Research on support groups' activities
Relevance of the research
War is a traumatic event that can have a deep and lasting psychological impact on each individual and society as a whole. One of the ways to provide socio-psychological support to the population is to organize support groups for different target audiences to help them maintain their mental health in the conditions of a long-term traumatic event. In support groups, people have the opportunity to express their feelings, share their experiences and receive emotional support from other people who have gone through similar experiences.
Goal of the research
To describe the work of support groups on the example of the project of the NGO “International Center for Development and Leadership” ” Building the capacity of organizations and specialists to provide social services and socio-psychological help and support to Ukrainian people during the war”.
Duration of the research
The research was conducted on the basis of the International Non-governmental organization “ILDC” from October 2022 to April 23 in an online format.
Objective of the study
Describe the theoretical basis for conducting support groups, highlight key concepts related to the method of work of support groups
Identify the main requests of participants of support group and forms of support for their members
Describe the impact of support groups on the psycho-emotional state of participants
Methodology of the research
The first research tool was content analysis of the reports from the group facilitators, which provided a list of requests from participants and topics discussed during the meetings. A total of 106 facilitator reports describing the course of the meetings were analyzed. Based on the reports, schemes with requests and forms of support, which were discussed by the participants during the groups, were formed.
Appropriate permissions were obtained from the organization’s management to analyze the database. Personal data of the participants were not analyzed or disseminated.
The second research tool was an online survey of participants using Google forms. The sample was formed by the method of availability. The sample included respondents who participated in support groups organized by “ILDC” as part of an initiative to provide social services and psychosocial support to the population during the war. These people have been affected by the war and need psychosocial support to cope with stress and trauma caused by the hostilities.
The respondents were asked to answer a questionnaire consisting of 3 parts:
Block 1. Socio-demographic characteristics
Block 2. Questions about the experience of attending support groups
Block 3. Assessment of the psycho-emotional state of participants and the impact of attending support groups
results of the research
The theoretical foundations of support groups are described,
the key concepts related to the concept of “support groups” are highlighted
Since the outbreak of a full-scale war, the Ukrainian population has been subjected to a constant devastating impact. In the context of Russia’s undeclared war against Ukraine, the population has found itself in a situation of political violence (Levy, B. S. & Leaning, J. (2022). Political violence in this context, according to Levy and Leaning’s (2022) analysis of the Russian-Ukrainian war, included the use of military force, particularly missile attacks, to target civilian objects. This causes significant harm to the well-being of the civilian population.
The use of political violence in the Russian-Ukrainian war has serious and long-term consequences for the physical and psychological state of the civilian population. Ukrainians are currently experiencing constant stress as well as physical destruction caused by attacks on civilian areas and infrastructure.
Thus, in the conditions of war, people experience a number of emotional states that are a prerequisite for the formation of psychological and physiological problems, and they need both professional and equality-based support. The most adequate response to such requests is support groups and self/mutual-help aid groups.
It is worth highlighting the difference between the two methods of work:
Support groups are voluntary associations of people who have similar problems and crisis life circumstances, who meet for a long time to provide mutual help and support, exchange information and resources that can be useful in solving their problems. The specifics of such groups is that the responsibility for organizing and conducting meetings falls on a specialist, not a group member. The facilitator moderates the group, guiding discussions, promoting equal participation, and managing the process.
A self/mutual-help group is a collective of people united by a common life problem or situation. Self-help groups function autonomously, independently determining their activities, topics and methods of work, as they are developed by the group members themselves. Group activities are focused on the ongoing active cooperation of their members and do not involve a formal leader. Initial organizational issues may be handled by professionals, but this is not required. The “leader” is not an expert in the field, but rather someone who needs help.
In response to a request from people experiencing traumatic events, NGO “ILDC” launched support groups conducted by professional facilitators. Through this type of social support, participants have the opportunity to:
- share their pain
- talk about their fears
- feel that they are not alone
- find out how others deal with similar situations
”Support groups are often a place where you can start making sense of an experience that is initially perceived as overwhelming. Sharing experiences contributes to a sense of universality: “I am not alone”.
(El Jamil, F., Hamadeh, G.N., Osman, H. 2007)
It is important to note that one of the main principles of the support groups organized by NGO “ILDC” is the “resilience” approach
Resilience is the ability of a person to cope with challenging life events and recover from difficulties or stress.
An individual or a community can rebuild its life by drawing on the resources and capacities that are well developed. All the strengths and weaknesses that a person has, all that they have experienced in their lives, are conditions for growth. People can share resources, forming social networks that are a supportive environment. The main goal of working in this approach is to achieve a balance between stressful and supportive factors, risks and protective factors, and to ensure that needs and opportunities are matched.
