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/ December 2022
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http:// www.amazoniainvestiga.info ISSN 2322- 6307
DOI: https://doi.org/10.34069/AI/2022.60.12.14
How to Cite:
Korylchuk, N., Vlasenko, I., Livandovska, I., Bokova, S., & Demikhova, N. (2022). Theoretical and methodological principles of
providing medical and psychological assistance in the conditions of armed conflicts: experience for Ukraine. Amazonia
Investiga, 11(60), 135-144. https://doi.org/10.34069/AI/2022.60.12.14
Theoretical and methodological principles of providing medical and
psychological assistance in the conditions of armed conflicts:
experience for Ukraine
Principios teóricos y metodológicos de la prestación de asistencia médica y psicológica en
condiciones de conflicto armado: experiencia de Ucrania
Received: November 26, 2022 Accepted: December 27, 2022
Written by:
Neonila Korylchuk62
https://orcid.org/0000-0002-1055-9292
Inna Vlasenko63
https://orcid.org/0000-0003-2562-3637
Inna Livandovska64
https://orcid.org/0000-0001-9636-0454
Svitlana Bokova65
https://orcid.org/0000-0002-3426-9150
Nadiia Demikhova66
https://orcid.org/0000-0003-4139-1645
Abstract
The war in Ukraine opened up the problem of not
only physical, but also psychological
rehabilitation of its victims. The purpose of the
article is to analyze the theoretical and
methodological principles of providing medical
and psychological assistance in the conditions of
armed conflicts. The implementation of this task
is based on the use of general scientific (analysis,
synthesis, induction and deduction) and special
(historical, comparative) research methods. The
results analyzed primarily the Israeli strategy of
medical and psychological assistance to the
victims, since the Israeli army has a long
experience of conducting combat operations, so
it also has a strategy of helping to overcome
psychological and mental disorders. Also, the
peculiarities of psychological assistance in the
armies of NATO countries crystallized since
many new members of the Alliance belonged to
the socialist bloc. It has been proven that it is
important not only to provide assistance to the
servicemen themselves but also to their family
62
Associate Professor Department of Therapy and Family Medicine Faculty of Medicine I.YA. Horbachevsky Ternopil National
Medical University of the Ministry of Health of Ukraine, Ukraine.
63
PhD in Psychology, Associate Professor of Psychology of Personality and Social Practices Department Faculty of Psychology,
Social Work and Special Education Borys Grinchenko Kyiv University, Kyiv, Ukraine.
64
Lecturer Department of Psychology, Pavlo Tychyna Uman State Pedagogical University, Ukraine.
65
PhD, Assistant lecturer Sumy State University, Department of family medicine with course of dermatovenerology, Sumy, Ukraine.
66
Doctor of Medical Sciences , Professor Sumy State University, Department of family medicine with course of dermatovenerology,
Sumy, Ukraine.
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members, including by involving modern
pharmacological means. The conclusions also
emphasize the American experience, in
particular, the fact that much attention is paid in
the USA to the prevention of psychological
disorders.
Keywords: traumatic experience, civilians
military personnel, treatment, psychological
assistance, Ukraine.
Introduction
The end of the Yugoslav war of the 1990s
temporarily established a period of peaceful
coexistence in Europe. This situation changed in
2014: Russian troops arbitrarily occupied
Crimea, then announced the annexation of the
peninsula; in eastern Ukraine, the Kremlin
regime supported separatists, leading to the
transition of Donetsk and Luhansk to Russian
control. The antiterrorist operation (ATO) was
replaced by full-scale military action using heavy
military equipment, rocket artillery, and aviation.
Russian support allowed the fighters to freeze the
conflict, but the start of the Russian-Ukrainian
war was a new challenge to the global security
system. Along with military action came the
issue of medical and psychological assistance.
The Russian-Ukrainian war opened up new
problems in the functioning of many processes,
including medical and psychological care for
military personnel. Traumatic experience and its
control were previously underestimated in the
structure of the Ukrainian army, so using the
experience of foreign countries during open
military confrontation will be the key to returning
the psychological state of combatants to normal
(Stoner, 2022). Therefore, the purpose of this
article is to analyze the theoretical and
methodological foundations useful for Ukraine
on the provision of psychological assistance in
armed conflicts. This issue, given the
development of Russian aggression, has not yet
been adequately addressed in the scientific
literature. In the course of its consideration,
separate problems were also investigated: the
methods of preventing stress disorders used in
the armies of NATO countries and Israel. Since
the military structures of these countries have the
most experience of participation in armed
conflicts, and the system of support for
servicemen is established at a high level, the
study of such a system has additional relevance.
