Кафедра психології та педагогіки

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Adaptation and testing of an assessment for mental health and alcohol use problems among conflict-affected adults in Ukraine
(2018) Doty, S. Benjamin; Haroz, Emily; Singh, Namrita; Bogdanov, Sergiy; Bass, Judith; Murray, Laura; Callaway, Karis; Bolton, Paul
Background: In Ukraine, a large number of internally displaced persons (IDPs) and veterans experience social and psychological problems as a result of the ongoing conflict between Ukraine and Russia. Our purpose was to develop reliable and valid instruments to screen for common mental health and alcohol use problems in these populations. Methods: We used a three-step process of instrument adaptation and testing. The instrument - the Mental Health Assessment Inventory (MHAI) - combines adapted standard screeners with items derived locally in Ukraine. A validity study was conducted using a sample of 153 adults (54% male) ages 18 years and older. All participants in the sample were IDPs or veterans living in or near the major urban areas of Kyiv and Zaporizhia. Reliability testing (internal consistency, test-retest) and validity testing (construct, criterion) of the MHAI were conducted using classical test theory. After initial testing, we used Item Response Theory (IRT) to shorten and further refine the instrument. Results: The MHAI showed good internal consistency and test-retest reliability for the main outcomes: depression (α = 0.94; r = .84), post-traumatic stress (PTS; α = 0.97; r = 0.87), anxiety (α = 0.90; r = 0.80), and alcohol use (α = 0.86; r = 0.91). There was good evidence of convergent construct validity among the scales for depression, PTS, and anxiety, but not for alcohol use. Item Response Theory (IRT) analysis supported use of shortened versions of the scales for depression, PTS, and anxiety, as they retained comparable psychometric properties to the full scales of the MHAI. Conclusion: The findings support the reliability and validity of the assessment - the MHAI - for screening of common mental health problems among Ukrainian IDPs and veterans. Use of IRT shortened the instrument to improve practicality and potential sustainability.
Common strategies in empirically supported psychological interventions for alcohol use disorders: A meta-review
(2022) Nadkarni, Abhijit; Massazza, Alessandro; Guda, Rahul; Fernandes, Luanna; Garg, Ankur; Jolly, Mehak; Skovgaard Andersen, Lena; Bhatia, Urvita; Bogdanov, Sergiy; Roberts, Bayard; Tol, Wietse; Velleman, Richard; Moore, Quincy; Fuhr, Daniela
Issues: Despite the large number of effective psychological interventions for alcohol use disorders (AUD), there is still a lack of clarity concerning the strategies that make these interventions effective. Approach: The overall goal of this review was to identify, examine and synthesise the information about common strategies from evidence-based psychological interventions for AUDs by conducting a review of systematic reviews, that is, a meta-review. We isolated the relevant primary studies from eligible systematic reviews and extracted information about the interventions from these studies to understand the strategies used. Analysis was restricted to narrative summaries. Key Findings: Thirteen reviews were eligible for inclusion in our meta-review. Of these, eight demonstrated the effectiveness of a range of psychological interventions—behavioural couples therapy, cognitive behaviour therapy combined with motivational interviewing, brief interventions, contingency management, psychotherapy plus brief interventions, Alcoholics Anonymous and 12-step treatment programs, family-therapy or family-involved treatment, and community reinforcement approach. The most commonly used component strategies in effective interventions for AUDs included assessment, personalised feedback, motivational interviewing, goal setting, setting and review of homework, problem solving skills and relapse prevention/management. Implications: Evidence about commonly used strategies in evidence-based psychological interventions for AUDs offer the possibility of creating menu-driven interventions that can be tailored to respond to individual client needs and preferences in different contexts.
