Helping the children of Ukraine cope with war’s mental toll

• Link to: Northwestern Now Story

• Researcher met with providers, academics, researchers in Ukraine to teach evidence-based psychological methods such as cognitive behavioral therapy
• Plan is to bring the program to other war zones to help children cope
• Psychologists can learn from war zones to help U.S. children cope with violence in the form of community violence and school shootings

CHICAGO --- Looking at the drawings scattered across pediatric psychologist Dr. Lauren Potthoff’s desk, most people would never guess they were drawn by children in war-torn Ukraine.

Potthoff recently spent seven days in Kyiv to volunteer with Ukrainian-based Voices of Children, a nonprofit foundation that provides psychological, psychosocial and targeted humanitarian support to Ukrainian families and children affected by the war.

While there, she visited the largest children’s hospital in Ukraine and a school in an area previously occupied by Russian troops during the war. 

“What was so incredible to me is that these kids are so resilient,” said Potthoff, assistant professor of psychiatry and behavioral science and pediatrics at Northwestern University Feinberg School of Medicine and a pediatric psychologist at Ann & Robert H. Lurie Children’s Hospital of Chicago. “They're living through an active war, hearing bomb sirens and air alerts every day, yet they were still drawing little pigs on paper to show us, and they're like, ‘We learned how to draw this pig. Can I draw it for you?’”

Resilient, yes, but the children still desperately need ways to cope with living through war, Potthoff said. Although she visited children, her purpose was to “train the trainers.” She and a fellow representative from the European Paediatric Psychology Network (EPPN) met with academics and researchers on the ground to teach evidence-based psychological methods such as cognitive behavioral therapy (CBT).

“Psychology in Ukraine is really different than what it is here; there's no licensure requirement to become a psychologist, and there's not a lot of evidence-based treatment being practiced there currently,” Potthoff said. “So, we tried to disseminate and lay this foundation of science.”

Potthoff said she and fellow members of the EPPN and Voices of Children plan to create a mentorship program in which they’ll match psychologists across Europe and the U.S. with psychologists in Ukraine to receive peer-to-peer support for specific specialties, such as pediatric oncology or pediatric mental health.

It's important to support children in Ukraine or other war zones using a trauma-informed lens, Potthoff said.

“We can talk to them about how it feels when they’re feeling anxious about something, but we need to acknowledge the context of war,” Potthoff said. “We can ask, ‘How does it feel in your body when you're feeling anxious about a test?’ And they're going to say, ‘I don't care about a test. I am worried about my dad on the front line. I'm worried about whether or not I'm going to have to take my test in a bomb shelter.’"

Implementing the training program elsewhere

At Lurie Children’s, Potthoff’s typical “day job” is meeting with patients who have been diagnosed with Inflammatory Bowel Disease (e.g. Crohn’s Disease) and other gastrointestinal disorders to help them understand and cope with their diagnoses. But she said she’ll continue to work with Voices of Children and the EPPN to implement the programs they’ve developed in Ukraine elsewhere.

“There are kids suffering everywhere,” Potthoff said. “We're conducting the work in a way in which people who are helping kids through trauma, war and atrocities in Gaza, Lebanon or Israel can say, ‘Here's the framework they used in Ukraine and here’s the data from there.’ Things in the Middle East are certainly different, but how can they take this framework and apply it in their setting?”

Implementing what she learned in Ukraine to help kids back home

Potthoff said while Ukraine and other war zones are wildly different from life in the U.S., psychologists can still learn from those war zones to help U.S. children cope with violence, whether it’s from community violence or school shootings.

“It's not an active war, obviously, but when there's a school shooting, it's unexpected, scary and traumatizing,” Potthoff said. “There are lessons learned from the kids in Ukraine and how parents and providers are supporting kids there that we can implement here as well, such as letting kids lead conversations about what they’re feeling or are concerned about while acknowledging their resiliency and validating whatever reaction they’re having.”