Karl Yngvar Dale

• Dale, Karl Yngvar & Ødegård, Atle (2026). Anchoring practice in flux: Experiences among professionals in Norwegian specialized ambulatory mental health care teams. Current Psychology. ISSN 1046-1310. 45(18). doi: 10.1007/s12144-026-10096-7. Fulltekst i vitenarkiv Vis sammendrag

  This study investigates how mental health professionals working in Norwegian specialized ambulatory teams navigate complex ethical, relational, and organizational demands within fragmented care environments. Using an exploratory qualitative design, we conducted semi-structured focus group interviews with practitioners across 11 teams, including Assertive Community Treatment (ACT), acute, follow-up, and rehabilitation services. Reflexive thematic analysis yielded four interrelated themes: Anchoring Amid Chaos, Bearing Ethical Strain, Reinventing in Motion, and Sustaining Care Through Strong Relationships. These themes illustrate how professionals navigate fragmented systems by exercising moral judgment, building relational connections, improvising in real time, and coordinating informally across organizational divides. Theoretically framed by Zigon’s concept of moral breakdown, Rogers’ person-centered theory, Schön’s reflective practitioner model, Luhmann’s systems theory, and the PINCOM model of interprofessional collaboration, the study positions these practitioners as reflective mediators who uphold continuity and therapeutic integrity amid institutional fragmentation. While grounded in a specific regional context, the findings provide experience-near insights into the micro-practices that sustain recovery-oriented care within decentralized and unpredictable systems. The study highlights the need to support the anchoring role of frontline professionals by fostering ethical reflection, strengthening relational infrastructure, and enabling responsive collaboration across fragmented systems. These findings underscore the importance of recognizing the adaptive anchoring work among practitioners and offer concrete directions for training, evaluation, and policy in community-based mental health care.

• Dale, Karl Yngvar; Sæbjørnsen, Siv Elin Nord & Ødegård, Atle (2026). From Stigma to Recognition in Dual Diagnosis Care: A Multilevel Conceptual Framework. Community mental health journal. ISSN 0010-3853. doi: 10.1007/s10597-026-01688-5. Fulltekst i vitenarkiv Vis sammendrag

  People experiencing co-occurring mental health problems and substance use disorders face some of the most fundamental challenges in contemporary mental health and addiction services. Despite longstanding policy commitments to integrated care, dual diagnosis care remains characterized by persistent fragmentation. Existing multilevel perspectives have advanced understanding of how stigma contributes to exclusion across healthcare systems, yet provide less guidance for explaining how continuity of care is established and sustained across interconnected institutional, organizational, and relational contexts. Drawing on a conceptual synthesis of empirical and theoretical literature, this article develops a multilevel framework integrating recognition theory, stigma theory, and ecological systems theory. The framework conceptualizes dual diagnosis care as shaped by interacting stigma- and recognition-related processes operating across macro (institutional), meso (organizational), and micro (relational) levels. Fragmentation and continuity are understood as emergent outcomes of the degree of alignment or misalignment between these processes across levels of care. Recognition is conceptualized not merely as a feature of interpersonal encounters, but as a coordinating principle through which institutional commitments, organizational arrangements, and relational practices may become aligned to support continuity, participation, legitimacy, collaboration, and trust. By extending existing multilevel perspectives beyond explanations of exclusion alone, the framework provides an analytical lens for understanding why fragmentation may persist despite policy commitments to integrated care and how continuity may emerge when recognition-supporting conditions are aligned across systems of care.

• Dale, Karl Yngvar; Larsen, Bjørn Kjetil; Hean, Sarah Catherine Patricia Duff & Ødegård, Atle (2025). Exploring relational and structuring skills among Norwegian probation officers during mandatory supervision sessions. European Journal of Probation (EJP). 17(1), s. 35–51. doi: 10.1177/20662203251327514. Fulltekst i vitenarkiv Vis sammendrag

  This study draws on person-centered therapy, Bordin’s working alliance model, and the guidelines from the Norwegian Prison and Probation Service to explore how Norwegian probation officers demonstrate key relational skills during supervision. Thirteen participants from probation offices in western Norway took part in three focus groups: two with supervisees and one with probation officers. Thematic analysis revealed two key themes: (1) perceptions of inconsistent focus and (2) a cautious atmosphere of trust. While empathy emerged as a crucial factor in building a working alliance, it sometimes came at the cost of structure and planning. However, this imbalance did not necessarily undermine the sessions’ effectiveness, as trust and rapport form a strong foundation for growth. The findings highlight that balancing a strong bond with clear structure is central to effective probation supervision. This implies that probation officers should leverage relational trust to introduce structure, thereby fostering sustainable behavioral change.

• Vigfusdottir, Johanna; Høidal, Reidun; Breivik, Edvard; Jonsbu, Egil; Dale, Karl Yngvar & Mork, Erlend (2024). The Norwegian version of the Personal Feelings Questionnaire-2: clinical utility and psychometric properties. Current Psychology. ISSN 1046-1310. 43, s. 36714–36725. doi: 10.1007/s12144-024-07101-2. Fulltekst i vitenarkiv Vis sammendrag