A Complex Intervention for Alcohol Misuse Among Conflict-Affected Populations in Uganda and Ukraine: Study Protocol for the Qualitative Components in the CHANGE Trial
(2021) Massazza, Alessandro; Fuhr, Daniela; Bogdanov, Sergiy; Tol, Wietse; Roberts, Bayard; Nadkarni, Abhijit; Akudrabo, Geoffrey; Skovgaard Andersen, Lena; Dumchev, Kostyantyn; Karachevskyy, Andriy; Kinyanda, Eugene; Koss, Kateryna; Moore, Quincy; May, Carl R.
Qualitative research is increasingly being integrated within the development and evaluation phases of trials of complex health interventions. Qualitative research can complement effectiveness data and provide insights around how context and implementation impact the results of the trial and to what extent interventions fit implementation contexts after evaluation. Several qualitative studies have been conducted at different stages of trials of mental health and psychosocial support interventions for populations affected by adversity such as armed conflict and disasters. However, these qualitative components are usually implemented as disjointed components within the trial. The current protocol aims to provide a shared framework detailing the qualitative components of the CHANGE project trial: a program of work to address alcohol misuse and associated mental health comorbidities among conflict-affected populations in Uganda and Ukraine. In particular, the objectives of the current protocol are (i) to identify the specific qualitative questions and methods that will be undertaken in CHANGE; (ii) characterize the different methodological approaches to analyzing the data; and (iii) explain how each qualitative component within the different work-packages will cumulatively add value to each other over the duration of the CHANGE project. The current protocol will represent a useful template for the integration of serial qualitative research components within complex health interventions in humanitarian settings. Each qualitative components described will undergo formal ethics approval by ethics boards in the United Kingdom, Uganda, and Ukraine. Multiple mechanisms will be in place to ensure rigor and trustworthiness of the research by meeting the criteria of credibility, transferability, dependability, and confirmability.
Cпецифіка прояву навчального стресу старшокласників загальноосвітньої школи в екзаменаційний період
(2010) Голубєва, Марія; Макаренко, О. М.; Герасимова, А.; Таранська, З.
У статті представлені результати досліджень, які були проведені зі старшокласниками середніх шкіл в екзаменаційний період. Авторами статті розроблено та апробовано ряд корекційних тренінгових занять, які ефективно вплинули на зниження екзаменаційного стресу.
Developing a Culturally Relevant Measure of Resilience for War-Affected Adolescents in Eastern Ukraine
(2021) Bogdanov, Sergiy; Girnyk, Andriy; Chernobrovkina, Vira; Chernobrovkin, Volodymyr; Vinogradov, Alexander; Harbar, Kateryna; Kovalevskaya, Yuliya; Basenko, Oksana; Ivanyuk, Irina; Hook, Kimberly; Wessells, Mike
Psychosocial support in education that is provided during emergencies frequently aims to support children’s resilience, but strong, contextual measures of resilience are in short supply in Eastern Europe. In this article, our aim is to describe the development and psychometric properties of the first measure of resilience for waraffected adolescents in Eastern Ukraine. We used qualitative methods to identify the main cultural characteristics of resiliency and then used these constructs to develop the measure. We used exploratory structural equation modeling to extract five factors that showed high internal consistency: family support (ω=0.89), optimism (ω=0.87), persistence (ω=0.87), health (ω=0.86), and social networking (ω=0.87). Confirmatory factor analysis suggested that a concise model of resiliency fit the data almost as well as the exploratory structural equation modeling model. The measure demonstrated good test-retest reliability. In this article, we also discuss the importance of development, validation, and the use of culturally relevant measures of resilience for strengthening psychosocial support programs in schools, particularly in Ukraine.
