obstacles are due not to a lack of statutory authorities in the national legislation for information exchange, but to uncertainty and insufficient competence in the practice of the regulations. In order to reveal abuse, it is important to ensure that more children and adolescents report abuse. The children"s own knowledge concerning violence and abuse is an important precondition for ensuring that more children and adolescents make such reports. These groups must be made aware of their right to grow up without violence or subjection to isolated incidents of violence. Increased knowledge is also important for victims of violence and abuse in order to bring to an end the isolation suffered by victims of violence. Knowledge of violence and abuse should therefore be given to children and adolescents at school. In order to ensure that children and adolescents report violence and abuse, it is important that available facilities have a low threshold. As referred to above in the report, the national 46 provision includes a number of telephone help lines directed at children and adolescents. As referred to above under II (C) (2), the establishment of an alarm telephone for children and adolescents is now proposed in the Action plan against domestic violence 2008–2011 "Turning Point". Parents and other persons may also ring this number and be referred on. A common number of this kind may help lower the threshold for children and adolescents so that more of them report violence and abuse. There is also a need to ensure increased detection of violence against and abuse of the smallest children. This group is most dependent of all on intervention by someone in the child"s life who reports the problem. It is also this group that has a tendency to be least visible in violence prevention work. Besides strengthening the competence on violence and abuse of the professions that come into contact with the smallest children (child health clinics, day care facilities, hospitals/A and E units, child welfare) this is also a matter of strengthening the ability of personnel30 to see that small children are being subjected to violence and abuse and to intensify work on strengthening the professions" competence in talking to children about such experiences. As referred to above, a great deal of work is already being carried out in medical fields associated with the detection of violence and abuse. At the same time, many cases of violence are still not detected. In this connection reference can be made to a project involving the gathering of data from the medical records of all children less than three years of age admitted to Ullevål University Hospital in Oslo during the last 10 years with serious head injuries (a total of 91 children). The study shows that many children have been treated for serious head injuries without sufficient investigation of the causes and mechanisms of injury (Myhre, 2007) In addition, there is a need to investigate the extent to which the various agencies (child health clinics, day care facilities, hospitals/A and E units, child welfare, mental health clinics for children and young people) report suspicions of violence and abuse to the child welfare authorities and the police with a view to ensuring that the information reaches agencies with the authority to implement measures. In cases where a child dies as a result of violence, death location investigations are a measure that may help increase the rate of detection. For further information, see part II (C) (3) of the report. However, death location investigations are not compulsory. There may therefore be grounds for assessing their role in detecting deaths of children caused by violence. A satisfactory treatment provision As mentioned previously, the national measures associated with the prevention of violence against children give priority first to helping exposed children, and then to developing more general prevention measures. A satisfactory treatment provision is of central importance in this connection. Increased detection of violence and abuse will increase the pressure on the treatment channels. An increase in the number of persons seeking assistance will require a robust treatment provision with a broad range of facilities. In Norway, a good treatment provision has been developed for male batterers (cf. the assessment made by the Norwegian 30 This also involves a closer examination of the various professions" premises for noticing children subjected to violence and abuse. In her doctoral dissertation, Cecilie Basberg Neumann (2007) throws light on the role of public health nurses in this connection. She shows how the professional understanding of public health nurses lies in normality, and how the public health nurse plays a didactic role in laying sound foundations for the child"s future good health. According to Basberg Neumann, the public health nurse"s focus by virtue of her professional role results in a weakening of her potential for detecting violence and abuse. If one examines the implementation of knowledge of violence and abuse in the light of this, provision should be made for the fact that the knowledge provided to the professions should be adapted to the framework in which the various professions work. 47 Centre for Violence and Traumatic Stress Studies and two surveys). It is necessary to ensure that the treatment provision is equally adequate as regards other forms of violence and for subgroups of perpetrators and victims. This is not least important for young victims31 and/or perpetrators. In this connection, there is furthermore a need for a systematic development32 and assessment of appropriate methods of treatment. Providing a broad range of treatment facilities does not entail that all municipalities shall be able to provide all types of treatment, but the facilities must be available in Norway. It is important to think in terms of "sustainability", not only of the organizational structure but also of the content of the provision, which requires the continued presence of competent personnel. It is furthermore important to ensure that perpetrators and victims receive early treatment. This is of central importance in ensuring that the child receives help as quickly as possible. Early assistance is also important for prevention of future abuse since research shows that violence and abuse often have a cyclic pattern (cf. Mossige and Abrahamsen, 2007). Need for targeted measures Recent research shows furthermore that abuse is often carried out by young perpetrators (cf. the NOVA report) against young victims. Both the national scope survey of violence and sexual abuse and the Nordic-Baltic study of sexual abuse show that the greatest proportion of unwanted sexual acts were carried out by persons in the same age group, i.e. by young people (cf. Mossige 2007 and Abrahamsen and Mossige 2007). The investigations also show that the number of girls who have experienced unwanted sexual acts is disconcertingly high, and also that boys report unwanted sexual acts (cf. Mossige 2007). This indicates that young people should be a high priority group in violence prevention work in the time ahead. In the national scope survey, rather more than 20 per cent of those who reported unwanted sexual acts were under the influence of alcohol when the act took place. With a view to developing efficient preventive strategies, more knowledge should be obtained concerning this violence. There is a need both for more scope surveys and more in-depth studies. In addition, there is a need for studies that follow larger groups over time in order to obtain more detailed knowledge of the development of violence and abuse in