  Shame and guilt are universal emotions meant to elicit socially approved behaviors and inhibit antisocial behavior. Excessive feelings of shame and guilt—shame especially—are linked to various destructive behaviors, difficulties in emotion regulation, maladaptive personality traits, psychological difficulties, and negative impacts on treatment outcomes. These make it especially important to have a valid instrument to evaluate the mechanisms related to these emotions. No validated self-report instrument measuring generalized shame and guilt was available in Norwegian. The Personal Feelings Questionnaire (PFQ-2) is designed to measure the level of generalized shame and guilt. This project’s aim was to translate the PFQ-2 into Norwegian and evaluate the clinical utility and psychometric properties of a Norwegian version of the PFQ-2. Data were collected from students at a local university college in Norway (N = 320, age: M = 25.4, SD = 8) and patients at a local outpatient psychiatric hospital (N = 53, age: M = 31.4, SD = 10.43). To be able to evaluate the factor structure of the Norwegian version of the PFQ-2, the dataset was divided in two by random selection with a 50/50 split. First an Exploratory factor analysis (EFA) was conducted on one half of the sample (N = 180) and then a Confirmatory factor analysis (CFA) on the other half (N = 193). According to the EFA the factor structure was similar to the original factor structure, with the exception of one item (item 6). Confirmatory factor analysis showed a good goodness of fit for the two factors measuring shame and guilt. The internal consistency was high in both subscales (shame, α = 0.818, and guilt, α = 0.834). The instrument showed further adequate construct validity, where the clinical sample experienced greater shame than the community sample (M = 17, SD = 6.887 vs. M = 13, SD = 5.311) and stronger guilt (M = 18, SD = 5.248 vs. M = 14, SD = 15.210). The subscales correlated with other constructs, as expected. The PFQ-2—with the suggested adjustment of moving one item (item 6) from the shame scale to the guilt scale—can be used to evaluate the levels of feelings of shame and guilt among adults in Norway.

• Larsen, Bjørn Kjetil; Dale, Karl Yngvar & Ødegård, Atle (2021). Interprofessional collaboration in reintegration after prison for prisoners with substance abuse issues : a scoping review. International Journal for Crime, Justice and Social Democracy. ISSN 2202-7998. 10(2), s. 1–17. doi: 10.5204/ijcjsd.1951. Fulltekst i vitenarkiv Vis sammendrag

  Reintegration after prison for prisoners with interlinked welfare needs has been one of the most challenging issues for decades in the criminal justice system. The WHO and the UN highlight the demand for well-functioning collaboration between professionals and welfare agencies handling these challenges. However, interprofessional collaboration has been an underdeveloped field of research and theory, especially concerning prisoners with substance abuse issues. The present study undertakes a scoping review of research on interprofessional collaboration in reintegration after prison for prisoners with substance abuse issues, particularly identifying factors that influence collaboration. Nineteen included studies from the USA, the U.K., Australia, and Norway show that relational and structural factors influence collaboration and that innovative projects are perceived as improving collaboration. A tentative conceptual model of factors that influence collaboration is presented and may serve as a basis for reflection and further development of a theoretical framework within the field of research. Keywords: interprofessional collaboration, prisoners, prison, reintegration, scoping review

• Fluttert, Frans A. J.; Eidhammer, Gunnar & Dale, Karl Yngvar (2021). Early recognition method : ‘Opening doors’ in risk management dialogue between mental health and prison services. I Hean, Sarah Catherine Patricia Duff; Johnsen, Berit; Kloetzer, Laure & Kajamaa, Anu (Red.), Improving interagency collaboration, innovation and learning in criminal justice systems. Supporting offender rehabilitation. Palgrave Macmillan. ISSN 9783030706616. s. 267–295. doi: 10.1007/978-3-030-70661-6_11. Fulltekst i vitenarkiv Vis sammendrag

  In secured institutions, which include prison services, violence between clients or towards staff has a major impact, eliciting feelings of stress, anger and fear for those involved. In this chapter we explain how violence can be understood as a complexity of multiple factors, and why a structured risk management strategy is necessary to adequately assess and manage violence. We describe specifically the Early Recognition Method (ERM) as a step-wise forward strategy aiming to identify, formulate and manage early warning signs of violence and allows a risk management dialogue to develop between prison staff and inmates. The ERM-dialogue strategy has successfully been developed and applied in forensic psychiatry and in this chapter we explore how, in a process of innovation, the knowledge and research of the ERM-applied in forensic services, has been transferred to prison services. The ‘multivoicedness’ of the ERM is explored through the theoretical concept of the ‘Self’

• Nobakht, Habib Niyaraq; Ojagh, Faeze Sadat & Dale, Karl Yngvar (2021). Validity, reliability and internal consistency of Persian versions of the Childhood Trauma Questionnaire, the Traumatic Exposure Severity Scale and the Peritraumatic Dissociative Experiences Questionnaire. Journal of Trauma & Dissociation. ISSN 1529-9732. 22(3), s. 332–348. doi: 10.1080/15299732.2020.1869640. Fulltekst i vitenarkiv Vis sammendrag

  The Childhood Trauma Questionnaire (CTQ), the Traumatic Exposure Severity Scale (TESS) and the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) are questionnaires widely used in studies of trauma and dissociation. This study aimed to examine the validity of the Persian versions of these questionnaires among a total of 230 individuals from the cities of Kermanshah and Sarpol-e Zahab that had experienced 2017 Iran earthquake. Results from a confirmatory factor analysis did not support the original five-factor solution for the TESS. Two principal component analyses resulted in a four-component solution for a revised version of the scale. PDEQ scores, TESS scores, and its sub-scales, were found to significantly correlate with a PTSD measure with their effect sizes ranging from medium to large according to Cohen’s guidelines. Furthermore, significant correlations between two sub-scales of the CTQ and a dissociation measure were found with medium effect sizes. Consequently, reliability and validity measures obtained from the sample of this study were supportive of the use of the Persian versions of the TESS, the PDEQ, and the CTQ among Persian-speaking populations. Further research on psychological responses to earthquakes and other natural disasters can provide the opportunity for cross-cultural comparisons in terms of specific resilience factors and vulnerabilities following mass trauma. Keywords: earthquake, trauma, post-traumatic stress, peritraumatic dissociation, dissociation