Literature Review
A thorough study of the peculiarities of medical
and psychological aid to servicemen began in the
second half of the 20th century. In particular,
Bell (1964) characterized social, psychological,
and medical assistance to soldiers in independent
African countries. Pattison (2008) drew attention
to the legitimate aspects of warfare and the
problem of helping soldiers on the battlefield.
Baker & Pattison (2011) examined the principles
of military campaigning based on the American
experience.
Since the beginning of the Russian-Ukrainian
war (2014), there have been many scholarly
studies on the specifics of supporting the affected
population. Fatyga et al., (2022) analyzed the
specifics of organizing medical care for
Ukrainians in Poland. Khaustov (2019)
characterized the theoretical aspects of medical-
psychological assistance, defined its main
components. Rajab (2018) investigated the
manifestations of social life in the military zones
of Saudi Arabia.
Ukrainian scholars have also actively researched
the peculiarities of support for military
personnel. For example, Kharchenko (2019)
analyzed basic cognitive representations of
traumatic emotional experiences in combat
participants. He conducted an empirical survey-
based study and noted that traumatic experiences
were found in the majority of military personnel.
However, Klochko (2020) outlined the
importance of social support in Ukraine against
the backdrop of military events. Shushkevich
(2022) investigated the domestic life of the
Ukrainian population living in the war zone.
Stebliuk et al., (2019) characterized key aspects
of the organization of medical and psychological
support for the military in Ukraine.
For this article, the work of those authors who
have studied the peculiarities of the Russian-
Ukrainian war is also important. Martz (2022)
Korylchuk, N., Vlasenko, I., Livandovska, I., Bokova, S., Demikhova, N. / Volume 11 - Issue 60: 135-144 / December, 2022
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studied changes in the national identity position
of Ukrainians against the background of the
spread of the Russian-Ukrainian confrontation.
Almäng (2019) identified the stages and
attributes of hybrid warfare based on. Bînă &
Dragomir (2020) characterized the peculiarities
of the development of the Russian-Ukrainian
confrontation, identified the main mechanisms of
information warfare.
Dijkstra et al., (2022) identified political,
economic, and social transformations against the
background of the development of a large-scale
war in Ukraine. Tsekhmister et al., (2021)
investigated the specifics of medical treatment as
a result of the spread of the Covid-19 pandemic.
Most authors analyzed the peculiarities of the
organization of psychological counseling and
medical support in regions where armed
confrontations took place. On the other hand,
Ukrainian researchers analyzed the peculiarities
of providing care based on the Ukrainian
experience. At the same time, the problem of
introducing international experience into the
system of providing medical and psychological
aid to the affected population of Ukraine remains
unexplored and topical.
Methodology
General scientific methods of research were used
in the work. Of particular importance was the
historical method, which traced the evolution of
medical-psychological aid in Israeli-Arab wars
and NATO operations. Based on comparativist
such practices are compared and weighty
achievements, which should be borrowed by the
Ukrainian side in the large-scale Russian-
Ukrainian war, are highlighted. As a result of the
use of concretization the problem of
psychological support for veterans in the United
States is reflected. Based on the prognostic
method the important achievements of Ukraine,
the prospects of their implementation and
realization are determined.
The main empirical materials of the research are
the programs of medico-psychological assistance
of military structures of the NATO countries, the
special attention is given to the American
experience. The peculiarities of medical and
psychological aid in Israel are reflected based on
mass media materials. In addition, the study is
built on a thorough analysis of the scientific
literature, on the principles of scholarship and
objectivity.