Development and Piloting of a Mental Health Prevention and Referral Program for Veterans and Their Families in Ukraine
(2023) Nguyen, Amanda J.; Russell, Tara; Skavenski, Stephanie; Bogdanov, Sergiy; Lomakina, Kira; Ivaniuk, Iryna; Aldridge, Luke R.; Bolton, Paul; Murray, Laura; Bass, Judy
Background: While growing evidence exists for the effectiveness of mental health interventions in global mental health, the evidence base for psychosocial supports is lacking despite the need for a broader range of supports that span the prevention–treatment continuum and can be integrated into other service systems. Following rigorous evaluation of the Common Elements Treatment Approach (CETA) in Ukraine, this article describes the development and feasibility testing of CETA Psychosocial Support (CPSS), a brief psychosocial prevention and referral program for Ukrainian veterans and their families. CPSS Development: CPSS development used evidence-based CETA intervention components and was informed by a stakeholder needs analysis incorporating feedback from veterans and their families, literature review, and expert consultations. The program includes psychoeducation, cognitive coping skill development, and a self-assessment tool that identifies participants for potential referral. After initial development of the program, the intervention underwent: (1) initial implementation by skilled providers focused on iterative refinement; (2) additional field-testing of the refined intervention by newly trained providers in real-world conditions; and (3) a formal pilot evaluation with collection of pre-post mental health assessments and implementation ratings using locally validated instruments. Results: Fifteen CPSS providers delivered 14 group sessions to 109 participants (55 veterans, 39 family members, and 15 providers from veterans’ service organizations). After incorporating changes related to content, process, and group dynamics, data from the pilot evaluation suggest the refined CPSS program is an acceptable and potentially effective brief psychosocial prevention and promotion program that can be implemented by trained veteran providers. Forty percent of participants required safety or referral follow-ups. Conclusion: The iterative, inclusive development process resulted in an appropriate program with content and implementation strategies tailored to Ukrainian veterans and their families. Brief psychosocial programs can fit within a larger multitiered mental health and psychosocial continuum of care that supports further referral.
Effectiveness Testing of a Multi-Layered Model of Psychosocial Support Within School in Conflict-affected Eastern Ukraine
(2019) Bogdanov, Sergiy; Basenko, Oksana; Zaleska, Oksana
This article presents an example of how academic partners working with government, UN, or other implementing agencies can fill critical gaps in education in emergencies data and evidence. The psychosocial support intervention in Eastern Ukraine presented here made a significant difference in the well-being of affected children in part through systematic reflection on qualitative and quantitative research findings.
Evaluating context and interest in training in evidence-based mental health care: a qualitative investigation among healthcare providers in Kyiv, Ukraine
(2021) Hook, Kimberly; Kozishkurt, Julia; Kovalchuk, Olga; Goncharenko, Evelina; Kodovbetskyi, Vitalii; Opanasenko, Milana; Kopytko, Andrii; Girnyk, Andriy; Kliuzko, Kateryna; Drainoni, Mari‑Lynn; Bogdanov, Sergiy
Objective: Increasing access to quality, evidence-based mental health treatments, including psychotherapy, is a global priority. Knowledge of factors associated with delivery settings is critical to ensure that new practices are appropriate and efectively adapted for novel settings. Understanding perceived needs for training and interest in ongoing education is one key factor. This qualitative study aimed to identify perspectives on contemporary evidencebased psychotherapies, perceived needs for mental health training, and existing barriers and facilitators to provision of mental health services in community clinics in Ukraine. Purposive and snowball sampling was used to recruit 18 physicians and psychologists employed in community clinics in Kyiv. A combination of free-listing and semistructured interviews was used to collect data, which were thematically coded using emergent coding. Results: Findings from this study indicated that participants recognize a need for improved mental health knowledge and training, as well as suggested interest and openness to learning shortterm, structured psychological interventions. Additional barriers and existing strengths described by participants provide insight into possible factors that may impact future trainings in and implementation of modern mental health approaches.
