Кафедра психології та педагогіки

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Browsing Кафедра психології та педагогіки by Author "Fuhr, Daniela"

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    A comparative analysis of explanatory models of alcohol misuse in conflict-affected groups in Uganda and Ukraine
    (2023) Van Der Boor, Catharina; Moore, Quincy; Andersen, Lena Skovgaard; Koss, Kateryna; Roberts, Bayard; May, Carl; Nadkarni, Abhijit; Bogdanov, Sergiy; Tol, Wietse; Fuhr, Daniela
    Objective: To explore the contextual and interpersonal circumstances that influence AUDs in conflict-affected men in Uganda and Ukraine. Specifically, we investigated context-specific explanatory models of AUDs and the differences and similarities between these two settings.
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    Development of a non-specialist worker delivered psychological intervention to address alcohol use disorders and psychological distress among conflict-affected populations in Uganda and Ukraine
    (2025) Nadkarni, Abhijit; Massazza, Alessandro; Tol, Wietse A.; Bogdanov, Sergiy; Andersen, Lena; Moore, Quincy; Roberts, Bayard; Weiss, Helen; Singh, Soumya; Neuman, Melissa; May, Carl; Fuhr, Daniela
    Background. Despite the significant burden of alcohol use disorders (AUD), there is a large treatment gap, especially in settings and populations affected by armed conflict. A key barrier to care is the lack of contextually relevant interventions and adequately skilled human resources to deliver them. This paper describes the systematic development of the CHANGE intervention, a potentially scalable psychological intervention for people with co-existing AUD and psychological distress in conflict-affected populations, delivered by non-specialist workers (NSWs). Methods. CHANGE was developed in sequential steps: (1) identifying potential treatment strategies through a metareview and Delphi survey with international experts; (2) in-depth interviews (IDIs) with key stakeholders from the study settings in Uganda and Ukraine; and (3) three consultative workshops with international experts and experts from Uganda and Ukraine to develop a theoretical framework for the intervention informed by outputs of the Delphi and IDIs. Results. In the Delphi survey, experts reached agreement on the acceptability, feasibility and potential effectiveness of the following components: identify high-risk situations, problem solving skills, assessment, handling drinking urges, communication skills, pros and cons of drinking, and identifying high-risk situations. From the IDIs we identified (a) causal attributions for using alcohol e.g., psychosocial stressors; (b) cultural norms related to alcohol consumption such as patriarchal stereotypes; and (c) coping strategies to deal with drinking problems such as distraction. The CHANGE intervention developed through the consultative workshops can be delivered in three sequential phases focussed on assessment, feedback, and information (Phase 1); providing the client with need-based skills for dealing with high-risk situations related to alcohol use (Phase 2), and relapse prevention and management (Phase 3). Conclusions CHANGE is a contextually relevant and potentially scalable treatment for co-existing AUD and psychological distress to be delivered by NSWs to conflict-affected populations. Effectiveness and cost-effectiveness of CHANGE will be tested in Uganda and Ukraine.
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    Explanatory models and coping with alcohol misuse among conflict-affected men in Ukraine
    (2025) Bogdanov, Sergiy; Koss, Kateryna; Hook, Kimberly; Moore, Quincy; Van Der Boor, Catharina; Massazza, Alessandro; Fuhr, Daniela; Roberts, Bayard; May, Carl; Fedorets, Olha; Bayer, Oxana; Karachevskyy, Andrii; Nadkarni, Abhijit
    Affecting nearly 10% of men globally, alcohol use disorders (AUDs) represent a significant public health burden. Existing work, including from Ukraine, suggests that living in conflict settings may exacerbate the risk of AUDs. However, there is a dearth of evidence regarding alcohol misuse, as well as knowledge of factors associated with alcohol misuse patterns, in conflict settings. The aim of this qualitative study was to investigate explanatory models of alcohol misuse among conflict-affected men in Ukraine. Purposive and snowball sampling were used to recruit 66 conflict-affected men with alcohol misuse, family members of men who misuse alcohol, community health workers, and mental health and psychosocial support providers from locations across Ukraine. In the group of men who misuse alcohol (n = 25), we recruited individuals with diverse experiences of adversity: 1) internally displaced persons from eastern Ukraine and Crimea displaced after 2014; 2) Ukrainian military veterans or territorial defense volunteers from various regions; and 3) men living 5–15 km from the frontline. Semistructured interviews were conducted in Ukrainian or Russian, and analysed using deductive and inductive analysis. Qualitative data received from each subgroup were analysed separately. The resulting explanatory model represents how Ukrainian conflict-affected men describe causes of alcohol misuse. Participants identified that alcohol misuse among Ukrainian men is often used as "self-treatment" to address mental health symptoms and feelings of demoralization that are exacerbated by a lack of supportive social environments and socioeconomic problems; these behaviours also occur in an environment that deems alcohol misuse to be culturally appropriate. Family members and service providers offered a similar understanding of alcohol misuse as the men themselves. Strategies suggested by conflict-affected men to protect against alcohol misuse included engaging in alternative activities, finding supportive social environments, fear of negative consequences from alcohol misuse and increasing self-awareness and self-control. These findings indicate possible implications for interventions that target alcohol misuse among conflict-affected men, as well as demonstrate a need for developing culturally sensitive interventions that can address this unaddressed public health need.
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    Scaling up a psychological intervention for alcohol misuse in wartime: a qualitative study in Ukraine
    (2025) Antia, K.; Van der Boor, C.; Biklian, O.; Kachay, V.; Bogdanov, Sergiy; Roberts, Bayard; Fuhr, Daniela
    Background: The war in Ukraine has intensified mental health vulnerabilities, including alcohol misuse among conflict-affected men. The CHANGE intervention, a new transdiagnostic intervention building on WHO’s Problem Management Plus (PMþ), aims to address alcohol misuse and common mental disorders. This study explores the scalability of CHANGE within Ukraine’s war-affected health system. Methods: This qualitative study, guided by CFIR, involved online interviews with twenty stakeholders: 13 program implementers (i.e. providers), 2 adopters (i.e. organisations adopting CHANGE), and 5 maintainers (i.e. national health officials). Interview guides explored key barriers, facilitators, and implementation strategies for CHANGE in Ukraine. Results: The key implementation barriers identified were: insufficient state support, a lack of primary care referrals, limited societal awareness of psychological interventions, scarce funding and challenges in integrating CHANGE into existing services. Conversely, implementers and adopters highlighted established partnerships with local and national organisations as crucial facilitators, alongside a supportive work environment, team professionalism, and recipient/deliverer centredness. The ongoing war impacts implementation by: fears of data confidentiality and mobilisation reduce participation, economic hardship limits access, and insecurity causes service disruption. Key facilitators include: online adaptation, enabling remote access, and increased attention from community organisations to society’s mental health needs. Strategies suggested for CHANGE scale-up involve awareness-raising campaigns, building trust through community engagement and leveraging existing networks for effective outreach. Conclusions: Implementation of a psychological intervention during war benefits from online adaptation for remote access and community engagement. Implementation strategies from CHANGE could inform global dissemination efforts in similar contexts. Key messages: • By exploring implementation strategies of a psychological intervention amid active war, this study enhances the understanding of mental health service scalability in conflict-affected settings. • Research into implementation strategies is crucial to overcome war-related barriers during the deployment of psychological interventions like CHANGE.