Trauma-Informed Care in Ukraine: Approaches for a Traumatized Society

Ukraine is experiencing trauma at a societal scale unprecedented in its recent history. Millions of people have been exposed to life-threatening danger, witnessed violence on other people, lost loved ones, been forced from their homes, experienced torture or sexual violence in captivity, or lived under occupation. The accumulated traumatic burden on the Ukrainian population — both the acute trauma of specific incidents and the chronic ongoing stress of sustained conflict — represents a public mental health crisis that will require decades to address fully. Within this context, trauma-informed care — an approach to services, systems, and relationships that recognizes trauma's pervasive impacts and actively avoids re-traumatization — is increasingly recognized as the appropriate framework for Ukraine's entire social sector, not just mental health services.

Understanding Trauma-Informed Care

Trauma-informed care (TIC) is not a specific therapy technique but a framework for how any service or interaction is provided. A trauma-informed approach is characterized by: safety (physical and emotional safety for all parties); trustworthiness and transparency (clear communication about what is happening and why); peer support (connections with others with shared experience); collaboration (sharing of power in decision-making); empowerment (building on strengths and supporting agency); and cultural sensitivity (acknowledging cultural and community factors). In a Ukrainian wartime context, trauma-informed approaches mean: a social worker conducting an IDP assessment doing so in a way that does not re-traumatize the person recounting losses; a school creating physical and emotional safety conditions for children managing war trauma; or a doctor recognizing that a patient's physical symptoms may be somatized expressions of psychological trauma.

Evidence-Based Trauma Treatment Approaches

EMDR in Ukraine: Group Adaptations

Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy approach with strong evidence for PTSD, recommended by WHO and multiple international clinical guideline bodies. Standard EMDR requires qualified individual therapists working one-to-one with clients — a delivery model that cannot scale to Ukraine's millions of people with trauma-related needs given the available trained therapist workforce. In response, EMDR practitioners and researchers developed group-adapted protocols — notably the EMDR group protocols developed by research teams working in conflict-affected populations globally. These group formats allow one therapist to guide a group of 5–20 participants through adapted EMDR processing procedures simultaneously, significantly increasing throughput. Ukrainian psychologists and international EMDR trainers have trained large cohorts of Ukrainian practitioners in group EMDR, deploying these protocols in IDP centers, hospitals, schools, and community settings.

Somatic and Body-Based Approaches

Somatic therapy approaches — which work with the body's physical presentation of trauma rather than primarily through verbal processing — have gained significant presence in Ukraine's trauma response landscape. Somatic Experiencing (SE), developed by Peter Levine, and approaches including sensorimotor psychotherapy address the physiological aspects of trauma: the ways in which traumatic experiences become stored in the body as incomplete defensive responses, chronic tension patterns, hyperarousal, or dissociation. These approaches can be particularly accessible for people who have difficulty engaging with purely verbal cognitive approaches, including people with severe dissociation, very young children, and individuals from cultural backgrounds where emotional verbal expression is less normalized. Body-based arts practices — movement, dance, craft work, music — have been incorporated into community psychosocial programs as accessible approaches reaching people who would not engage with clinical mental health services.

Workforce Training in Trauma-Informed Practice

Training teachers, social workers, police, medical staff, humanitarian workers, and other frontline professionals in trauma-informed approaches dramatically multiplies the impact of a limited specialist workforce. UNICEF, WHO, and international NGOs implemented large-scale training programs to build trauma-informed competency across Ukraine's social sector. Teacher training in trauma-informed classroom management — recognizing trauma responses in students, avoiding punitive approaches that re-traumatize, creating safe classroom environments, responding to disclosures sensitively — reached tens of thousands of Ukrainian teachers. Social worker training in trauma-informed case management adapted standard casework practice to minimize re-traumatization during assessments and interventions with displaced and bereaved clients. First responders — police, emergency services, and military medical staff — received Psychological First Aid training to respond appropriately to civilians in acute trauma.

FAQ

What is trauma-informed care and why is it important in Ukraine?

Trauma-informed care is an approach to services and interactions that recognizes the pervasive prevalence of trauma, aims to create physical and emotional safety, avoids re-traumatization, and builds on people's strengths. In Ukraine, where millions have been traumatized by the war, applying this framework across health, social, and educational services is essential for effective, safe service delivery.

What is EMDR and is it used in Ukraine?

EMDR (Eye Movement Desensitization and Reprocessing) is a WHO-recommended evidence-based psychotherapy for PTSD. In Ukraine, group-adapted EMDR protocols are being used to reach larger numbers of affected individuals given the limited individual therapist capacity relative to overwhelming need.

What somatic therapies are used in Ukraine's mental health response?

Somatic Experiencing (SE), sensorimotor psychotherapy, body-based arts therapies (movement, dance, craft), yoga-based approaches, and other body-centered interventions are incorporated in Ukraine's psychosocial support landscape, particularly through NGO programs and community-based settings.

How are teachers trained in trauma-informed approaches?

UNICEF and national education ministry programs have provided trauma-informed classroom management training to tens of thousands of Ukrainian teachers, covering recognition of trauma responses in students, avoiding re-traumatizing discipline, creating safe learning environments, and responding to trauma disclosures appropriately.

Is there enough mental health professional capacity in Ukraine?

No. Ukraine faces a severe shortage of specialized mental health professionals relative to the scale of need. Responses include task-shifting to trained non-specialists (Psychological First Aid delivered by social workers, teachers, volunteers), group interventions to multiply therapist reach, digital mental health platforms, and international volunteer mental health programs.

Sources

1. WHO Ukraine. Mental Health Action Plan and Trauma-Informed Care Guidance. who.int
2. UNICEF Ukraine. Teacher Training in Trauma-Informed Practice. unicef.org
3. EMDR International Association. Group EMDR Protocols for Disaster Response. emdria.org
4. Ministry of Health of Ukraine. Mental Health Response Framework. moz.gov.ua
5. UNHCR Ukraine. Community-Based Mental Health and Psychosocial Support. unhcr.org