Experience of implementing in Ukraine the harm reduction intervention for adolescents
(2018) Zharuk, Iryna; Purick, Olena; Sazonova, Yana
In 2015, the International Charitable Foundation "Alliance for Public Health" with support from Elton John Aids Foundation had launched in five Ukrainian cities the innovative harm reduction interventions targeting adolescents who use drugs. This paper presents the experience of elaboration and implementation of the innovative for Ukraine intervention. It is based on the mix-methods approach and incorporates findings from a number of studies conducted in 2015-2017 by the International Charitable Foundation "Alliance for Public Health". The project has provided tailored harm reduction services to 9,400 adolescents and their sexual partners. Out of 4,593 clients who accessed services in 2017, 25% were female and 75% male; 96% were aged 14 to 19. The reporting data indicate that on the average a client retains in the project for 5 months and paid on the average 6 visits to an organization. The package of services included core (preventive) and complementary (recreational) services. The most popular complementary services were safe space for relaxed communication with peers, free access to Internet and refreshments. In each city, where intervention was implemented, service combination depended on NGO proactivity and partnerships, including the partnership with the State Social Services for Families, Children and Youth. The project was based on the participatory approach. Services were planned based on the Participatory Site Assessment. The intervention design was based on combining conventional outreach with chain referral model – Peer Driven Intervention (PDI). Participatory approach was also utilized through effective engagement of 30 AUDs as assistant social workers and outreach via social media. The evaluation study confirms positive effects of the interventions on its clients. 18% of evaluated participants who reported injecting drug use at baseline, has reported only non-injecting use at follow-up, and 27% reported complete cessation of drug use.
Explorative Study of Psychosocial Stress Factors that Cause Professional Burnout Among Teachers, Who Leave Near the Front-Line Zone in the East of Ukraine
(2018) Girnyk, Andriy; Donets, Yulia; Bogdanov, Sergiy; Solovyova, Victoriya; Romanenko, Lyudmyla
The subject of the research was the correlation between life circumstances and the degree of emotional and professional burnout of pedagogical staff working near (0 to 15 km) the contact line between the Ukrainian troops and the separatist groups in Donbas. The purpose was to develop recommendations to design a training curriculum on stress prevention and management for pedagogical staff. The sample consisted of 81 teachers who were divided into two groups: teachers, who work in the area 0-15 km from the front-line (41 persons) and the second group, who work in the area 40-60 km from the front-line (40 people). The mixed method approach utilized both quantitative self-assessment and qualitative group and individual interviews. The results show that both groups of teachers experience an equally high degree of professional burnout. Of the teachers within 15km of the contact line 41.1% had a high degree of burn out and 39.4% had extremely high degree of burnout, while the prevalence of high and extreme levels of burnout were 45% and 37.5% for the teachers 40-60km from the contact line. Among stress factors that are correlated with teacher’s burnout we found: war, excessive and poorly organized work, uncertainty about the future, working with difficult students, ideological differences with students and their parents. Based on these results, recommendations for the design a training agenda on professional burnout prevention pedagogical staff have been developed.
Global mental health: the role of collaboration during the COVID-19 pandemic
(2021) Hook, Kimberly; Carroll, Haley; Louis, Elizabeth; Prom, Maria; Stanton, Amelia; Bogdanov, Sergiy; Chiliza, Bonginkosi; Freier, Luisa Feline; Rukundo, Godfrey Zari; Ghebrehiwet, Senait; Borba, Christina; Fricchione, Gregory; Henderson, David
The authors of this commentary believe that strong relationships, and in turn effective collaborations, are key in continuing to conduct GMH research generally and specifically in response to the COVID-19 pandemic. From the perspective of researchers in the United States (US), Peru, South Africa, Uganda, and Ukraine, we discuss the role of collaboration as experienced throughout the ongoing pandemic. Specifically, we highlight two key domains that have been especially relevant over the past months − technology and funding – and discuss their impacts on our global collaborations, considering how these lessons learned may be relevant as we move forward.
Luminescence of singlet oxygen generated by fullerene C60 — aminopropylsilica nanocomposites
(2022) Losytskuy, M.; Kharchenko, R.; Gryn, D.; Dotsenko, M.; Boiko, Y.; Kozachkova, O.; Samoilov, A.; Golub, Alexander; Yashchuk, V.