• Fluttert, Frans A. J.; Bjørkly, Stål & Dale, Karl Yngvar (2020). The impact of a discarded diagnosis and focus on early warning signs of aggression on relations between user and municipal service providers : a narrative of a complex case. Current Psychology. ISSN 1046-1310. 41(8), s. 5503–5513. doi: 10.1007/s12144-020-01055-x. Fulltekst i vitenarkiv Vis sammendrag

  By means of a nurse-driven risk management strategy, a community mental health nursing team was assisted in their struggles to cope in the care of a very aggressive and disturbed patient. The aim of this study was to discuss how a wrong diagnosis lead to relational consequences in care and how applying the Early Recognition Method (ERM) contributed to a relational change. Self psychology concepts were used to analyze and understand the underlying psychological process in the interaction between the nurses and patient. This case narrative illustrates qualitative research strategies through the lens of the theoretical framework of symbolic interactionism. Nurses gained a better understanding of the complexity of the patient and the nature and effects of their interactions with her. The patient’s diagnosis was adjusted, resulting in perspectives that allowed for meaningful interactions and stabilization of aggressive behaviors. The most prominent result was the nurses becoming more confident and competent in their management of the care process. Nurses in community mental health care benefit from structured risk management strategies in unraveling the complexity of severe aggression. Self psychology is a meaningful lens by which to better understand the underlying psychological process in the interaction between nurses and a complex patient.

• Vigfusdottir, Johanna; Dale, Karl Yngvar; Gratz, Kim L.; Klonsky, E. David; Jonsbu, Egil & Høidal, Reidun (2020). The psychometric properties and clinical utility of the Norwegian versions of the deliberate self-harm inventory and the inventory of statements about self-injury. Current Psychology. ISSN 1046-1310. 41(10), s. 6766–6776. doi: 10.1007/s12144-020-01189-y. Fulltekst i vitenarkiv Vis sammendrag

  Deliberate self-harm (DSH) is a widespread transdiagnostic health problem with increasing prevalence among adolescences, and young adults. It is therefore essential to effectively chart the epidemiology of DSH, as well as to assess the efficacy of interventions designed to modify this behavior. The aim was to translate and analyze the psychometric properties of the Norwegian versions of two instruments designed to assess DSH: the Deliberate Self-harm Inventory (DSHI) and the Inventory of Statements About Self-Injury (ISAS), as well as to assess the prevalence of DSH within a nonclinical Norwegian adult population. Of the 402 participants who completed a questionnaire packet comprising the DSHI, ISAS, general questions about DSH, and other related measures, 30.6% reported some form of DSH. Those with a history of DSH reported greater difficulties with emotion regulation than those without. Participants with and without a history of DSH did not differ in unrelated constructs, including social desirability. The frequency of specific DSH behaviors was in accordance with previous research, with cutting being the most frequent. The factor structure of DSH functions in the Norwegian ISAS was generally comparable to the factor structure of the English version. Overall, results indicate that: a) the Norwegian versions of the DSHI and ISAS behave as expected and in accordance with prior research in other languages and other populations, and b) both the DSHI and ISAS have high internal consistency and adequate construct, convergent, and discriminant validity, and may be applied to evaluate DSH in adult Norwegian populations.

• Nobakht, Habib Niyaraq; Ojagh, Faeze Sadat & Dale, Karl Yngvar (2019). Risk factors of post-traumatic stress among survivors of the 2017 Iran earthquake : the importance of peritraumatic dissociation. Psychiatry Research. ISSN 0165-1781. 271(January), s. 702–707. doi: 10.1016/j.psychres.2018.12.057. Fulltekst i vitenarkiv Vis sammendrag

  The aim of this study was to explore the roles of pre-earthquake characteristics (age, gender, years of education, history of childhood and recent trauma and trait dissociation), during-the-earthquake state (peritraumatic dissociation) and post-earthquake difficulties (severity of exposure to earthquake) in post-traumatic stress among survivors of the 2017 Iran earthquake. A total number of 127 individuals in Kermanshah and 103 individuals in Sarpol-e Zahab completed and returned a 105-item questionnaire. Among these, 32 (25.2%) participants in the Kermanshah sample and 80 (77.7%) participants in the Sarpol-e Zahab sample scored equal to, or more than, the cut-off score of 33 on the Impact of Event Scale – Revised and, thus, were considered as having high likelihood of having PTSD. A three-model hierarchical linear regression analysis showed that pre-earthquake characteristics, during-the-earthquake state and post-earthquake difficulties each explained a unique variance of 11.3%, 34.4% and 14.7%, respectively, and together explained a total variance of 60.4% in post-traumatic stress. Earthquake victims who report higher degrees of peritraumatic dissociation during and immediately after the earthquake are more vulnerable to develop PTSD and should be prioritized in terms of receiving psychological interventions. Keywords: earthquake, trauma, post-traumatic stress, peritraumatic dissociation, trait dissociation

• Nobakht, Habib Niyaraq & Dale, Karl Yngvar (2019). The mediational roles of sleep disorders and nightmares in the relationship between trauma and dissociation. Dreaming (New York, N.Y.). ISSN 1053-0797. 29(1), s. 79–90. doi: 10.1037/drm0000095. Fulltekst i vitenarkiv Vis sammendrag

