Psychological help for Ukraine. How did the WNS researchers help?

Help for Ukraine at the Faculty of Social Sciences has been in full swing since the first moments of Russia's attack on the country. On February 25th, the 'Students for Ukraine' collection started, thanks to which necessary items are sent to our eastern neighbours and handed over to refugees in the Tricity.

The issue of long-term assistance for refugees has arisen.

People fleeing war-torn places are at risk of post-traumatic stress disorder, high levels of anxiety and depression, among other things. Pregnant women, young mothers and those in adolescence are particularly at risk. 

The problem was addressed by psychologists from our University: dr hab. Małgorzata Lipowska, prof. UG, dr Agata Rudnik and dr Małgorzata Chrzan - Dętkoś. The form of assistance varies, but each of these activities facilitates the delivery of professional psychological help to people who need it most now.

dr hab. Małgorzata Lipowska, prof. UG

Dr hab. Małgorzata Lipowska, prof. UG, Pomorskie Voivodeship consultant for clinical psychology. Together with 15 consultants and the Laboratory of Psychological and Pedagogical Tests from Gdańsk, she has developed a bilingual, detailed developmental interview questionnaire that will help psychologists, teachers and GPs to examine children from Ukraine.

- 'Refugees from Ukraine, especially children, need psychological help' is a slogan that appears in almost all media. However, the problem is that it is not clear exactly how it should be provided. The first barrier is language. I was still learning Russian, but for many years now, there is only English, French and German in schools. Moreover, not all refugees speak Russian, especially children. 

Ukrainian children come to us from a war-torn country, some of them literally 'walked over dead bodies', but families unaffected by warfare also come to Poland, but this does not mean that they do not need help. Carers with children about whom we know nothing come for support. What is worse, we cannot communicate with the mother. It is very difficult to judge 'at a guess' whether a child who e.g. does not speak is traumatised by war or perhaps does not speak due to e.g. autism. Therefore, I called the Psychological and Pedagogical Testing Centre in Gdańsk, which has been cooperating with us for years. The core of the laboratory are graduates of the Faculty of Social Sciences of the University of Gdańsk, our former students and doctoral students. I contacted them because last year, the Laboratory prepared a Polish adaptation of the TONI-4 Nonverbal Intelligence Test, which is of course culturally independent, which is perfect, isn't it? 

The response was immediate, the Unit sent out free test kits and other materials useful for testing non-Polish speakers to all voivodship consultants in Poland. We distributed them among institutions in different provinces. However, this still did not solve the basic problem, namely that we could not communicate with these patients. 

In a collaborative effort, I and 15 clinical psychology consultants from other voivodeships joined remotely with representatives of the Psychological and Pedagogical Testing Centre in Gdansk, to think among specialists about what we could do in the short term.

extract from the development interview questionnaire

extract from the development interview questionnaire

After this conversation, we knew that first of all we had to prepare a bilingual, detailed development interview questionnaire. As consultants, we are all clinical psychologists, but everyone deals with something different, so when working on the questionnaire we divided the areas. We prepared questions from the most basic to the most detailed. The Laboratory of Psychological and Pedagogical Tests coordinated the work, again free of charge, translated the prepared questions into Ukrainian, gave them a uniform form and developed the interview questionnaire graphically. It is now free for everyone to download.

This questionnaire is not only an auxiliary material for psychologists. We have prepared it so that it can be used by a teacher, doctor or anyone who deals with a child coming from Ukraine. There are some more advanced questions about, for example, neurodevelopmental disorders, but you do not need to answer them if the interviewer does not need this information. This questionnaire can only be partially completed.

The form of the questionnaire itself is very intuitive. It is not a psychological test - it is a tool useful to work with a child 'for starters'. Let me repeat, we do not know which children will come to us for help. Maybe a particular child has had problems for years or has even been diagnosed with a disorder or illness before, and we will attribute everything to trauma. War trauma is terrible, but disabled children and children with experiences other than war also come to us. We do not know this, because we do not have their documentation. 

The Ukrainian-Polish Questionnaire for the Analysis of the Development and Current Difficulties of Children and Adolescents, which we have prepared, also includes very basic questions such as 'At what age did the child sit down?', 'How many siblings does he/she have?', 'Did he/she function well in kindergarten?'. These are important not only for the psychologist but also for the doctor or educator. As provincial consultants, we sent the Questionnaire to provincial offices, marshal's offices, institutions such as MOPS, curatorships, schools, offices, and we made it available on social media. 

As far as more advanced diagnostic tools are concerned, for the time being, there is no need to prepare them only for refugees from Ukraine. We already have tests in Poland that are culturally independent. At our Faculty of Social Sciences, many research, as well as practical projects, use these tests. 'Przystanek Mama', which assists mothers in the perinatal period, uses the Edinburgh Depression Scale because it is available in Ukrainian. Many other tests also have their Ukrainian versions, so there is no need to invent a new test, but it is useful to make available and distribute already existing non-verbal or Ukrainian language tools. Test laboratories are now preparing further Ukrainian adaptations of existing tools on the market.

