Yale Psychiatry Faculty Facilitate Trauma Training for Ukrainian Clinicians

A group of Yale Psychiatry researchers and clinicians recently traveled to Ukraine to ensure that their colleagues have the tools they need to care for both themselves and their patients in the wake of widespread wartime trauma.

Ilan Harpaz-Rotem, PhD, ABPP, professor of psychiatry and of psychology and a leading expert on posttraumatic stress disorder (PTSD) and Shelley Amen, MD, PhD, assistant clinical professor of psychiatry, traveled to Poland last year to hold training for psychologists and psychiatrists. Harpaz-Rotem and Amen recently completed a second visit, this time accompanied by Or Duek, PhD, assistant professor adjunct in psychiatry. Across both trips they met with and provided training for 40 clinicians.

The training visit was funded in part by a $50,000 donation from the MacMillan Center to Doctors United for Ukraine (DU4U), a nonprofit organization co-founded by Yale faculty with ties to Ukraine, including Irina Esterlis, PhD, associate professor of psychiatry; Alla Vash-Magrita, MD, associate professor of obstetrics, gynecology & reproductive sciences; and Andrey Zinchuk, MD, MHS, assistant professor of pulmonary, critical care & sleep medicine. It was facilitated by Yale’s Scholars at Risk program, which provides training and assistance to at-risk artists, scholars, and practitioners who face persecution because of their work or for some other reason in their home country.

“The idea is to give psychologists and psychiatrists the basic tools and the ability to provide effective treatment for the aftermath of trauma and create an infrastructure to deal with what they are facing,” Harpaz-Rotem said.

“The psychologists in Ukraine are not equipped to deal with what is happening, and many of them are working for free because there is so much trauma,” Esterlis explained. “The psychologists are being traumatized, the people are being traumatized, and the psychologists don’t know how to protect themselves from this trauma or help people – and they feel horrible because they can’t help.”

Esterlis established the connection between the DU4U and Lviv Hospital, and together with Marta Kuzma, former Dean of the Yale School of Art, who was working with the Primo Levi Center, ultimately connected Harpaz-Rotem with the chief of psychiatry at Lviv Hospital to deliver expertise in the treatment of PTSD. The Primo Levi Center seeks to provide care for and assist victims of torture and political violence.

In Ukraine, the most common model of mental health care – long-term psychotherapy – cannot adequately treat large groups of people experiencing acute trauma and PTSD. With hundreds of soldiers and civilians being traumatized daily, on a level not seen in decades, mental health professionals are overwhelmed and under-resourced.

The goal of the visits has been to help psychologists and psychiatrists understand the difference between acute stress and PTSD, how those are treated, and to treat PTSD in a shorter timeframe that will allow for increased capacity of the number of people they can provide care for, Harpaz-Rotem said. Steven Marans, PhD, MSW, Harris Professor in the Child Study Center and director of the National Center for Children Exposed to Violence/Childhood Violent Trauma Center, also participated in the recent visit, and provided clinicians with an overview of the Child and Family Traumatic Stress Intervention (CFTSI).

“Clinicians have felt helpless, and we have installed some hope that providing effective treatment is attainable in a relatively short period of time,” Harpaz-Rotem said. “We also hope to establish relationships so we can have a long-term research collaboration and understand the long-term effects of PTSD in this population.”

While the training efforts were initially focused on caring for traumatized women and children, they have since been expanded to include providing care for soldiers and veterans experiencing PTSD. Harpaz-Rotem, Amen, and Duek are all military veterans and bring their personal experiences of serving in active duty to their training, to help clinicians better understand military trauma.

Shortly after war broke out in Ukraine last year, Esterlis decided to bake special Ukrainian poppyseed breads in exchange for donations to charities that could provide aid to Ukrainians. In total, Esterlis estimates she raised $30,000.

Her work was one of the forces that brought together the co-founders of DU4U, an organization that raises funds to purchase lifesaving medical equipment or other tools that hospitals in Ukraine need to care for patients, and targeted support for trauma survivors through training and supplies for mental health professionals. To date, the nonprofit has raised approximately $1 million.

Esterlis’ role within DU4U has been to facilitate mental health aid. The organization has collaborated with EMDR Austria, which offers basic eye movement desensitization and reprocessing (EMDR) curricula and is a proven treatment for PTSD, to pay for psychologists to participate in EMDR therapy. They also worked to establish a program to help internally displaced people in Ukraine, arranged art therapy for children and group therapy for adults, and raised money to compensate psychologists for providing mental health treatment. Previously, they worked for free due to the demand for services.

“Even if the war ends tomorrow, the mental health and medical issues will not end tomorrow,” Esterlis said. “There are going to be decades of mental health issues. People are going to need help. Psychologists are going to need help and more training. The public is going to need help and support. It’s a long-lasting effect across generations and for generations to come.”

To learn more about Doctors United for Ukraine, including information about how to support the organization, visit its website.