  The aim of this study was to test the validity of the “sleep-dissociation” perspective. In addition, and to gain a more comprehensive overview of the trauma–sleep– dissociation complex, we aimed to test in which manner and to what degree trauma sleep disorders and nightmares are related to dissociation. A total of 100 male and 100 female university students with mean age of 24 completed and returned a 160-item questionnaire designed to detect the extent of dissociation, childhood and recent trauma history, sleep disorders, and nightmares. Correlation analyses showed that sleep disorders and nightmares correlated significantly with history of childhood and recent trauma and dissociation. Findings from bootstrap- ping procedures showed that nightmares and sleep disorders, separately from each other, mediated the relationship between trauma and dissociation. However, when nightmares and sleep disorders were analyzed together in one data set, the only significant mediator was nightmares, which explained a substantial proportion of the total effect of childhood trauma on dissociation. These observations support the “sleep-dissociation” perspective on the relationship between trauma and dissociation, meaning that traumatic events might engender both sleep disturbances and nightmares, which in turn might play a pivotal role in the genesis of dissociative symptoms. The results of this study imply that trauma survivors, routinely, should be assessed and monitored with regard to sleep disorders and nightmares. Treating nightmares and, consequently, securing trauma survivors a consistent sleeping pattern and quality may play an important role in preventing the potential occurrence of dissociative symptoms. Keywords: trauma, sleep disorders, nightmares, dissociation

• Nobakht, Habib Niyaraq & Dale, Karl Yngvar (2018). The Importance of Religious/Ritual Abuse as a Traumatic Predictor of Dissociation. Journal of Interpersonal Violence. ISSN 0886-2605. 33(23), s. 3575–3588. doi: 10.1177/0886260517723747. Fulltekst i vitenarkiv Vis sammendrag

  This study aimed to ascertain the prevalence of different types of Religious/Ritual Abuse (RA) among Iranian young adults and to investigate the relationships between RA, childhood and recent trauma, and different patterns of dissociativity. A total of 100 male and 100 female university students completed and returned a 51-item questionnaire designed to detect the extent of dissociation, childhood and recent trauma history, and RA; 12.5% of participants reported history of RA. Pearson correlation analysis showed that RA strongly correlated with dissociativity. The most notable finding of this study is that RA and being victim of violence within the last 3 years are the most important traumatic predictors of dissociativity. More research on the nature of the relationship between RA and dissociation is suggested. Keywords: trauma, dissociation, religious abuse, ritual abuse

• Nobakht, Habib Niyaraq & Dale, Karl Yngvar (2018). An exploration of the roles of trauma and dissociation in mystical experiences and near-death experiences. The Journal of Spirituality in Mental Health. ISSN 1934-9637. 20(4), s. 321–332. doi: 10.1080/19349637.2018.1439796. Fulltekst i vitenarkiv Vis sammendrag

  The study aimed to corroborate the notion that mystical experiences and near-death experiences (NDE) are associated with trauma and dissociation and to test whether the prevalence of NDE is congruent across cultures. Among 100 university students who completed a 99-item questionnaire, 20 scored 7 or above on the NDE Scale. Furthermore, group comparisons showed that participants with either mystical experiences or NDE scored significantly higher than those without such experiences on all dissociative measures, but not on the trauma-related measures and absorption. The results support earlier findings implying that dissociation is a common feature in NDE and mystical experiences. Keywords: Trauma, dissociation, mystical experiences, near-death experiences, absorption

• Orvik, Sissel Telnes & Dale, Karl Yngvar (2017). Faglig frihet og uklare rammer : kommunale fagansattes erfaringer med psykisk helsearbeid. Tidsskrift for psykisk helsearbeid. ISSN 1503-6707. 14(3), s. 221–231. doi: 10.18261/issn.1504-3010-2017-03-03. Fulltekst i vitenarkiv Vis sammendrag

  Siden begynnelsen av 1990-tallet har flere lovendringer ført til stadig nye oppgaver for kommunalt fagansatte som arbeider med psykisk helse- og rusarbeid. Hensikten med denne studien var å undersøke hvordan slike fagpersoner erfarer sin arbeidshverdag. Det ble gjennomført semi-strukturerte intervju av syv ansatte. Tre hovedfunn skilte seg ut: 1) De fagansatte beskriver et behov for å synliggjøre og dokumentere egen identitet og praksiskompetanse, 2) de erfarer en følelse av stress og bekymring for fremtiden og med tanke på daglige oppgaver, og 3) de erfarer en stor grad av faglig frihet, glede og motivasjon i sin arbeidshverdag. Nøkkelord: psykisk helsearbeider, psykiatrisk sykepleier, kommunal, lokal, opplevelse, erfaring, samhandlingsreformen

• Ormbostad, Helga A.K.; Dale, Karl Yngvar; Gjengedal, Eva & Stallvik, Marianne (2017). Faktorer som virker inn ved frafall i døgnbehandling for pasienter med ruslidelser : en case-studie med vekt på både pasient- og behandlerperspektivet. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 13(1). doi: 10.7557/14.4076. Fulltekst i vitenarkiv Vis sammendrag

  Retention in substance abuse treatment is one of the most consistent predictors of successful treatment. Despite drop-out rates from 17-57 % for inpatient treatment, little is known of potential risk factors related to treatment programs and processes. The aim of this study is to obtain knowledge of this phenomenon by studying underlying processes and conditions associated with dropout. The case study method is chosen because of the scant literature and the ability of this method to gain in-depth information. The data material consists of qualitative interviews of patients and clinical staff together with journal material. The results indicate complex conditions associated with attrition and that the patients left treatment despite positive experiences and perceived usefulness of the program. It is suggested that there might be a process prior to the decision of leaving and that special attention should be paid to patients at higher risk for drop-out.

