Ukrainian parents who joined a support group programme called 'Hope Groups', designed for families living through the war, reported that violence against children was cut in half, alongside less than half the amount of depression and anxiety symptoms, compared with parents who had not yet participated in the programme, according to a new trial led by the University of Oxford.
These findings come from a randomised controlled trial of 510 parents and caregivers published today in The Lancet Regional Health – Europe, led by researchers at Oxford's Department of Social Policy and Intervention, Ukrainian partner organisations, World Without Orphans, and World Relief. It is among the first randomised trials to test whether a group-based mental health, parenting, and violence prevention programme can work during an active war, rather than after the fighting stops.
More than one in five children worldwide were living in a conflict zone in 2024, according to analysis by the Peace Research Institute Oslo. Decades of research on adverse childhood experiences demonstrate the lifelong consequences of trauma experienced in childhood, which makes the case for acting as soon as possible during a crisis.
Sydney Tucker, lead author, Department of Social Policy and Intervention, University of Oxford, said: 'Often, society may think that there is no way to protect families during an active war, and investment towards mental health or child protection programming may tragically wait until the war ends. However, if we wait, we are missing a crucial window of critical action. The evidence shows that investment to scale the Hope Groups intervention can bring significant relief for parents from depression and anxiety symptoms, and prevent violence against children, even amidst the active war.'
After Russia's 2022 full-scale invasion, Ukrainians wanted resources related to how to care for their children and keep them safe from violence, and they also needed resources to process their own trauma, grief, and loss. The Hope Groups were developed as a 12-session programme from evidence-based content and adapted with Ukrainian parents, rather than an imported ready-made programme. Groups of five to seven met wherever was possible amidst the war: in shelters, community centres, churches and people's homes, or over Telegram video calls. Sessions were led by local facilitators recruited and trained through churches and community organisations, a deliberately non-clinical model designed to work in a crisis, when systems are overwhelmed.
Olha Ruina, co-author, NGO Nehemiah (Громадська організація "Неємія"), Uzhhorod, Ukraine, said: 'In Hope Groups, for the first time in a long time, participants experienced safety, trust, and hope. Amidst a prolonged war, this kind of support for families is exactly what people needed. It is what will strengthen the resilience of Ukrainian society.'
What the trial found
Compared with parents on a waitlist, parents who took part in the Hope Groups programme experienced the following changes at the end of the programme:
- 52.7% less physical or emotional violence against children
- 57.4% lower levels of depression and anxiety symptoms among parents and carers
- 33.1% stronger protective parenting practices
- 65.4% higher hopefulness about the future and coping with grief
- 56% lower levels of behavioural issues among their children
- 68% higher levels of behaviours to prevent violence against women
- No harms or adverse events identified in either group
All figures are differences between the two groups at the end of the programme, based on what parents reported. This study is the only known randomised controlled trial of a parenting programme in active war that found improvements across all key areas of: parental mental health, positive parenting practices, violence against children, and child behavioural issues.
The researchers are calling on donors and humanitarian agencies to fund parenting and caregiver mental health support as a standard part of the response to war and displacement, rather than waiting for peace.
