By Khrystyna Dudashvili - Head of MHPSS Programs*, Founder of Recovery Camp program at Sincere Heart Charity Foundation, Ukraine

Introduction
The full-scale invasion of Ukraine by the Russian Federation in February 2022 was not only a military and humanitarian disaster, but also a massive mental health crisis for the civilian population. The destruction of infrastructure, prolonged shelling, forced displacement, loss of loved ones and a chronic sense of danger have created conditions for repeated and cumulative trauma. Children are among the most vulnerable groups, as the war has disrupted the key environments for their development: family, school, community and support systems.

International research shows that the impact of war on children is rarely limited to a single traumatic event. Instead, it takes the form of prolonged stress, which increases the risk of developing post-traumatic stress disorder, anxiety and depressive disorders, behavioural difficulties and social functioning disorders. In the Ukrainian context, these risks are exacerbated by limited access to specialised mental health services, a shortage of child specialists, and uneven distribution of services across regions.

It is against the backdrop of these systemic limitations that, since September 2022, six-day psychosocial recovery camps based on the ‘mother-child’ model have been implemented in Lviv by the new official national partner of Active Citizenship Network, Sincere Heart Charity Foundation, as part of the Recovery Camp programme. The aim of this intervention was not only to temporarily reduce distress levels, but also to identify children at risk at an early stage, develop self-regulation skills and create mechanisms for further support.

Unmet needs of children affected by war
An analysis of the practical experience of the Sincere Heart Charity Foundation and cohort study data reveals a number of persistent unmet needs that are not covered by existing state or humanitarian interventions.

Firstly, there is a need for a safe environment. For children from frontline and de-occupied territories, safety is no longer a basic condition for a dignified life, rather than a privilege. Even after displacement, they often remain in an environment of high anxiety for their mother or family as a whole, which complicates recovery.

Secondly, there is a lack of early mental health screening. A significant proportion of children with clinically significant symptoms of PTSD are not clearly identified by the health care system due to a lack of regular assessments, stigmatisation or a shortage of specialists in communities.

Thirdly, there remains an unmet need for family-oriented approaches. In many interventions, the child is considered in isolation from the primary caregiver, even though it is the mother's emotional state that significantly modulates the course of the child's trauma.

Fourth, there is a critical lack of sustained support. Even after the problem has been identified, families often encounter barriers for clear referral and support pathways, especially in cases of internal displacement.

The Recovery Camp intervention model
The Recovery Camp programme is designed as a short-term but intensive psychosocial intervention that combines elements of evidence-based approaches to trauma work and recreational recovery. Each six-day camp includes 65 participants – children and their mothers – and is implemented by an interdisciplinary team of stress management and recreation consultants and mental health professionals with master's degrees. As of early 2026, 295 camps of various formats have been held as part of the Recovery Camp programme, with a total of 22,700 participants.

The programme combines play therapy, art therapy, music, dance, body-oriented practices, breathing techniques and yoga. When working with traumatic material, a cognitive approach is used with a focus on stabilisation, normalisation of reactions and the development of self-regulation skills. Mothers participate in support groups and psychoeducational sessions on stress management, which helps to reduce their own symptoms and strengthen their parental support resources.

A distinctive feature of the model is the integration of recreational counsellors into the psychotherapeutic process. They undergo continuous training in the basic principles of psychotherapy and coordinate their work with mental health professionals, which has made it possible to create a single safe space for children throughout their stay at the camp.

Scientific validation of the programme and extended description of the intervention model
The Recovery Camp initiative is the first programme in Ukraine to provide psycho-emotional support to children affected by war that has undergone official scientific research. Over two years, the programme was the subject of a thorough and systematic study, which included an analysis of the children's psycho-emotional state, an assessment of the effectiveness of interventions, and tracking of further assistance pathways. The results of the study were sent to the University of California (USA) for academic analysis and interpretation.

Further research has demonstrated the programme's highly positive impact on children who have survived war and has received international scientific recognition. In particular, the results were published in the American scientific and medical journal JAMA Network Open and featured in the Australian magazine Cosmos, confirming the programme's compliance with international standards of evidence-based psychosocial care.