• Nobakht, Habib Niyaraq & Dale, Karl Yngvar (2017). The prevalence of deliberate self-harm and its relationships to trauma and dissociation among Iranian young adults. Journal of Trauma & Dissociation. ISSN 1529-9732. 18(4), s. 610–623. doi: 10.1080/15299732.2016.1246397. Fulltekst i vitenarkiv Vis sammendrag

  This study aims to investigate the prevalence of deliberate self-harm and its relationships to childhood and recent trauma and different patterns of dissociative features. A total of 100 male and 100 female college students were administered a 58-item questionnaire designed to detect the extent of dissociation, deliberate self-harm, and trauma history. Participants with deliberate self-harm behaviors reported more traumatic experiences and dissociative features than participants without such behaviors. Furthermore, the prevalence of deliberate self-harm (i.e., 40.5%) was similar to previous studies on college student populations. However, and contrary to earlier research, deliberate self-harm was significantly more prevalent among men (48%) than women (33%). The findings support the notion that trauma, pathological dissociation, and depersonalization/derealization play important functional roles in self-harm behaviors. From this perspective, it is feasible to understand individuals who engage in self-harm as either escaping from uncomfortable dissociative states or experiencing an infra-psychological conflict in which one dissociative part of the self is being abusive toward another. Keywords: deliberate self-harm, depersonalization/derealization, dissociation, trauma

• Eines, Trude Fløystad & Dale, Karl Yngvar (2015). Challenges in the standardization of nursing education in Europe: A literature study focusing on the implementation of qualification frameworks. The Nordic Journal of Nursing Research (NJNR). ISSN 2057-1585. 35(4), s. 235–240. doi: 10.1177/0107408315592768. Fulltekst i vitenarkiv Vis sammendrag

  Two European qualification frameworks for higher education have been developed over the past decades. One of the goals of these are to promote common descriptions of learning outcomes at various levels within higher education. This article describes a) how national qualification frameworks have been perceived within bachelor nursing education, and b) the correspondence between learning outcomes and assessment methods. Evidently, a key factor for success is that the governing entities create a climate for good cooperation within and between the education institutions. However, our findings suggest that the communication between the experts and the educational institutions, who worked with the development and implementation of the national qualifications frameworks, has been far from good enough. Furthermore, there is a need to develop valid criteria for nursing competence, which in turn, could be integrated into the QFs and the NQFs. In this manner, on might secure that nursing education will uphold and meet the highest standards in all educational systems across Europe. Keywords: assessment methods, higher education, learning outcomes, nursing students, qualification frameworks

• Ulvund, Ingeborg; Dale, Karl Yngvar & Ødegård, Atle (2015). Skal – skal ikke : jordmødre og psykiatriske sykepleieres erfaringer med varsling av avvik. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 11(2), s. 86–96. doi: 10.7557/14.3714. Fulltekst i vitenarkiv
• Dale, Karl Yngvar; Ødegård, Atle; Nesje, Svanhild Villa; Iversen, Hans Petter & Bjørkly, Stål (2011). Bygge ned og bygge annerledes : endringer i psykisk helsetilbud for voksne i Nordmøre og Romsdal i lys av reduserte døgntilbud og opptrappingsplanen. Tidsskrift for psykisk helsearbeid. ISSN 1503-6707. 8(3), s. 227–236. Fulltekst i vitenarkiv Vis sammendrag

  Det gis en presentasjon av seks ulike tiltak innen psykisk helsearbeid som har blitt utviklet i Nordmøre og Romsdal i den perioden Opptrappingsplanen har virket. Opptrappingsplanen la føringer for hvordan man skulle organisere tilbudene lokalt for personer med psykiske lidelser. Parallelt med denne planen har det foregått en radikal nedbygging av antall døgnplasser innen spesialisthelsetjenesten i Nordmøre og Roms- dal. Utvalget er på ingen måte fullstendig, men det utgjør eksempler på utviklingstrender innen psykisk helsearbeid som har vokst frem i brytningsfeltet mellom Opptrappingsplanens føringer, faglig nyorien- tering og organisasjonsendringer ved sentralinstitusjonen. Eksemplene omfatter kompensatoriske tiltak, tilbakefallsforebygging, profesjonalisert brukermedvirkning og interkommunalt samarbeid. Økt fokus på brukermedvirkning og mer effektivt samarbeid trekkes frem som de mest sentrale løsningene i denne overgangsperioden. Endringene synes også å representere et brudd med den etablerte sykdomsmodellen når det gjelder både hjelperelasjon og organisering av tilbud.

• Dale, Karl Yngvar; Ødegård, Atle; Tschudi, Finn; Cromwell, Rue L; Saunders, Buddy & Elden, Åke [Vis alle 7 forfattere av denne artikkelen] (2010). Cognitive complexity and dissociative identity disorder. Journal of constructivist psychology. ISSN 1072-0537. 23(2), s. 158–165. doi: 10.1080/10720530903563264. Fulltekst i vitenarkiv Vis sammendrag

  Thirteen patients with dissociative identity disorder (DID), 13 with other mental disorders, and 10 nondiagnosed comparison participants were given individual grids. Results showed that displaying alternate personalities did not portend a more multidimensional level of thinking. Instead, the nonclinical comparison group had the greater degree of complexity in comparison to both clinical groups. A notable clinical observation was that DID patients, as compared to non-DID participants, had a greater understanding and speed in completing the grid. Findings are discussed in terms of the advantages of personal construct theory for conceptualizing the construct of dissociation.