Results and Discussion
Theoretical aspects of medical-psychological
assistance
An important challenge for Ukrainian society in
conditions of full-scale war is the preservation of
the psychological and physical health of
participants of military operations, affected
civilians. This, in turn, requires the immediate
implementation and use of effective
rehabilitation measures (Stebliuk et al., 2019). At
the same time, such rehabilitation assistance
should be integrative in nature and include the
following aspects: psychotherapeutic,
psychodiagnostic, psychocorrective, preventive,
career guidance, using both individual and group
forms of psychosocial rehabilitation (Khaustov,
2019). In general, Medico-psychological
assistance is understood as a set of therapeutic,
preventive, recreational, and rehabilitative
measures of a medical and psychological
direction aimed at maintaining health, reducing
the consequences of physical and psychological
trauma suffered (See Table 1).
Table 1.
Types of medical-psychological assistance
psychological assistance-Main types of medical
Preventive 1.
Functional 2.
Clinically 3.
psychological-Socio 4.
Concluded by authors
Medical-psychological aid should be systematic.
In general, the tasks of rehabilitation and its ways
vary depending on the period of its passage. In
particular, preventive measures are carried out at
each period of rehabilitation (Khaustov, 2019).
Preventive care is carried out with the
participation of medical and psychological
services and is used to restore health reserves.
However, clinical rehabilitation is understood as
a system of therapeutic, diagnostic measures,
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which are aimed at the restoration and
physiological health of the person (Klochko,
2020). At the same time, functional rehabilitation
constitutes a component of clinical care and is
applied at all periods of its organization. Social-
psychological rehabilitation is aimed at the
restoration of impaired psychological health. For
Ukraine, the experience of countries around the
world that have encountered the problem of
rehabilitation of war victims remains important.
For this reason, the experience of Israel and the
USA is important and points to the fact that
assistance to the victims is a complex problem
for which the state is responsible.
Medical and Psychological Support for
Civilians in War: The Experience of Croatia
and Israel
Psychological and medical protection of the
population and psychological and social support
of civil protection services are among the main
directions of assistance in military conditions
(Klochko, 2020). This assistance implies that at
the critical moment of an emergency situation,
the civilian population, relatives of the dead and
injured, and witnesses of the events will be
provided with appropriate assistance through
emotional protection, and reduction of the
manifestation of negative psychological and
emotional states.
Medical-psychological assistance to civilians,
according to the Israeli experience of special
work bodies, is provided in the following cases:
1. if a person with a traumatic experience has
expressed a wish to receive such assistance
2. when there are severe traumas
3. when pathological manifestations of
inadequate response to the traumatic event
have formed (pronounced psychosomatic
symptoms, or acute agitation)
4. in the presence of both symptoms at once.
Arab researchers prove that medical-
psychological assistance to the civilian
population should be provided comprehensively,
systematically, and in compliance with several
important principles: timeliness,
comprehensiveness, flexibility, taking into
account any external and internal factors (Rajab,
2018).
The military experience of the Republic of
Croatia (1991-1995) shows that the civilian
population in particular suffers from many
psychological problems. Initially, Croatia's
psychological services focused on the military,
but subsequently, the development of many
psychological traumas in civilians became
noticeable. Since January 1995, social and
psychological-psychiatric support centers for
civilians began to operate. Such departments first
appeared in psychiatric hospitals, where (at that
time innovative) programs for medical and
psychological aid to victims were developed and
implemented. During 1999-2022, several
programs to support participants and victims of
war were adopted. The 2005 National Program
for Medical and Psychological Assistance placed
great emphasis on the rehabilitation and
psychological recovery of family members of
defenders.
Croatia now has a 3rd National Program, adopted
in 2014. It focuses significantly on supporting the
civilian population, improving the quality of life
of war victims, the social and psychological
reintegration of residents of the occupied
territories, etc. In this document, the category
“victims of war” officially includes the civilian
population, and family members of those killed,
captured, or missing. Separately, the program
includes support for those who were physically
injured, sexually abused during the war, or
simply witnessed war crimes. The key objectives
of the Croatian civilian support model are:
1. full reintegration of victims into normal life,
2. timely provision of psychological and
medical assistance,
3. post-traumatic support in medical
institutions.
Croatia now has a comprehensive system of
social, psychological, and medical support for
civilians affected by war (Klochko, 2020). There
is an extensive network of regional centers
providing such assistance. They are entrusted
with such tasks as treatment and diagnosis of
mental trauma, medical care, psychological
counseling, and support. Separately, research
work now also takes place in such institutions,
which is important for subsequent research into
the social and psychological reactions of the
individual to war.
