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max-kukurudziak-qbc3Zmxw0G8-unsplash.jpgIn February 2022, Russia invaded Ukraine. As a result, millions of people have been exposed to war and war-related trauma, and the world is witnessing an immense mental health crisis. Ukrainian mental health systems cannot address this crisis effectively alone, and the main reason is that mental health professionals in the country generally are not trained in evidence-based care for posttraumatic stress disorder (PTSD) and trauma-related sequelae. A National Institutes of Health (NIH) Fogarty-funded project (1D43TW012463) recently started by Drs. Liberzon and Nickelsen aims to change that.
This five-year NIH-funded project has two main goals. The first is to train Ukrainian mental health providers in evidence-based PTSD/trauma care. The second is to train a cadre of Ukrainian scientists who will examine the implementation of these interventions as well as their impact on society.
PTSD experts from American universities will implement this project by traveling to Ukraine once a year to provide in-person trainings. The Ukrainian clinician trainees will also receive ongoing supervision (online) from U.S. specialists. Each year, four trainees will take part in a “summer school” program in the U.S., where they will work on developing scientific pilot projects and implement those projects after returning to Ukraine.
In May 2023, project leaders Dr. Liberzon and Dr. Nickelsen traveled to Kyiv, with the purpose of assessing the ongoing situation in Ukraine and establishing the in-country training. They spent a week in Kyiv, and it was a challenging visit. Air raid sirens were active almost every night, and the team had to spend five nights out of six in the shelter. It was sobering to realize that Ukrainian people are living like this while trying to function effectively for more than a year already. Despite these circumstances, the team met with key local individuals involved in this effort: the provost of a leading Ukrainian University, the CEO of the Ukrainian Government Initiative for Mental Health Reform and others. After returning to the US, the team started recruiting Ukrainian participants for the first in-person workshop and found overwhelming interest in this project from Ukrainian mental health professionals. The research team received over three hundred applications for 35 slots. Similarly, the willingness of US professionals to help with the implementation of this project was equally inspiring.
At the beginning of October 2023, the U.S. team (Drs. Liberzon, Nickelsen, Ory, Tafet and Muller) traveled to Ukraine and conducted the first week-long, in-country training. To allow a safe environment for learning, the training took place in Lviv (Western Ukraine) in a sheltered space. During the workshop, the following topics were covered: prolonged exposure and trauma behavioral therapy interventions, pharmacotherapy for PTSD, acute intervention, cognitive-behavioral therapy principles, implementation science and more.  The level of enthusiasm and commitment of the Ukrainian clinicians was no less than inspiring, and the appreciation and specific feedback provided were uniquely gratifying. It suggested a great beginning for the important project that is on course to make a real difference in just one place where it is desperately needed.

About the authors

Israel Liberzon, MD is a Distinguished University Professor and the William and Dorothy Stearman Endowed Professor at Texas A&M University School of Medicine, where he was recruited in 2018 as the founding Head of the Department of Psychiatry and Behavioral Sciences. Dr. Liberzon received his MD from Sackler Medical School, Tel Aviv University, Israel (1986), and after completing a Postdoctoral Fellowship, and Psychiatry Residency, was appointed Assistant Professor at the University of Michigan (1992), where he served as faculty until his move to Texas A&M (2018). Dr. Liberzon is a one of the leading experts in the fields of fear, anxiety and Post-traumatic Stress Disorder (PTSD), and is a rare scientist, whose research bridges basic animal studies, clinical and translational research, and patient care. He is one of the pioneers of the functional neuroimaging of stress, emotions and trauma, and his research elucidated several major brain and neuroendocrine mechanisms of stress response and PTSD. His work helped to transform the understanding of the roles of the hippocampus, hippocampal-prefrontal neurocircuits and contextual processing in PTSD pathophysiology. Dr. Liberzon has also developed the widely used animal model of PTSD (SPS) that led to more than 400 publications. He has authored over 300 peer reviewed manuscripts, which have been cited more than 43,000 times (h-index 99) and trained many clinicians/researchers who are now academic leaders in the field.
Tetiana Nickelsen, PhD is an Associate Research Scientist at Texas A&M University, Department of Psychiatry and Behavioral Sciences. Dr. Nickelsen received her PhD in psychology from Kotsiubindky Pedagogical University, Ukraine (2015). While in Ukraine, Dr. Nickelsen dedicated her professional career to improving mental health care access and delivery to vulnerable populations in Ukraine, combining research and advocacy (as a PI on multiple Ukrainian grants funded by international foundations like The Global Fund, GIZ and more). In parallel, she facilitated the adoption and implementation of key policy changes in the mental healthcare systems in Ukraine and former Soviet Union republics. In collaboration with the University of Michigan research team, Dr. Nickelsen built a research partnership in Ukraine by serving as a Local PI on NIH-funded D43 program. In 2016 she joined the Michigan team for additional training with a focus on psychological trauma and substance use. In 2018 she was invited to join the PTSD program at Texas A&M University Department of Psychiatry and Behavioral Sciences as Assistant Research Scientist. Dr. Nickelsen’s scientific interest is in the mechanisms of PTSD and in PTSD/trauma care. After the Russian invasion of Ukraine in 2022, she led the effort to bring evidence-based trauma care to Ukraine and study the implementation of this care. She aims to study PTSD in Ukraine and to create a strong pool of Ukrainian scientists to conduct joint (U.S./Ukraine) scientific work in the field of PTSD in the future.