Norwegian society. The available results indicate a need to strengthen information on sex, drugs and alcohol directed at young people. Because they reach many children and adolescents and constitute a very important low- threshold provision, the school and the school health service play a central role in this connection, as do the arenas where young people spend their free time, such as sports clubs, music activities and recreation centres. Targeted national public awareness campaigns can play an important role in raising awareness and supporting social norms regarding sexual exploitation. At the same time, it is important to make a systematic review of the information work regarding sexuality, attitudes and limit setting, including an assessment of the age 31 In this connection, we refer to a study carried out by the psychologist and researcher Ane Simonsen. This sums up the characteristics of young persons receiving treatment at the former outpatients" clinic "Alternative to Violence - Young", an outpatients" clinic for young people with violence and aggression problems. The study shows that the method of treatment was more effective for some groups of young people than for others. Negative factors included drug abuse, membership of gangs" age over 16 years. Alternative to Violence has no current treatment provision for this group (cf. Sexual and physical abuse of children. Project Plan for the Section for Children and Adolescents, NKVTS, 2007). 32 An example of trial of a method of treatment aimed at this group is the study "Traumefokusert kognitiv atferdsterapi for barn: En prosess- og effektstudie" [Trauma-focused cognitive behaviour therapy for children: A process and effect study]. (The study is currently in progress and is being conducted by Tine K. Jensen at NKVTS cf. www.NKVTS.no). 48 groups that the instruction should be aimed at. Specific measures, for example, in the form of discussions and role-play are appropriate in this connection. The measures must be designed in such a way that young people experience that the issues raised actually concern their daily lives. At the same time, it is important that the provision is designed in a way that does not place any strain on children and adolescents exposed to abuse. An example is a cooperative project between a school and a child health clinic. The project was directed at young people and raised issues concerning sexuality, ethics and interpersonal relations in a broader and more thorough way than is usual in the Norwegian school. Activities included focus groups, which discussed topics such as limit setting and respect. When the cooperative project was assessed, attention was drawn to the fact that the young people had benefited from the instruction and were able to relate it to their daily lives (Hellem 2004). In addition, there is a need for targeted measures directed at high-risk groups. NOVA"s self- report survey of violence against and abuse of children and adolescents found marginalized groups to be at a greater risk of being subjected to various forms of violence and abuse. This indicates that the work on improving the situation for marginalized groups plays an important role in preventive work. There is furthermore a need to strengthen the information work associated with groups that, with reference to culture or tradition, advocate social acceptance of the use of corporal punishment in bringing up children. As referred to previously, parental guidance programmes are used today to disseminate information on, among other things, the prohibition of corporal punishment of children and on alternative ways of setting limits. Although the need for targeted measures is emphasized, it is at the same time important to communicate that the use of violence is not a phenomenon that exclusively affects or is carried out by specific groups. Although a higher frequency is found in certain groups, these are acts that take place across nationalities, cultures and social classes. Preventive work must be viewed in connection with children"s conditions for growing up in general. If all children are given sound and secure conditions for growing up, children and adolescents in general are less vulnerable to violence and abuse. 3 Prevention strategies and their implementation A challenge in the national preventive work associated with violence against children involves ensuring more systematic implementation of strategies and measures. Preparation of plans for implementation, assessment and systematization of knowledge concerning preventive measures plays a central role in this connection. Assessment of the measures implemented is necessary to the achievement of the national objective that preventive work shall be knowledge-based. In addition, there is a need to obtain more international knowledge concerning successful preventive strategies. Exchange of experience across national borders as a stage in the process of developing a European model for prevention of violence against children is thus also an important stage in the national work. C. Conclusions Central areas of focus at national, regional and local levels: 49 Keeping a focus on all forms of violence Keeping a focus on all forms of violence against children is a central national goal of work on violence prevention. In this connection, there is a need for a keener focus on preventing physical violence against children in general and against the smallest children in particular. Adopting a global approach where different forms of violence are viewed in relation to each other. Improved treatment provision and increased risk of detection Further development of a broad national strategy for prevention of violence against children. This involves: (1) ensuring children subjected to violence a satisfactory treatment provision (2) increasing the risk of detection by raising the competence of the first line service and (3) informing the public about the harmful effects of violence so that violence and abuse are not tolerated and so that more cases are reported to the relevant authorities. Work to achieve a robust treatment provision with a broad range of facilities for different groups of victims of violence with a focus on early intervention. Maintaining a child-oriented perspective in preventive work Involving children and adolescents in the preventive work in a manner that safeguards the children, neither imposing responsibility nor reinforcing feelings of guilt the victims may have. Strengthening and preserving knowledge and competence on violence and abuse Preserving knowledge of different forms of violence against children in terms of organization, resources and knowledge at all levels. Continuing the focus on raising competence on violence against children in professional training programmes and in organizations and services that are in contact with children and adolescents. Coordination across professions and organizational systems Strengthening the interdisciplinary cooperation across organizational structures. Rooting projects and measures in the ordinary structures in order to safeguard "sustainability". The need for targeted measures Strengthening attitudinal development in youth environments associated with sexuality and respect for boundaries. Making efforts to improve the living conditions of marginalized groups. Preventive work shall be knowledge-based Concentrating on increased knowledge of violence against and abuse of children with regard to scope, prevalence, violence and abuse as a phenomenon, risk factors, detrimental effects, and systematic assessments of measures, action plans and implementation. 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