Psychotraumatology in Lithuania: history and current challenges

Interview with prof. Evaldas Kazlauskas (Vilnius University, Lithuania)


Theme: Therapy

 

Questions of psychotraumatology were important in Lithuania for many years, especially having in mind the situation with Soviet occupation. Current situation in Ukraine, war refugees that came to Lithuania increases the interest of mental health specialists in trauma and PTSD. About trauma, PTSD, development of psychotraumatology in Lithuania in the interview with a prominent specialist in this field prof. Evaldas Kazlauskas.



For many years psychotraumatology has been an area of your special interest. What factors influenced your choice? I ask as we had "rather calm" times until the covid two years ago and war a few months ago happened.


I have been active in the field of psychotraumatology for over 20 years. I became seriously interested in stress and trauma during my psychology studies at Vilnius University. While I was a student in clinical psychology, my supervisor and mentor clinical psychologist prof. Danute Gailiene invited me to join a project that explored the long-term effects of political oppression of Soviet and Nazi occupations in Lithuania. I am very grateful to prof. Danute Gailiene for initiating this important study and inviting me as this shaped my future career a lot. We conducted a large-scale study of survivors of political oppression which demonstrated long-term posttraumatic effects of political violence.


This study of political violence aftermath inspired me to search for the best ways to help survivors of traumatic experiences. I started collaborations with researchers and clinicians who were experts in the field of traumatic stress in other countries, which helped me to gain expertise in psychotraumatology, and learn modern assessment and therapy methods of trauma care. We have conducted many studies in Lithuania and other countries which demonstrated the high prevalence of traumatic experiences in Europe. Most of the population cope with adversities quite well, unfortunately, there is a substantial proportion of survivors that suffer from posttraumatic stress disorder symptoms. So, the need for trauma care is evident.


For me, it was always very important bridging scientific knowledge with clinical practice, and implementation of evidence-based trauma-informed care in healthcare and social care. Currently, as a President of the European Society for Traumatic Stress Studies (ESTSS) which is a large network of experts in psychotraumatology in Europe. As a network ESTSS aims to disseminate evidence-based knowledge in psychotraumatology and support mental health professionals and survivors across Europe.


The war in Ukraine. We understand that we will deal with the consequences after some time. What can be done today to have less problems later? What psychosocial interventions? Are there any specific interventions? Do you have any prognosis on how it will affect our mental health? Mental health of Ukrainian people?


The Russian invasion of Ukraine and the war in Ukraine is a major concern globally. Mental health professionals have a lot of knowledge that war will bring long-term suffering and mental disorders for decades to war-affected populations. The ESTSS has members in Ukraine, and I am aware of the atrocities in Ukraine. Over the decades the field of traumatic stress accumulated vast knowledge on human responses to traumatic experiences and best practices. Unfortunately, most of this knowledge comes from clinical practice and research in peaceful countries. Mental health professionals in Ukraine are working hard in helping the war-affected population, however, this is very difficult. Mental health professionals experience a lot of pressure as they help their communities, but also the worry about their close ones and their own lives are in danger. Still, the resilience and strong will of the Ukrainian population inspire a lot.


War in Ukraine. Image by Blue/Yellow.
War in Ukraine. Image by Blue/Yellow.

The current needs in Ukraine are mostly humanitarian support, military support, and political support from the international community. The healing of society cannot start until the war in Ukraine is stopped, and we all should do everything we can to stop the war. I was very inspired to see the united global response and support for Ukraine. Ukrainians constantly confirm that this support is very important for them. War brought large refugee numbers to Europe as people are forced to leave their homes. At the initial stage basic needs, such as housing and feeding were top priorities for Ukrainians fleeing the war zone in Ukraine. However, we can expect that many will have prolonged traumatic stress symptoms and might need specialized trauma-focused treatments. Fortunately, the current research demonstrated that we can upscale our interventions using digital psychosocial interventions. There have been quite a lot of studies in other conflict areas recently, also in collaboration with WHO, that showed that such interventions as DWM and PM+ can be effective.


Covid theme is not the most important now, yet there are a lot of discussions about the impact of quarantine on mental health both children, and adults. Do you see any tendencies?


I have been involved in several studies on the impact of COVID-19 on mental health internationally, and locally in Lithuania. Overall, the current evidence shows that we do not have a mental disorders pandemic associated with COVID-19. However, we also see that the most vulnerable were affected, such as adolescents. The real long-term impact of the pandemic on mental health and social life will be revealed only in several years. It was interesting to see for me how the COVID-19 pandemic boosted societal recognition of the importance of mental health worldwide. Governments across many countries, and particularly in Europe, launched a lot of programs to support populations’ mental health. We learned a lot about ways to deliver mental health services via digital technologies which will hopefully stay and will be used even after the pandemic, to improve the delivery of healthcare services. Many other initiatives, such as online training and supervision of healthcare professionals were successfully implemented during the pandemic, and we proceed with training and dissemination of knowledge online. So, I would see not only the negative impact of the COVID-19 pandemic, but also the positive side.