The Recovery Camp intervention model provides multi-level psychological support, including both group and individual formats. Group psychological support for children is aimed at normalising traumatic reactions, restoring a sense of security, and developing emotional regulation and social interaction skills. Support groups for mothers focus on reducing stress levels, increasing parental sensitivity, and understanding the impact of trauma on a child's behaviour.

Individual psychological assistance is provided to children with increased levels of distress or symptoms indicating possible post-traumatic stress disorder. Such consultations are conducted by mental health professionals, taking into account the child's age, the nature of the traumatic experience, and existing functional impairments. If necessary, families are referred for further specialised care, ensuring continuity of support after the camp ends.

Research methods
Between September 2022 and July 2024, a cohort study was conducted involving 1,291 children aged 6 to 16 and 963 mothers. Participants were recruited from frontline regions of Ukraine, including Odesa, Kharkiv, Donetsk, Sumy, Zaporizhzhia, Dnipro, and Kherson regions, through partner organisations, social networks, and the Telegram messenger.

The children's mental health was screened using the CATS-2 tool, which assesses the impact of traumatic events, PTSD symptoms according to DSM-5 and ICD-11 criteria, and the level of functional impairment over the past four weeks. The tool is highly reliable and has been validated for use in the context of the war in Ukraine. The assessment was conducted in Ukrainian using age-appropriate forms for caregivers and self-reports for adolescents.

Following the completion of the camp, mothers participated in unstructured exit interviews to reflect on changes in their children's condition and to identify needs for further support. One week after the programme concluded, telephone follow-ups were initiated to facilitate referrals to appropriate specialists.

Results
The study sample included 1,291 children aged 6 to 16 years, with a mean age of 9.3 years. Girls accounted for almost half of the sample — 633 children (49.0%). The study also included 963 mothers. According to the screening results, 438 children (33.9%) had CATS-2 scores indicating elevated levels of distress or symptoms consistent with probable post-traumatic stress disorder related to traumatic experiences (Table 1). The most common difficulties observed in children were difficulty concentrating, increased nervousness or restlessness, and sleep disturbances.

Table 1. Traumatic experiences of children reported during admission to the camp

After the camps concluded, the programme team contacted 436 mothers for further follow-up and to assess the possibility of referring them to specialised services (in two cases, further follow-up was lost). Among the mothers surveyed, 346 (79.4%) had already contacted or planned to contact mental health services, and 233 families (53.4%) were referred to mental health specialists. Despite the short duration of the intervention, positive changes were observed in most children: 968 children (75.0%) showed an overall improvement in their psychosocial status after participating in the programme (Table 2).

Table 2. Changes in children reported after the intervention

Discussion
The results confirm that short-term, structured psychosocial intervention can significantly reduce distress and enhance children's functioning even in the context of ongoing war. The mother-child model proved to be particularly relevant to the Ukrainian context, where the mother is often the only stable adult in a child's life.

At the same time, the study has limitations, including the absence of a control group and limited generalisability of results due to the specificity of the sample. An important finding was also that two-thirds of the children did not have clinically significant symptoms, which led to a review of the interviews with an emphasis on resilience factors and protective mechanisms.

Advocacy role of the Sincere Heart Charity Foundation
The Recovery Camp programme is not only a practical intervention, but also a tool for advocating for the mental health of children affected by war. Scientific verification of the model, publication of results in international peer-reviewed journals, and cooperation with academic and donor institutions allow the topic of childhood trauma to be moved from the humanitarian sphere to the sphere of policy and systemic solutions.

Through the development of the Recovery Camp Academy, the foundation is investing in scaling up the approach and transferring expertise to other organisations and communities, which is critically important in the context of a protracted war and limited resources in the state system.

Conclusions
The experience of implementing Recovery Camp demonstrates that the public sector can play a pivotal role in addressing gaps in the mental health system by combining practical assistance, research and advocacy. Integrated, family-centred and evidence-based interventions have the potential to serve as a foundation for national strategies to support children growing up in war zones.

*MHPSS (Mental Health and Psychosocial Support): A set of measures to protect and strengthen the mental well-being of people affected by crises, conflicts or emergencies, helping them to cope with stress, prevent mental disorders and restore normal functioning at the individual and community levels.

(January 2026)