• Dale, Karl Yngvar; Berg, Renate; Elden, Åke; Ødegård, Atle & Holte, A (2009). Testing the diagnosis of dissociative identity disorder through measures of dissociation, absorption, hypnotizability and PTSD : a Norwegian pilot study. Journal of Trauma & Dissociation. ISSN 1529-9732. 10(1), s. 102–112. doi: 10.1080/15299730802488478. Fulltekst i vitenarkiv Vis sammendrag

  A total of 14 women meeting criteria for dissociative identity disorder (DID) based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]) were compared to a group of women (n = 10) with other dissociative diagnoses and a group of normal controls (n = 14) with regard to dissociativity, absorption, trauma related symptoms and hypnotizability. Both of the clinical groups reported histories of childhood trauma and attained high PTSD scores. The DID group differed significantly from the group with other dissociative diagnoses and the non-diagnosed comparison group with regard to hypnotizability, the variety of dissociative symptomatology, and the magnitude of dissociative symptomatology. However, no significant differences between the two clinical groups were detected with regard to absorption, general dissociative level, or symptoms related to traumatic stress. Results support the notion that DID can be regarded as a clinical entity which is separable from other dissociative disorders. Results also indicated that hypnotizability is the most important clinical feature of DID.

• Dale, Karl Yngvar; Flaten, Magne Arve; Elden, Åke & Holte, Arne (2008). Dissociative identity disorder and prepulse inhibition of the acoustic startle reflex. Neuropsychiatric Disease and Treatment. ISSN 1176-6328. 4(3), s. 653–662. doi: 10.2147/NDT.S3006. Fulltekst i vitenarkiv
• Dale, Karl Yngvar (1996). Dissosiativ identitetsforstyrrelse : presentasjon av et behandlingsopplegg ved en voksenpsykiatrisk poliklinikk i Finnmark. Tidsskrift for Norsk psykologforening (Psykologtidsskriftet). ISSN 0332-6470. 33(11), s. 1043–1049. Fulltekst i vitenarkiv

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• Hogset, Heidi; Berge, Dag Magne & Dale, Karl Yngvar (2018). Det regionale i det internasjonale : fjordantologien 2018. Universitetsforlaget. ISBN 9788215031217. 401 s. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Karlsen, Lillian; Dale, Karl Yngvar; Winsjansen, Bente; Lindseth, Gunnel & Driller, Bardo (2020). Is the public in Norway confident that public health service is able to handle palliative care issues? Fulltekst i vitenarkiv
• Karlsen, Lillian; Dale, Karl Yngvar; Winsjansen, Bente; Lindseth, Gunnel & Driller, Bardo (2019). In case of life-limiting illness- What is most important for you? Fulltekst i vitenarkiv
• Dale, Karl Yngvar (2019). In case of life-limiting illness : what is most important for the public in Norway? Fulltekst i vitenarkiv
• Larsen, Bjørn Kjetil; Dale, Karl Yngvar & Ødegård, Atle (2019). Exploring interprofessional collaboration in the transition from prison to community for male adult offenders with substance abuse issues : a scoping review. Fulltekst i vitenarkiv Vis sammendrag

  Offenders with substance abuse issues has interlinked challenges including lack of housing, loss of social network, high recidivism rates and mental health issues facing their release from prison. Reintegration after prison for offenders with complex psycho-social needs has been one of the most challenging issues for decades within the criminal justice system. Academics, practitioners and policymakers are urging for a more effective approach. Internationally, large groups of offenders are struggling with substance abuse issues. Complex social needs demand a broad range of services from welfare agencies and well-functioning collaboration between professionals. Interprofessional collaboration has been underdeveloped as a field of research and theory. In this scoping review we aimed to present an overview of empirical studies on interprofessional collaboration in the transition phase from prison to community for male offenders with drug abuse issues. Results show a gap in empirical based knowledge in this area. Research has highlighted the need for interprofessional collaboration but does not delve enough into how interprofessional collaboration is organized or the effect of it. Eight included empirical studies show that unclear distribution of responsibility, resource limitations, logistical issues and attitudes towards the offenders’ challenge interprofessional collaboration, while social innovation are perceived as improving collaboration. This scoping review contributes with knowledge and inspiration in a clearly underdeveloped, but highly important, field of research.

• Karlsen, Lillian; Driller, Bardo; Dale, Karl Yngvar; Brenne, Anne Tove & knudsen, anne kari (2018). Preferred place of death; requirement of the public and of advanced cancer patients in Norway. Fulltekst i vitenarkiv
• Karlsen, Lillian; Driller, Bardo; Dale, Karl Yngvar; Winsjansen, Bente & Strømskag, Kjell Erik (2018). In case of serious disease with limited life expectancy; what are people in Norway most concerned about? Fulltekst i vitenarkiv
• Karlsen, Lillian; Driller, Bardo; Dale, Karl Yngvar; Brenne, Anne-Tove & Knudsen, Anne Kari (2018). Where would you prefer to die? : answers from general public and advanced cancer patients in Mid-Norway. Fulltekst i vitenarkiv
• Hogset, Heidi; Berge, Dag Magne & Dale, Karl Yngvar (2018). I spenningsfeltet mellom det regionale og det internasjonale. I Hogset, Heidi; Berge, Dag Magne & Dale, Karl Yngvar (Red.), Det regionale i det internasjonale : fjordantologien 2018. Universitetsforlaget. ISSN 9788215031217. s. 15–28. doi: 10.18261/9788215031224-2018-01. Fulltekst i vitenarkiv Vis sammendrag

  «Globalisering» er definert som ein prosess som fører til auka integrering på tvers av landegrensar. Artiklane i denne antologien tematiserar korleis denne prosessen påverkar lokale og regionale tilhøve i Norge. Prosessen kan karakteriserast med omgrepet «glokalisering», som femnar at globalisering er ein prosess som skjer i interaksjon mellom globale og lokale prosessar. Bidraga representerar eit breitt fagleg mangfald. Nøkkelord: internasjonalisering, glokalisering, kommunikasjon, integrering, outsourcing