Immobilization of C6Q fullerene molecules on silica nanoparticles is a promising way to design nanosystems for X-ray photodynamic therapy. Here, generation of singlet oxygen by C60 fullerene aminopropylsilica nanocomposites with and without attached palladium ions, as well as by pristine C60 fullerene was studied. Intensive luminescence spectra of singlet oxygen stimulated by 405 nm excitation of C60 fullerene solution, as well as suspensions of fullerene aminopropylsilica nanocomposites with and without attached palladium ions in benzene were obtained. It was shown that immobilization of C60 fullerene on aminopropylsilica nanoparticles, both in the absence and in the presence of attached palladium ions, does not significantly affect the efficiency of singlet oxygen generation by C60 fullerene. Thus, C60 fullerene attached to aminopropylsilica nanoparticles could be used for the designing of sensitizer nanosystems for X-ray photodynamic therapy.
Measuring implementation in global mental health: validation of a pragmatic implementation science measure in eastern Ukraine using an experimental vignette design
(2019) Haroz, Emily; Bolton, Paul; Nguyen, A.; Lee, C.; Bogdanov, Sergiy; Bass, Judith; Singh, Namrita; Doty, S. Benjamin; Murray, Laura
There is mounting evidence supporting the effectiveness of task-shifted mental health interventions in low- and middle-income countries (LMIC). However, there has been limited systematic scale-up or sustainability of these programs, indicating a need to study implementation. One barrier to progress is a lack of locally relevant and valid implementation measures. We adapted an existing brief dissemination and implementation (D&I) measure which includes scales for acceptability, appropriateness, feasibility and accessibility for local use and studied its validity and reliability among a sample of consumers in Ukraine.
Meeting the long-term health needs of Ukrainian refugees
(2023) Murphy, Adrianna; Bartovic, Jozef; Bogdanov, Sergiy; Bozorgmehr, Kayvan; Gheorgita, Stela; Habicht, Triin; Richardson, Erica; Azzopardi-Muscat, Natasha; McKee, Martin
Objectives: Since Russia's full-scale invasion of Ukraine on 24 February 2022, millions of people have fled the country. Most people have gone to the neighbouring countries of Poland, Slovakia, Hungary, Romania, and Moldova. This vulnerable population has significant healthcare needs. Among the most challenging to address will be chronic non-communicable diseases (NCDs), including mental disorders, as these require long-term, continuous care and access to medicines. Host country health systems are faced with the challenge of ensuring accessible and affordable care for NCDs and mental disorders to this population. Our objectives were to review host country health system experiences and identify priorities for research to inform sustainable health system responses to the health care needs of refugees from Ukraine. Study Design: In-person conference workshop. Methods: A workshop on this subject was held in November 2022 at the European Public Health Conference in Berlin. Results: The workshop included participants from academia and non-governmental organisations, health practitioners, and World Health Organisation regional and country offices. This short communication reports the main conclusions from the workshop. Conclusion: Addressing the challenges and research priorities identified will require international solidarity and co-operation.
Mental health care in Eastern Europe and Central Asia: An analysis of needs and a call for greater investment
(2021) Hook, Kimberly; Bogdanov, Sergiy
Over the past decade, there has been increased attention to global mental health, which emphasizes improving access to quality mental health care in order to reduce the worldwide treatment gap. However, Eastern European and Central Asian countries and their specific mental health needs have largely been underemphasized, evidenced by a dearth in literature and funding. Here, we provide an overview of the mental health needs in Ukraine and its challenges with quality care provision as a key example in highlighting these gaps, then broaden our discussion to include parallels with other countries in the Eastern European and Central Asian region. We describe the unique strengths relative to mental health care provision that are present in Eastern Europe and Central Asia and suggest the importance of post-graduate training, regional collaboration, and capacity building specific to research management as strategies to address the current challenges. We stress that greater investment from funders, government, and the global mental health community are needed to improve the current mental health situation in Ukraine, specifically, and Eastern Europe and Central Asia, broadly. We argue that greater attention to Eastern Europe and Central Asia is needed to fully advance the agenda of the global mental health field.