Psychologists from Ukraine who could help children with problems are also an important problem at the moment. However, they cannot work as psychologists if we do not recognise their profession. We need to establish whether the qualifications of a psychologist from Ukraine are the same as those in our country. However, we cannot check this efficiently until the current Polish Act on the Psychologist Profession comes into force along with implementing regulations. We are trying to address this issue because solving this problem is the next step toward improving the living conditions of refugees from Ukraine.

dr Agata Rudnik

Dr Agata Rudnik, director of the Academic Psychological Support Centre UG. The Centre organises psychological support in four languages (Polish, Ukrainian, Russian and English).

- We very quickly managed to find people to work with who speak Ukrainian. At the very beginning of this situation, there was an attitude of 'all hands on deck'. We all shared our contacts and acquaintances, so there was no problem and we actually managed to find such people. That's why the website of the Academic Psychological Support Centre of the University of Gdańsk quickly included information in Ukrainian.

Until now, however, people who contact us communicate well in Polish. Our centre provides support for those studying and working at the university. So far we have received applications from Ukrainians and Ukrainian women who have been living in Poland for some time. We haven't needed language support so far, but it's always good to know that we can meet this need.

When the war in Ukraine started, we were approached by people experiencing helplessness, high levels of anxiety and insecurity. They were accompanied by attention and concentration problems, sleep difficulties, lack of appetite, lowered mood and even panic attacks, among other things. The result of these feelings is that they were unable to function. They could not cope with daily tasks. They needed support in planning their day, regulating this anxiety and in dealing with difficult emotions. Here, above all, we pointed out how our mind works, how emotions arise, how to deal with them, how not to create 'black scenarios', we advised to limit following the news, use verified sources of information, to take care of oneself - including doing breathing exercises, relaxation, attentiveness training, but also stressed the importance of relationships and contacts with others. We also showed how to support loved ones, especially how to talk to children. Sometimes it is enough just to be, to listen and to accompany.

So far we have not seen an increase in the number of people who come to us. With 12 hours of on-call time per day, as before, we are currently signing everyone up for appointments in about 2-3 weeks (depending on the consultation times chosen) In the beginning, we were mainly in the mobilisation and reassurance phase. Now, in the context of the war, psychological help is especially needed for those who face post-traumatic stress disorder, but also for those who are intensely involved in helping. Let us remember that our resources are also depleted if we forget ourselves in all this and lose ourselves in helping others. Our batteries also need to be recharged so that we can work effectively.

Among other things, we have organised a series of open online meetings called 'Let's support each other (not only) here and now'. (materials from the meetings are available on the ACWP website), we have held additional walk-in (no need to sign up in advance) Skype calls and we have provided the opportunity to talk in four languages. If there is a need, we will once again propose to create support groups - 'Students for Students'. It's not always about psychological help, sometimes we just want to sit and talk with others. I think this could be particularly important in the future. We're constantly monitoring what the needs are for psychological support, and we try to respond to them all the time.

Dr Magdalena Chrzan-Dętkoś

Dr Magdalena Chrzan-Dętkoś, manager of 'Przystanek Mama' on the UG side - as part of the 'Przystanek Mama' project (support for women in the perinatal period; project in cooperation between the Institute of Psychology and COPERNICUS Treatment Centre), support is offered in Ukrainian.

- I coordinate the 'Przystanek Mama' project concerning postnatal depression together with the Copernicus Hospital. We operate in 3 provinces and cooperate with 38 primary health care centres and 7 maternity wards. Together, we offer help to young mothers who feel depressed or lack pleasure from their activities, i.e. the first symptoms of depression. 

Research shows that adolescents, pregnant women and young mothers are at additional risk in situations of forced refuge. These people belong to a particularly 'vulnerable group' that needs special, adequate support. According to research: If one's inner sense of security has been severely damaged by the experience of danger, and a sense of inner homelessness has developed in a precarious situation in a foreign country, the capacity for empathy and intuitive parenting is weakened. This can lead to the destabilisation of maternal/parental function (Varvin, 2016, p. 829 after Utari-Witt, Walter, 2021). 

I was keen to launch a website as soon as possible where mothers from Ukraine could fill in an online questionnaire and receive the result: :

Edinburgh Postnatal Depression Scale | Test for Mums | Przystanek Mama (copernicus.gda.pl)

Excerpt from the test for mothers available in Ukrainian on the website 'Przystanek Mama'

Logo "Przystanek Mama"

Thanks to the organisation 'Students for Ukraine', we managed to translate the materials on mental health prevention into Ukrainian very quickly. The refugee version has been available since mid-March.
I am also keen to publicise the need for additional support and prevention of mental health among young Ukrainian mothers. Data from countries at war indicate an increased risk of premature birth and low birth weight in newborns. These results are explained by stress, but also by poorer access to medical care. Stress is inevitable, but protective factors can be put in place to lessen the negative effects of chronic stress.

Currently, my students are involved in discussions with midwives who care for young mothers from Ukraine. We want to find out more about the needs of both the staff and the people from Ukraine so that our prevention programme can be tailored to their needs.  
I also run classes where we work with first-year psychology students on the Child Development Scale created by me and published by the Psychological and Pedagogical Testing Centre in Gdańsk. It is an auxiliary tool for diagnosing children between the ages of 12 months and 12 years. We plan to translate it into Ukrainian. In this way, we want to make it easier for Psychological-educational Counselling Centres and other support centres to work with Ukrainian children and parents.

First-year psychology students working on the Child Development Scale
Marcel Jakubowski / Press Office UG