Types of support provided by participation in support groups:
*according to the classification of Cutrona and Suhr (1992)
Informational
providing information on a stressful issue
Emotional
expression of empathy and care
Networking
Expressing a sense of belonging and community
Respect
showing value, respect, confidence in abilities
Basic principles of support groups:
Safe and friendly environment
Support of equals
Compliance with the rules of ecological communication
Flexibility and sensitivity to individual needs of participants
Resilience approach
Description of the experience of support groups
Having received new challenges and realizing the need to support the population in dealing with the consequences of the war, the NGO “ILDC” began the process of organizing the first support groups in less than a month from February 24.
The goal of conducting support groups was to provide socio-psychological support to Ukrainians affected by the war. Having gained the support of involved experts and scientific consultants, it was decided that it was appropriate to hold support groups in the current circumstances.
The first step was to find a facilitator who was ready to lead a group in a crisis and had the personal resources to do so. Three facilitators were involved, all of them women. Facilitators are certified trainers of the organization and have the necessary knowledge and competencies to conduct groups. The online format of the groups was chosen, which allows more participants to join, without being limited to one location.
The first group took place on March 22, 2022, and the target audience was defined as all people affected by the war. The second group was opened later (in July 2022) for women whose husbands are at war. The first four meetings were open to new participants, but later the registration was closed and a list of regular participants was created. As the issue of coping with separation from a husband in the military is very personal for women, this format provides for a more private setting.
The support groups were held once a week, each time at a set time. This provided an additional sense of stability for the participants, which was extremely important in a state of unpredictability. Each meeting had a limited time frame – 90 minutes for each group. The organizers emphasized the importance of sticking to the time limit and encouraged participants not to be late (to avoid interrupting the group dynamics during the discussion) and not to stay longer than the deadline. Sometimes, due to the large number of participants or the extremely high relevance of the topic under discussion, meetings may be delayed, but not for more than 20 minutes.
The study included 106 support groups organized by “ILDC” during March 2022 – April 2023
support groups for all those affected by the war
support groups for women whose husbands are at war
The main requests of support group participants and forms of support for their members were identified
The study emphasizes the profound impact of external events and the general context of the war on the participants of support groups. By analyzing the facilitators’ reports and forming diagrams with the topics discussed, some dynamics of changes in the participants’ condition were identified and described.
Period 1 (March – April 2022)
The first months of the full-scale war brought shocking shocks to the entire population of Ukraine. Participants of support groups felt a loss of control over their lives, experiencing uncertainty, anxiety, fear and intrusive thoughts. The forced migration added to the emotional stress, causing pain, sadness and a deep gap between the past and the present. Physical problems appeared, fueled by constant stress. In the early stages, it is noteworthy that participants express a desire to take care of their loved ones, but at the same time an unwillingness to take care of themselves.
Period 2 (April – August 2022)
With a temporary lull at the front, the participants adapted to “life during the war.” There was a transition from severe distress to a search for meaning and self-identification, as well as recognition of “war fatigue.” The positive impact of participation of support groups was noted. It is also important that participants allow themselves to take care of themselves, to think about themselves, not just others. Additionally, there are discussions about the importance of everyone’s personal contribution to the victory.
Period 3 (August – October 2022)
The escalation of the conflict undermined the temporary relative stability as Russia terrorized civilians and the military and fired missiles at civilian targets. “War fatigue” has deepened, generating feelings of despair and anger. Participants notice a deterioration in their relationships with loved ones due to the constant stress. In such circumstances, participation of the support group has become an important support in times of crisis, promoting a sense of unity. To continue living and fighting for their future, it is also important for them to realize their personal identity as Ukrainians. Participants discuss the importance of the Ukrainian language and identifying themselves as a separate people both at home and abroad.
Period 4 (October 2022-January 2023)
The central theme of this period is the power outage due to constant missile attacks on the Ukrainian energy system. Participants discuss adaptation to the new realities of life and the importance of meeting basic needs (which was not noticed in peacetime). Even in such difficult conditions, the participants discuss the desire for self-realization, but also the simultaneous feeling of reproach for this. At the same time, the relationships between participants of the group become closer and more trusting (“the group inspires to live”, the feeling that the group is a “big family”). Along with the impossibility of meeting basic needs, participants feel a change in their attitude towards themselves, and self-care comes into the forefront in their interactions with both their loved ones and society.