Problem Management Plus and Alcohol (PM+A): A New Intervention to Address Alcohol Misuse and Psychological Distress Among Conflict-Affected Populations
(2021) Fuhr, Daniela; Bogdanov, Sergiy; Tol, Wietse; Nadkarni, Abhijit; Roberts, Bayard
Problem Management+ (PM+) is a transdiagnostic intervention and addresses symptoms across multiple common mental disorders. It does not yet include strategies to reduce alcohol misuse which is a considerable problem among conflict-affected men, and part of the comorbidity spectrum. In this commentary, we describe the need to address symptoms of common mental disorders and alcohol misuse among conflict-affected populations. We introduce the CHANGE project (Alcohol use in humanitarian settings: A programme of work to address alcohol use and associated adversities among conflict-affected populations in Uganda and Ukraine) which tries to fill the evidence gap in intervention research, and seeks to complement PM+ with components addressing alcohol misuse. The principal output of the CHANGE project will be a new intervention manual called PM+A which will be made available in an open access format.
Process evaluations of mental health and psychosocial support interventions for populations affected by humanitarian crises
(2022) Massazza, Alessandro; May, Carl R.; Roberts, Bayard; Tol, Wietse; Bogdanov, Sergiy; Nadkarni, Abhijit; Fuhr, Daniela
Background: Randomised controlled trials (RCTs) have been increasingly used to test the effectiveness of mental health and psychosocial support(MHPSS) interventions for populations affected by humanitarian crises. Process evaluations are often integrated within RCTs of psychological interventions to investigate the implementation of the intervention, the impact of context, and possible mechanisms of action. We aimed to explore limitations and strengths of how process evaluations are currently conceptualised and implemented within MHPSS RCTs specifically. Methods: In April–June 2021 we conducted semi-structured interviews with 24 researchers involved in RCTs of MHPSS interventions in 23 different countries. Participants were selected based on systematic reviews of MHPSS interventions, funders’ databases, and personal networks. Data were analysed using codebook thematic analysis. Results: The conduct of process evaluations was characterized by high heterogeneity in perceived function, implementation outcomes assessed, and methods used. While process evaluations were overwhelmingly considered as an important component of an RCT, there were different opinions on their perceived quality. This could be explained by the varying prioritization of effectiveness data over implementation data, confusion around the nature of process evaluations, and challenges in the collection and analysis of process data in humanitarian settings. Various practical recommendations were made by participants to improve future process evaluations in relation to: (i) study design (e.g., embedding process evaluations in study protocol and overall study objectives); (ii) methods (e.g., use of mixed methods); and (iii) increased financial and human resources dedicated to process evaluations. Conclusion: The current state of process evaluations in MHPSS RCTs is heterogeneous. The quality of process evaluations should be improved to strengthen implementation science of the growing number of evidenceinformed MHPSS interventions.
Project: Safe Space: comprehensive psychosocial support to war-affected Ukrainian schools : research report
(2023) Bogdanov, Sergiy; Harbar, Kateryna; Bychko, Hanna
The "Safe Space" is a comprehensive psychosocial program, specifically aimed at enhancing the resilience of schoolchildren in the aftermath of traumatic events. Its multifaceted approach includes components directed at both children and their immediate social environment, involving parents and teachers. The Safe Space programme has a multi-level structure. This ensures that support is provided to everyone involved at different stages of implementation. Recognizing the dynamic nature of trauma response, the program allows for the integration of new research and methodologies, continuously evolving to meet the ever-changing needs of the community it serves. The model includes training teachers on resilience strengthening at the first level and training school psychologists in the 7-session group intervention with students at second level. Within educational institutions, the program is executed by school psychologists and teachers, who undergo specialized training in Safe Space methodology. Training for psychologists includes 3 days of didactics followed by weekly supervisions. Certification can succeed after conducting at list 2 children’s groups under supervision. Teacher’s training includes 1 day of didactic in the class room followed by 2 monthly online supervisions. Due to the security reasons caused by war all didactically trainings for teachers and school psychologists have happened in online format only.