Social and psychological assistance for families
of military personnel is important. Current
scientific research suggests that effective
psychological support for such families should
take into account the following principles:
1. respect for personal aspects of family life
2. informing the family about possible
psychological results of the war
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3. combining psychological support and social
counseling of the family
4. solving psychotherapeutic family problems
(Stebliuk et al., 2019).
Taking into account the term of rendering
support and the tasks to be solved in the scientific
literature, several types of aid are distinguished -
emergency, short-term, and prolonged
psychological aid. The first type is necessary
right after a traumatic event - in the first days. It
is also realized at displays of acute symptoms
occurring as a consequence of additional stresses.
At the same time, short-term support is
implemented during the first weeks or months
after a certain psychological trauma. If the person
has not received such support in time, specialists
have to provide it on a delayed basis. It is less
effective and takes more time (Shushkevich,
2022).
The latter type of aid is implemented within
several years after psychological trauma.
Nevertheless, we believe that such division is
only provisional. In fact, the aforementioned
types of aid quite often are implemented
concurrently. Consequently, emergency aid
should be started right after psychotraumas, or
during the crisis period. Nevertheless, it can also
proceed during the stabilization period. We shall
pay attention bb to the fact that short-term aid
starts during the stabilization period and
continues until recovery. During the recovery
stage, prolonged support continues during the
integration period. On average, it can last more
than two years.
Providing psychological and social assistance
to children affected by war
The experience of the “Israeli Trauma Coalition”
proves that children are the most vulnerable
category of the population, especially those
severely affected by war events. This entails
instability in their psychological relations with
their parents. Even in situations where children
are still not involved in military conflict, they are
under considerable stress because they are
disturbed by their surroundings. Children who
relocated with their families from a war zone still
suffer from many traumatic factors (Stoner,
2022). At the same time, a child who has been
relocated from a war zone without a family, or
who has lost part of his or her family, experiences
such events particularly severely. Such children
experience severe traumatization, so they cannot
do without psychological support. Sometimes
because of the lack of habits to discuss personal
experiences or fears because of various
individual events, children may not express their
anxious states openly (Klochko, 2020).
However, direct observation of children's
behavior by professionals can detect worrisome
adjustments.
Children's stress is seen in many factors,
particularly emotions, and behavior (as well as
body behavior). The use of various therapies - art
therapy, story therapy, music therapy, puppet
therapy, dance therapy, fantasy therapy, etc. - can
help to survive crisis events. In addition, the use
of various games, communication with peers,
and frequent trips with adults will help to
overcome a difficult emotional state.
Support of children from displaced families
should be aimed at overcoming the results of the
traumatic influence of stressful circumstances
and the prevention of relapse to psychological
disorders. Professionals should understand that
such aid should be implemented on the principles
of comprehensiveness, systematisms, and
targeting. Accordingly, researchers allocate
several basic manifestations of psychological
work with children who have been victims of
war:
1. Systematic work with the environment in
which the child is
2. Support and work with relatives
3. Psychological and social work with the
child.
In this complex, the main thing is psychological
work with the child, which should be aimed at
renewing feelings of safety, restoring the child's
psychological resources, and adapting to new
conditions.
In Israel, psychological support at all levels is
provided in schools and universities. This is done
not only by psychologists and nurses but also by
ordinary teachers, who have to take special
courses in psychological support and adaptation
of children who have been victims of war to the
typical educational environment. Consequently,
one of the main goals of educational institutions
in Israel is the psychological support of all
participants in the educational process. The first
(emergency) psychological aid is provided by all
employees of an educational institution.
Separately, schools hold special consultations
with parents, who are also involved in the process
of supporting the psychological condition of the
child. It is worth noting that Ukraine has begun
to use the Israeli experience and implement the
innovations noted above. Ukrainian teachers also
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engage in psychological aid and social
counseling of students and parents.
Note that, unlike Ukraine, in Israel teaching at all
levels takes place in person. Additional
conditions are created for the mental adaptation
of pupils and students, specialists train all
participants in the educational process to respond
appropriately to military events and teach how to
behave in shelters. Children in grades 10-11 take
part in special training in first aid. The above
experience may be useful for Ukrainian realities
since Russian aggression causes considerable
damage to the mental and psychological health of
the population.