• Rønning, Solrun Brenk; Hoemsnes, Helene; Solheim, Inger Helen; Orøy, Aud Jorun & Dale, Karl Yngvar (2018). Kan økt kompetanse imøtekomme behov i regionen? s. 12–12. Fulltekst i vitenarkiv
• Rønning, Solrun Brenk; Hoemsnes, Helene; Solheim, Inger Helen; Orøy, Aud Jorun & Dale, Karl Yngvar (2018). Kan økt kompetanse imøtekomme behov i regionen? s. 22–22. Fulltekst i vitenarkiv
• Rønning, Solrun Brenk; Hoemsnes, Helene; Solheim, Inger Helen; Orøy, Aud Jorun & Dale, Karl Yngvar (2018). Kan økt kompetanse imøtekomme behov i regionen? : nasjonale føringer for kompetanse innen helse- sosial og velferdstjenester er tydelige. s. 40–40. Fulltekst i vitenarkiv
• Karlsen, Lillian; Dale, Karl Yngvar; Driller, Bardo; Winsjansen, Bente & Strømskag, Kjell Erik (2017). Advanced statements in end of life care; requirement of the public in Norway. Fulltekst i vitenarkiv
• Karlsen, Lillian; Dale, Karl Yngvar & Driller, Bardo (2016). Hvilke tanker og ønsker har et utvalg av befolkningen i ROR-kommunene med hensyn til forberedende samtaler og helhetlig plan for livets sluttfase ved alvorlig sykdom? Fulltekst i vitenarkiv
• Fluttert, Frans A. J.; Eidhammer, Gunnar; Friestad, Christine; Dale, Karl Yngvar; Bjørkly, Stål & Rustad, Åse-Bente L (2015). The Early Recognition Method used to identify precursors of aggression in prisoner. I Callaghan, Patrick; Oud, Nico; Bjørngaard, Johan Håkon; Nijman, Henk; Palmstierna, Tom & Duxbury, Joy (Red.), Violence in Clinical Psychiatry : Proceedings of the 9th European Congress on Violence in Clinical Psychiatry, 22 – 24 October 2015 Crowne Plaza Copenhagen Towers. Kavanah, Dwingeloo & Oud Consultancy. ISSN 9789057401442. s. 313–314. Fulltekst i vitenarkiv
• Fluttert, Frans A. J.; Eidhammer, Gunnar; Friestad, Christine; Dale, Karl Yngvar; Bjørkly, Stål & Rustad, Åse-Bente L (2015). The Early Recognition Method used to identify precursors of aggression in prisoner. Fulltekst i vitenarkiv
• Dale, Karl Yngvar (2011). Videreutdanning i psykisk helsearbeid. Fulltekst i vitenarkiv
• Sun, Hao; Berg, Jens Petter & Dale, Karl Yngvar (2011). Balansering av undervisning og egenlæring. I Bjørke, Gerd; Alfredsen, André; Ålvik, Trond & Skumsnes, Anne (Red.), Blikk inn i høgskolepedagogisk virksomhet : utdrag fra rapporter fra miniprosjekter ved "Program for pedagogisk basiskompetanse", Grunnmodulen, 2008-2010. Høgskolen i Oslo. ISSN 9788257947583. s. 26–31. Fulltekst i vitenarkiv Vis sammendrag

  Kapittelet er delvis skrevet på engelsk

• Liepelt, Silje; Kirchhoff, Ralf; Sundal, Hildegunn & Dale, Karl Yngvar (2025). Healthcare Professionals’ Experience with Root Cause Analysis: A Case Study. Norges teknisk-naturvitenskapelige universitet. ISSN 9788232694297. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Over the past three decades, the emphasis in healthcare has gradually shifted from individual responsibility for safety, quality, and performance to a systems-based perspective for addressing variation and adverse events. Despite extensive efforts to improve patient safety, adverse events remain a persistent challenge, with the World Health Organization (WHO) estimating that approximately 10% of patients worldwide experience harm during hospitalization. Root cause analysis is widely used in healthcare as a structured method for investigating sentinel events—unexpected incidents resulting in severe harm or death. The method aims to identify systemic weaknesses in processes, communication, and organizational structures to facilitate targeted safety interventions. However, its effectiveness in driving long-term improvements has been debated, as many RCA efforts remain reactive rather than proactively strengthening healthcare systems. Aim: To explore RCA and how healthcare professionals in a Norwegian hospital setting experience RCA following a sentinel event. The thesis sheds light on practical applications of RCA, considerin challenges and the potential for fostering improvements in patient safety. Methods: A qualitative single-case design was employed to explore healthcare professionals’ experience with RCA in a specialized hospital setting. Data collected involved semistructured interviews with RCA team members and managers and document analysis of RCA reports, policies, and Norwegian guidelines. Data were analyzed using thematic analysis to identify key themes related to the RCA process. Findings: Three articles present the findings, illustrating the complexities of implementing RCA in specialized healthcare. The dissertation highlights RCA’s potential to facilitate learning and improvement but also finds that resource constraints, inconsistent practices, and variations in implementation often hinder its effectiveness. Conclusion: This study highlights the potential and limitations of RCA as a tool for improving patient safety. While RCA provides a structured approach to learning from adverse events, its impact is contingent on organizational commitment, the availability of resources, and the ability to integrate findings into broader safety initiatives. This thesis contributes to an understanding of how healthcare organizations can strengthen their adaptive capacity by critically examining RCA’s role within a resilience-based framework. The findings emphasize the need for more proactive and integrative approaches to patient safety, ensuring that RCA identifies systemic weaknesses and drives meaningful and sustainable improvements in healthcare quality and safety.