A psycholinguistic cross-cultural study of the concept ‘conflict’ in India and Ukraine
(2021) Girnyk, Andriy; Krylova-Grek, Yuliya; Khan, Azizuddin
The paper presents a comparative study of the semantic field of the concept of conflict in Ukrainian and Indian cultures. The literature review has shown that there has not been any discussion on the abstract general concept of conflict. However, we consider such data exceptionally important for a better understanding of the worldview and cultural differences in diverse countries. Our study aimed to identify cultural features, similarities, and differences in the perception of the concept of conflict by representatives of various cultures. To investigate the way the concept of conflict is perceived, we used a set of methods, including speech activity analysis, free-listing for data gathering and processing, mathematical calculation, systematization, and generalization of results We conducted our study in three phases: at the first stage we gathered data, at the second we processed them, and at the third phase we generalized the findings and drawing conclusions. The students from Kyiv-Mohyla Academy (Ukraine) and Indian Institute of Technology Bombay (India) participated in the research (19–24 years old). In general, we got 292 questionnaires. The experiment revealed that the common semantic core of the concept of conflict in Ukrainian and Indian cultures contains seven words: fight, misunderstanding, war, disagreement, quarrel, struggle, aggression. But in contrast to the Ukrainian culture, in India, the associations with the given concept predominantly depict the person’s emotional state (sadness, anger, fear, confusion, and misunderstanding). Participants from India also mention caste discrimination and religious diversity. In Ukraine, the word conflict is much associated with negative interaction (quarrel, aggression, argument, dispute, etc.). Besides, in contrast to the Indian culture, there are no associations with social discrimination and religious diversity. The importance of our findings cannot be stressed too much since they can potentially be used in mediation, social advertising, and international negotiations.
A randomized-controlled trial of community- based transdiagnostic psychotherapy for veterans and internally displaced persons in Ukraine
(2021) Bogdanov, Sergiy; Augustinavicius, Jura; Bass, Judith; Metz, Kristie; Skavenski, Stephanie; Singh, Namrita; Moore, Quincy; Haroz, Emily; Kane, Jeremy; Doty, S. Benjamin; Murray, Laura; Bolton, Paul
Background. There is limited research on community-based mental health interventions in former Soviet countries despite different contextual factors from where most research has been conducted. Ongoing military conflict has resulted in many displaced persons and veterans and their families with high burdens of mental health problems. Lack of community-based services and poor uptake of existing psychiatric services led to the current trial to determine the effectiveness of the common elements treatment approach (CETA) on anxiety, depression, and posttraumatic stress symptoms (PTS) among conflict affected adults in Ukraine. Methods. We conducted a three-armed randomized-controlled trial of CETA delivered in its standard form (8–12 sessions), a brief form (five-sessions), and a wait-control condition. Eligible participants were displaced adults, army veterans and their adult family members with elevated depression and/or PTS and impaired functioning. Treatment was delivered by community-based providers trained in both standard and brief CETA. Outcome data were collected monthly. Results. There were 302 trial participants (n = 117 brief CETA, n = 129 standard CETA, n = 56 wait-controls). Compared with wait-controls, participants in standard and brief CETA experienced clinically and statistically significant reductions in depression, anxiety, and PTS and dysfunction (effect sizes d = 0.46–1.0–6). Comparing those who received standard CETA with brief CETA, the former reported fewer symptoms and less dysfunction with small-to-medium effect sized (d = 0.20–0.55). Conclusions. Standard CETA is more effective than brief CETA, but brief CETA also had significant effects compared with wait-controls. Given demonstrated effectiveness, CETA could be scaled up as an effective community-based approach.

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