Israel's Experience in Supporting Soldiers
Experts note that since the declaration of
independence of the state of Israel, every citizen
has had more or less to do with the system of
improving the country's defense capabilities
(Baker & Pattison, 2011). In less than 70 years,
Jews have been through four wars, many acts of
terrorism, and two intifadas. Note that both men
and women have reached the age of majority in
Israel's military service. Those who have served
in the armed forces do not forget their duties:
collecting money or groceries is commonplace
for Israelis. Often the necessary items are
collected at businesses. There are thousands of
aid centers around the country, so the self-
organization of transfers of food and necessary
items to the military is at a high level.
It should be noted that, unlike in Ukraine, in
Israel civilians do not buy helmets or bulletproof
vests, as the government is responsible for this.
The funds raised can be used to purchase food
and certain household items. While the Israeli
government is responsible for front-line training
and supplying weapons to soldiers, charitable
organizations, in particular, the Fiends of the
Israel Defense Forces (FIDF), aim to “help the
military with care in relieving the burden they
carry...”
However, the problem of rehabilitation of
soldiers in Israel comes down to a system of
measures to provide medical and psychological
support (Kharchenko, 2019). At the same time,
psychological assistance plays a key role in the
successful adaptation process. Consequently, the
experience of Israeli specialists indicates that
throughout the medical rehabilitation (inpatient,
outpatient part of treatment, and prosthetics)
patients should be provided with strong
psychological support. Israeli therapy includes
several periods (See Table 2).
Table 2.
The main stages of Israeli therapy
Stages of Israeli therapy for war victims
Medical treatment
Psychological help
Medical Treatment
Family therapy
Solutions and treatment for a variety of physical problems
Concluded by authors
Consequently, in Israel, therapy for war victims
takes place gradually and systematically.
However, it should be noted that here the
assistance and rehabilitation of soldiers is free of
charge and is carried out under various
government programs.
Peculiarities of organization of medical and
psychological care of Israeli servicemen
The work of Israeli psychologists is based on a
verbal review of all soldiers, followed by
corrections and recommendations for various
types of recreation, individual or group sessions.
The structure of psychological support for Israeli
soldiers was formed immediately with the
country's armed forces. In particular, at first,
military psychologists (officers for the protection
of the soul) dealt with the rehabilitation and
adaptation of soldiers after injuries. With the
development of military operations, however, the
concept of introducing the medical corps into
psychological care emerged. At present, Israeli
psychologists are not only tasked with
identifying symptoms that indicate the
importance of helping soldiers during combat
operations, monitoring and correcting the
soldier's condition in everyday conditions also
remain important. In recent years, psychologist
positions have been significantly reduced: the
number of social workers with psychological and
pedagogical training has been increased several
times over (Stebliuk et al., 2019). The main
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purpose of these changes was to adapt the system
to the needs of military personnel and to increase
referrals for psychological support in the face of
the reluctance to see psychiatrists/psychologists
typical of Israeli society (Pattison, 2008). As a
result of these transformations, there has been a
marked increase in the number of social
psychologists in the Israeli army system.
A certain role is played by a volunteer advocate
who, in parallel, locates those people who need
specialized psychological help. Predominantly
such work is directed at military personnel who
have not been wounded. Notwithstanding this, it
should be emphasized that in Israel all soldiers,
even those who have not been wounded, are
required to undergo psychological rehabilitation.
Social adaptation structures and conflict
commissions are of notable importance in the
psychological care of Israeli army soldiers. The
social adaptation profile should include the
soldier's social background, his skills, learning
abilities, the presence of certain deviations, etc.
However, conflict commissions examine
psychiatric pathologies and solve problems that
emerged during the period when the soldier's
profile was changed.
A mandatory component of any military
operation is so-called post-crisis testing, which is
organized by both social counselors and
psychologists (Stebliuk et al., 2019).
In Israel, psychological assistance consists of two
main aspects - the behavior of the soldier for
combat and during the military operation.
Therefore, it can be partially implemented by
commanders training soldiers in visual diagnosis.