• Langøy, Emmy Elizabeth; Dale, Karl Yngvar & Ødegård, Atle (2021). En evaluering av videreutdanning i habilitering og miljøarbeid (VHM). Høgskolen i Molde - Vitenskapelig høgskole i logistikk. ISSN 9788279623076. Fulltekst i vitenarkiv
• Dale, Karl Yngvar (2014). Traumatic stress, personality and psychobiological health : conceptualizations and research findings. Høgskolen i Molde - Vitenskapelig høgskole i logistikk. ISSN 9788279621928. Fulltekst i vitenarkiv
• Dale, Karl Yngvar & Ødegård, Atle (2014). Examining the Construct of Dissociation within the Framework of G-theory. Høgskolen i Molde - Vitenskapelig høgskole i logistikk. ISSN 9788279621881. Fulltekst i vitenarkiv
• Dale, Karl Yngvar; Driller, Bardo; Jørgensen, Else; Nygård, Linda Anette Kornstad & Strømskag, Kjell Erik (2013). Integrasjon av praksis, undervisning og forskning : hvordan kan man sikre høyest mulig kvalitet innen omsorg og behandling av alvorlig syke og døende på kommunalt nivå? Høgskolen i Molde - Vitenskapelig høgskole i logistikk. ISSN 9788279621768. Fulltekst i vitenarkiv Vis sammendrag

  Det sentrale spørsmålet vi stiller er: Hvordan kan praksis, undervisning og forskning samarbeide for å legge til rette for ”best practice” innen det palliative feltet. “Best practice” er beskrevet gjennom nasjonale retningslinjer og faglige ”gullstandarder”. Her vil vi fremholde at mye avhenger dels av et godt tilrettelagt utdanningssystem, dels et godt faglig samarbeid mellom helseforetak, det kommunale praksisfeltet og utdanningsinstitusjon, og sist men ikke minst: At alle disse instanser kan inngå i et tett og gjensidig utviklende forskningssamarbeid. Vi vil argumentere for at dette gir den beste muligheten for å sikre høyest mulig kvalitet i det palliative feltet, herunder at man evner å etablere en forskningsbasert praksis som også er i tråd med nasjonale retningslinjer. I artikkelen belyses dette gjennom et case.

• Dale, Karl Yngvar (2013). Ambulante team i Møre og Romsdal innen psykisk helse-feltet : en kvalitativ studie med fokus på praktiske og kliniske tilpasninger, innovative løsninger og samarbeidsrelasjoner : foreløpig prosjektrapport. Høgskolen i Molde - Vitenskapelig høgskole i logistikk. ISSN 9788279621782. Fulltekst i vitenarkiv Vis sammendrag

  Studien utforsker ambulant virksomhet i Møre og Romsdal med henblikk på a) innovasjon og nytenkning, b) arbeid og samarbeid i "felten", herunder etiske utfordringer, c) "pasientflyt" og d) oppfatninger teamene har om hverandres roller og metoder.

• Dale, Karl Yngvar & Holte, Arne (2008). Out of mind - out of sight : studies on clinical and psychophysiological characteristics of dissociative identity disorder. UiT Norges arktiske universitet. Fulltekst i vitenarkiv Vis sammendrag

  Dissociative identity disorder (DID; APA, 1994), previously labeled Multiple personality (APA, 1980) and Multiple Personality Disorder (APA, 1987), has good diagnostic validity (Gleaves, May, & Cardeña, 2001) and is supported by taxometric research, whereby two types of dissociation have been identified: Pathological dissociation, whose features are consistent with DID, and nonpathological dissociation (Waller, Putnam, & Carlson, 1996). On these grounds, we aimed to contribute to a further validation of the construct of DID by (1) testing to which extent DID may be separated from other dissociative disorders on a series of clinical and psychophysiological measures, and (2) exploring the characteristics of DID within the framework of Personal construct theory. 14 persons with DID were compared with persons with other dissociative disorders, and non‐clinical comparison participants with regard to severity of PTSD related features, dissociative functioning, hypnotizability (Paper I), and prepulse inhibition (PPI) of the acoustic startle eye‐blink reflex (Paper II). Persons with DID had reduced habituation of startle reflexes and increased PPI, compared to non‐DID participants. These data suggest the operation of an aberrant voluntary attentional processes in the face of unpleasant and threatening stimuli, and this may be a defining characteristic in DID. This finding supports the notion that DID is a separate clinical and nosological entity (Gleaves et al., 2001; Waller et al., 1996). Results also showed that persons with DID differed significantly from persons with other dissociative disorders with regard to the complexity and magnitude of dissociative symptomatology, and with regard to hypnotizability. These results are also indicative of DID being a separate clinical entity, qualitatively different from other dissociative disorders (Gleaves et al., 2001; Waller et al., 1996). As expected, histories of childhood sexual and physical assault were reported among persons with DID and persons with other dissociative disorders and both these groups attained high PTSD scores. Although the clinical groups did not differ significantly with regard to scores of current and lifetime PTSD, some differences were observable with regard to the type and occurrence of abuse, with, e.g., a higher percentage of the DID group having experienced sexual assault by a close relative during childhood compared to the group with other dissociative disorders. This is consistent with findings that DID is linked to the nature of the assault and to the relationship between the victim and the perpetrator (Boon & Drajer, 1993). In a design involving test technology developed within the framework of Personal construct theory (Kelly, 1955), 13 persons with DID were compared to persons with other clinical conditions and non‐diagnosed comparison participants with regard to cognitive complexity (Paper III). Contrary to expectations, results showed that displaying alternate personalities does not imply a more multidimensional level of thinking. However, persons with DID seemed to have a more advanced social skill in role thinking and role conceptualization, in comparison with non‐dissociative persons. The results have important implications for the identification, treatment, and understanding of DID.

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