Period 5 (January – March 2023)
The main specific feature is the experience of the anniversary of the war. The participants discuss anxiety and expectations of the anniversary of the full-scale invasion, the memories and emotions that rise, and the fear of a deterioration of the situation. Against the backdrop of analyzing the events of the past year, questions are raised about Ukrainian society in the context of war. Analyzing the past year, the participants note that the group has become a center of stability and support during the year of war and express deep mutual trust in each other. Realizing how much they have been through, they come to a deeper understanding of the main goal – the preservation of the Ukrainian nation.
Period 6 (March – April 2023)
The re-escalation of the conflict led to another emotional downturn, but participants recognized personal growth and new qualities. Criticism of the government’s actions and a focus on “living in the present” emerged. In the conditions of instability, participation in the group remained necessary for support, promoting resilience and striving to overcome difficulties.
The analysis of each period reveals the trajectory of change: from initial shock and acute conditions to the search for meaning, unity and continuation of the struggle amidst the complex challenges caused by the war. The support group became a vital pillar that supported the participants during the emotional instability and contributed to their readiness to continue living in the war.
A DETAILED SCHEME OF CHANGES IN THE REQUESTS AND CONCERNS OF PARTICIPANTS of support groups
The impact of support groups on the psycho-emotional state of participants is described
It was determined that attending support groups has a positive impact on the psycho-emotional state of participants.
Table 1 illustrates the change in the psycho-emotional state of respondents between BEFORE and AFTER participation in support groups (subjective assessment of respondents).
According to the data in the table, the average value of the participants’ psycho-emotional state has doubled (on a scale from 0 to 5, the average level before is 1.76, the level after is 4.07).
The average percentage of improvement in the psycho-emotional state of respondents is 46%.
In addition, the main changes noted by the participants were highlighted:
increase in self-esteem
developing a sense of control over your own life
a sense of belonging to a group
reducing stress, anxiety and uncertainty
a safe place to express oneself, share emotions and receive support from others
Table 1: “Changes in the psycho-emotional state of support group participants”
Participants indicated the most significant factors that helped them improve their condition:
understanding and empathy from other participants
resources and information shared by participants during the group
understanding that you are not alone in some experiences and other participants also have similar experiences
Answer to the question
“Did you feel any changes in your psycho-emotional state before and after attending support groups?”
Before I was panicking, I had a sense of crisis and uncertainty. After participation of groups, I feel more confident and have plans for the future, I am trying to build my life myself. I feel like I have more control. The group affects me positively in many ways: I feel heard, I feel like a part of something bigger, I feel supported.
RESULTS
During the war, people go through a number of emotional states that are a prerequisite of the formation of psychological and physiological problems, and they need both professional and equality-based support. Support groups are the most appropriate response to such requests. Group members can find support during an ongoing traumatic event (war) by sharing their experiences and gaining a sense of understanding in support groups. The opportunity to express their grief, emotions and concerns in a safe environment helps to build a sense of belonging and helps to develop resilience.
In the first months of the war, the International Center for Development and Leadership, an international non-governmental organization, recognized the urgent need of Ukrainians in times of crisis. The purpose of the support groups within the project was to provide socio-psychological support to Ukrainians affected by the war. The online format of the groups was chosen, which allows more participants to join, without restriction to one location. The first group was held on March 22, 2022, and the target audience was defined as all people affected by the war. The second group was opened later (in July 2022) for women whose husbands are at war. The support groups were held once a week, each time at a set time. Each meeting had a limited time frame – 90 minutes for each group. In total, between March 2022 and April 2023, “ILDC” organized and conducted 56 support groups for all those affected by the war and 48 support groups for women whose husbands are at war. Further activities of the groups are ongoing.
We analyzed 106 reports of support group facilitators and created schemes with requests and forms of support discussed by participants. The schemes were divided into time periods (six periods in total, from March 2022 to April 2023). We identified patterns in the impact of external events and the context of the overall situation on the topics and requests discussed. The most common requests and concerns of support group members were identified, such as: critical conditions (pain, sadness, fear and uncertainty of the future; physical problems (loss of sleep, binge eating or loss of appetite, physical tension, etc.), loss of control; anxiety, obsessive thoughts; difficulties in moving within the country; forced emigration abroad; fatigue from the war; concerns about the life and health of a military spouse. Among the ways that helped participants to support themselves were: working with emotions (legalizing anxiety, having an algorithm for dealing with emotions); regaining control and managing the situation (daily planning, daily routine (meeting basic needs), rituals and info-hygiene).
It was determined that attending support groups has a positive impact on the psycho-emotional state of participants. Compared to the beginning of participation in the group, their subjective assessment of their emotional state has doubled. In addition, the main changes noted by the participants were: increased self-esteem; development of a sense of control over their own lives; a sense of belonging to the group, reduction of stress, anxiety and uncertainty; a safe place to express themselves, share emotions and receive support from others.