Israeli commanders should also help regulate
combat shock in incoming soldiers. In addition,
any soldier should be able to provide
psychological assistance to another soldier in a
timely and thorough manner. Note that there are
no special military hospitals in the country
because any medical facility in its structure and
is a military hospital.
Preventing Stress Disorder and Overcoming
Psychological Trauma: The Experience of
NATO Military Peacekeeping Missions
The basics of psychological safety of civilian and
military personnel serving in international
peacekeeping missions depend primarily on the
accumulated experience of the leading armies of
the North Atlantic Alliance (Bell, 1964). The
developed techniques are extremely important
since they are also applied in the military
environments of Romania, Bulgaria, Poland, and
other states of the former socialist camp, to which
Ukraine belonged for a long time as well. Among
the characteristic features of psychological
support, it is possible to point out the presence of
the corresponding specialists in almost every
subdivision of the organizational structures of the
armed forces, the ramified and logical
subordination of employees of different service
organizations, the psychological support team
and the necessary material resources available
for a quick response, the presence in the
psychological support services of specialists of
sufficient qualification, quick response to
challenges and the comprehensive approach to
the tasks demanding a solution, the ac Negative
influence on the mental condition of servicemen
is manifested in general disorganization and
changes in behavior, in retardation of automatic
work of many previously achieved skills,
inadequate reaction to certain stimuli, difficulties
with a concentration of attention, narrowing of
attention and memory, extremely impulsive
behavior, etc. If the specified symptoms affect
the person for a long time, shifts in compensatory
mechanisms and biological adaptation will
acquire irreversible changes. This will adversely
affect the character and eventually cause
neuropsychiatric disorders and disorders (Adler
et al., 2013). Specialists believe that military
personnel acquire a state of additional anxiety
during combat (Kharchenko, 2019). Compulsive
anxiety becomes one of many mental states in
those individuals who are under constant stress
exposure. Anxiety becomes apparent due to
disturbed mental equilibrium, the emergence of
unpremeditated fears, reactions to non-existent
threats, and persistent anxiety.
Anxiety is experienced at several stages: first of
all at the level of anxiety, which has the form of
a feeling of subconscious danger, uncertainty,
and threateningness; secondly, fear develops,
which is the result of finding out specific
anxieties and factors that form a dangerous
situation (Kharchenko, 2019). An indicator of
conspicuous manifestations of behavior of
servicemen is their emotional-volitional sphere -
according to the level of its development, there is
a demonstrative degree of heterogeneous adverse
states, formed as a reaction to the influence of
stress and other stimuli from the environment
(Khaustov, 2019). For the Ukrainian military,
this state is threatening because they have been
involved in the war in eastern Ukraine since
2014, and since 2022 the Russian Federation has
been openly added to this conflict. A prolonged
stay on the line of contact leads to the formation
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of persistent psychological health problems,
which requires a response (Kharchenko, 2019).
The system of psychological support among
military personnel in international peacekeeping
missions of NATO countries is primarily
designed to build mental stability and
psychological readiness to act during combat,
work in difficult conditions, and in a changing
environment, after prolonged physical and
emotional exhaustion (Baker & Pattison, 2011).
It has been proven that most combat stress
reactions are experienced by servicemembers in
the first weeks of combat (Kharchenko, 2019).
The responsible persons, the representatives of
the medical service for countering mental
disorders, conduct activities to prevent combat
stress. For example, in Bulgaria since 2007 there
is a model of psychological training for
representatives of the peacekeeping mission,
which is the version that the performance of units
as a whole is dependent on the knowledge, skills,
and experience of the command staff, healthy
relationships within military units, the
promptness of the orders of senior leadership
(Adler et al., 2013). As part of the overall model
for training effective leaders, it has been
suggested that military leadership and
psychological training for officers and
professional military personnel should be
developed.
Within the Canadian armed forces, psychological
support is in the hands of psychologists, who are
equivalent to civil servants working in army units
and units. The main focus is on psychiatric
problems, and in Canada, psychologists are not
members of the military, whereas psychiatrists
are. At the same time, many Canadian cities
(Petawawa, Ottawa, Edmonton, and Valcartiere)
have opened multidisciplinary centers to provide
and manage the mental and psychological health
of members of the Canadian armed forces, which
include a psychiatrist, psychologist, social
worker, chaplain, and nurse. In addition, a
progressive Canadian experience is the creation
of a network of special organizations working
with the families of servicemen. In the Baltics,
psychological support is provided by specialists
in psychological services, who have been hired
relatively recently. To prepare the military for
peacekeeping missions special psychological
exercises are carried out aimed at stimulating a
number of qualities: mental abilities, confidence,
attention management, self-regulation, creative
directed imagination.
