Trauma-focused therapy helps Ukrainians cope amid war

March 18, 2024
Ukraine war toll
The toll of Russia's war in Ukraine has been heavy, including for Ukrainians' mental health. Credit: James Grall/Pact

When Russia launched its full-scale invasion of Ukraine in early 2022, Maryna was living just 30 miles from the Russian border, in the Ukrainian city of Sumy. Amid shelling, she fled to Poland with her elderly parents and two sons, ages 3 and 7. 

They were able to return to Maryna’s home and husband in the summer, but it wasn’t the end of the family’s constant stress. Maryna worried for her children, and then for their father when he joined the armed forces. She remembers a day at the playground when missiles began flying overhead, followed by explosions across the city. She and her children hit the ground.

Maryna decided to look for a therapist online to help her cope. She found the Integration Mental Health and Trauma Therapy Center, supported by the Pact-led Public Health System Recovery and Resilience project, or PHS R&R. In their first meeting, Maryna’s therapist told her it could take many sessions for her to feel better, but simply seeking help was an immediate relief. 

It is hard to overstate the mental health impact of the past two years on the people of Ukraine. Funded by USAID, PHS R&R was designed before Russia’s invasion and included a mental health component. But Pact and our partners have quickly, significantly expanded this component in order to increase access to mental health and psychosocial support services, or MHPSS. The project’s work includes expanding access to community-based mental health services, strengthening the country’s mental health workforce, promoting care seeking for mental health, and strengthening sustainable systems for comprehensive, evidence-based MHPSS. 

To address the nationwide need for evidence-informed mental health and psychosocial support services, PHS R&R supports local organizations including the therapy center that Maryna has visited. The center provides trauma-focused cognitive behavioral therapy (TF-CBT) to adults who have experienced significant psycho-traumatic effects or have post-traumatic stress disorder or other severe mental health conditions. 

The center’s 40 specialists provide in-person and online services to hundreds of clients, including veterans, internally displaced persons, residents of de-occupied territories, and family members of veterans, soldiers and people who are missing or in captivity. The center has developed a partner network of 80 organizations that refer individuals with severe trauma-caused mental health disorders.


At Maryna’s second therapy session, her therapist helped her to cope with feelings of fear, vulnerability and trauma that emerged after the playground incident. Over time, Maryna felt how working to calm and balance her psychological state had a positive effect not just on her but also on her children, who became less afraid. Their sleep problems disappeared, and their overall moods improved. Maryna later found a job as a school teacher. Therapy sessions helped her overcome new job anxiety and stress. 

“I learned techniques that I use in my everyday life to avoid panic attacks and anxiety,” Maryna explains. “I became more self-confident. I speak more clearly about my needs and desires. My condition has changed a lot compared to what it was before, when I often cried and was afraid to leave the shelter.”

Now understanding the benefits, Maryna says she encourages psychological support for Ukrainians who are struggling, especially military personnel like her husband and their families.