Four years into the full-scale war in Ukraine, how is prolonged exposure to conflict affecting children’s mental health and development?
Childhood is when personality, attachments, and basic patterns of safety are formed. During this time, children develop a basic understanding of how the world works. When a child faces multiple danger factors due to war, the world feels unsafe. That’s why it is crucial for them to also experience support and care from their close environment, usually their family.
Studies on the effects of prolonged or intense stress on a child’s brain development show that between the ages of 3 and 5, it is likely to impair learning and memory development. At 10 or 11, it increases the risk of anxiety and a constant state of anticipating danger later in life. Between 14 and 16, it affects the development of the prefrontal cortex, affecting emotional control, impulse regulation, and decision-making.
The key point is that a child needs to feel and know that even in difficult times, they remain important to adults and can receive attention, care and support.
Many of the children you work with have lost parental care or are at risk of losing it. How does this affect their ability to cope with trauma?
A stable family is the foundation for safety and the ability to develop healthy relationships. When children lack reliable, responsive adults, they are at greater risk of anxiety, mistrust, and difficulties with self-regulation. This experience is often referred to as “developmental trauma.” When this is combined with a major traumatic event — such as war, physical danger or the loss of an attachment figure — it creates a deep sense that the world cannot be safe or benevolent. In such conditions, it is more difficult for a child or adolescent to build trusting relationships, ask for help or feel part of a community.
What is crucial for such a child is the presence of a “witness” to their experiences — an adult who can notice, listen, acknowledge the pain, provide support and offer a sense of stability, as well as the understanding that difficult events influence life but do not define a person.
What are the most common signs of psychological distress you see among children and adolescents?
Most often, these include:
- High anxiety, panic attacks and sleep disturbances
- Emotional exhaustion, fatigue and apathy
- Headaches, stomach pain and regressive behaviour in younger children
- Speech difficulties, learning challenges and problems with concentration
- Withdrawal and social isolation
- Intrusive thoughts and fears that are not age-appropriate
- Aggressive or self-harming behaviour, particularly among adolescents
Can you share an example of how psychosocial or therapeutic support has helped a child recover?
To preserve anonymity and confidentiality, I will share a composite example that is quite common. A child lives in a region with frequent shelling. Ongoing fear and the sounds of explosions and sirens lead to speech difficulties, anxiety, fear of the dark and of being alone.
Our work includes psychoeducation for the parents, a recommendation to undergo medical screening to rule out neurological causes, and exercises to help the child stabilize through play and breathing techniques. Over time, positive changes become visible: the child’s anxiety decreases, sleep improves, and trust between the child and their parents grows stronger.
Which approaches have proven most effective in supporting children affected by war and loss?
Time and consistent support are crucial A key component is psychoeducation — explaining to parents or caregivers that the child’s reactions are natural responses to stress and crisis.
Effective approaches include:
- Psychological First Aid
- Stabilization techniques such as breathing, grounding and body-based exercises, including the Children and War programme and trauma-focused cognitive behavioural therapy
- Psychosocial support, including play therapy, art therapy and storytelling
- Restoration of daily routines such as sleep, nutrition, movement and learning
- Screening and referral to specialized services when needed
- Involvement of schools and communities
How do you involve caregivers and trusted adults in the recovery process?
The first step is to provide clear information about the child’s situation, what to expect, and what actions are needed.
Specialists conduct joint sessions with children and caregivers, as well as separate meetings. Group supervision and support groups for caregivers and foster parents are also essential. These measures provide stability and help create a coordinated action plan.
What are the long-term risks if children’s mental health needs are not met?
Unmet mental health needs cause difficulties in learning, building trusting relationships and integrating into society, resulting in increased risks of unemployment and poverty. These experiences shape the trajectory of a child’s future and affect the development of entire communities.
What gives you hope for children’s resilience despite these risks?
Hope comes from protective factors: caring adults, friendships, school, community activities and the availability of quality mental health and psychosocial support services.
Hope also comes from the children themselves — their curiosity and ability to release emotional tension through play and imagination. Their psyche is flexible, and this is what gives the greatest hope: with appropriate support, they are able to recover and continue growing.