In the U.S. Army, appropriate attention is paid to
the prevention of psychological trauma and
appropriate training of fighters, in particular,
training in conditions as close to combat as
possible (Adler et al., 2013). Soldiers without the
necessary level of training are not allowed to
serve in dangerous places and do not participate
in special operations (Pattison, 2008). Soldiers
are trained ahead of time to participate in direct
military operations. If an injury cannot be
avoided, specialists provide thorough surgical
care, the main task of which is to find out the
depth of the injury and its possible impact on the
future. Usually, the human body is able to
withstand stress, so after a few days, normal
behavior can be restored (Klochko, 2020).
Subsequently, therapy using psychological help
from psychologists is applied; if there is no
progress, thorough psychiatric treatment takes
place in appropriate institutions using not only
therapy but also pharmacological drugs.
Medication is provided for public funds,
according to the decision of the commission they
can be provided for a long time, in extremely
difficult medical cases, the appropriate
medication can be provided permanently (Adler
et al., 2013). Assistance is also used when certain
relapses of psychological trauma occur. Support
for military personnel and their families in the
United States is socially oriented.
The work of psychological and psychiatric
support for military structures in NATO
countries is of a high level and has a person-
centered structure. Let us note the importance of
the Canadian experience with an extensive
system of support (including psychiatric support)
of both the military themselves and their
families, including the social package. The
experience of all the countries analyzed points to
the urgency of introducing psychological help to
overcome the consequences of participation in
military actions.
Conclusions
Consequently, as a result of Russian military
aggression, attitudes toward psychological and
medical care in the Ukrainian army have changed
significantly. At the same time, for effective
treatment and overcoming of psychological
traumas, it is important to use the experience of
foreign countries, first of all, Israel and NATO
member states. Regarding the adaptation of
civilians to normal life, the experience of Croatia
is important, where several programs were
adopted to support areas affected by the 1993-
1995 war and improve the quality of life of war
victims in general. In Croatia, medico-
psychological assistance is also aimed at those
who were physically or sexually abused during
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the war. It is implemented in stages and requires
the active participation of both experienced
psychologists and the willingness of victims to
receive the necessary assistance.
As it has been established, children are the most
vulnerable category of victims of war. Thanks to
the modern development of psychological aid,
methods associated with art therapy, music
therapy, play therapy, etc. are recognized as
effective. At the same time, these techniques are
effective under the conditions of the complex
approach - when consultations are provided after
appropriate work with parents, the environment,
and the child. In particular, in the Israeli army,
the rehabilitation of servicemen is carried out
with the help of medical and psychological
support. Throughout medical rehabilitation
(takes place at the inpatient and outpatient levels)
patients receive effective psychological support.
In Israel, care and rehabilitation of soldiers is free
of charge - it is funded through various
government programs. The basis of the work of
Israeli psychologists is a verbal review of all
servicemen, followed by corrections and
recommendations for various types of recreation,
individual or group sessions.
The developed methods of army rehabilitation in
NATO countries are very important because they
are also applied in the countries of the former
socialist camp, which are today members of this
bloc. The experience of Canada, where military
psychologists are equated with civil servants, is
quite illustrative. Also important is the
combination of psychology and psychiatry,
which is extremely important for Ukrainian
reality. It is also worth taking over the experience
of organizing multidisciplinary centers to ensure
and regulate the mental and psychological health
of the Armed Forces. In the U.S. Army, special
attention is paid to the prevention of
psychological traumas and the appropriate
training of fighters. For medical care, therapy
using psychological approaches is used, if
necessary - psychiatric treatment in appropriate
institutions using not only therapy but also
pharmacological drugs. It is important to note
that the medication is provided at public expense,
which in Ukrainian conditions is problematic
because the budget expenditures are too high. At
the same time, the model itself can be applied,
because its basis is rational and time-tested.
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