Ukraine: Helping children to overcome the trauma of war

Eight-year-old Anna wanders into the brightly coloured room, one hand holding her mother and the other grasping her teddy bear.

She looks at her mother shyly, keeping close to her, as they come and sit on the sofa.

Anna is one of many children seeking psychological support in Bucha to help her understand the war and her own experiences of the conflict.

Bucha, less than an hour outside of Kyiv, was occupied by the Russians at the start of the invasion. It is now at the centre of a war crime investigation.

Anna's family, originally from the eastern region of Luhansk, moved to Bucha in 2014 when Russian proxy forces seized areas in eastern Ukraine. Just eight years later the family was forced to flee once more.

Anna's mother Viktoriya says she never would have imagined they'd have to evacuate again. She says was sleeping on 24 February when she heard a strange noise - and quickly realised the Russians had invaded.

"We turned on the television, understood what was happening and started packing our things," she says.

She woke up a surprised Anna, who kept asking what was going on and where they were going.

The family headed out of the city and towards safety in Kalush, western Ukraine. They stayed there for a few months, renting accommodation. As soon as Russian forces left, the family returned to their home in Bucha.

But the psychological scars from the invasion still remain.

"She's very emotional," Viktoriya says about Anna. "She gets scared of sounds. If she hears a train going by, then she immediately runs to me."

Viktoriya decided to sign Anna up to the Bucha Psychological Centre. Psychotherapists there use drawing and playtime to work with the children, sometimes individually or in groups.

"She likes to draw, she can talk about her drawings for hours. She gets her emotions on paper, she sculpts with plasticine. For her, I think it really helps to leave her negative emotions on paper," Viktoriya says.

As we talk, Anna plays in the sandpit and with toys in the room next door.

"She is open, we talk a lot. At first she felt a bit scared, as if a psychologist is a doctor," Viktoriya says.

Anna says she enjoys coming to the centre and talking with her therapist Lyudmila. But she still gets worried in some situations.

"When there's demining or a thunderstorm, I think it could be explosions," she says.

These feelings are typical of those who have experienced war, says Nataliya, one of the psychologists at the centre.

"A lot of children tend to become more attached to their parent. The child doesn't feel safe, free, and this is also a symptom of trauma," Nataliya says.

"Children can regress in age, for example, if they are seven years old, they can behave like they're three years old. They can wet themselves and have bad sleep. They can also become more irritated."

In some cases children can also be aggressive, she says.

There is a high demand for these centres in the country.

It's something that Voices of Children, an organisation that works throughout Ukraine, has also seen.

Nataliya Mosyuk, a psychologist at the charity, says she has also seen a rise in children coming for sessions at the organisation's six centres across Ukraine.

"The situation is difficult for children, of course. The sirens, the condition of their parents, to whom they are attached, the loss of their daily routines. They've lost their time with friends, time in school. So, they don't behave the same way they did," she says.

Illia, another child, arrives at the centre. He bounds in excitedly and smiles at the staff. He can be heard squealing with delight as he plays in the room next door.

His father Oleksandr says his son's behaviour has worsened since the invasion.

"He was calmer before the war. Then when the invasion happened, he became more irritated. But it's getting better," his father says.

It's Illia's second time visiting the centre, and Oleksandr says he is already improving.

"He couldn't sleep before but now he does," he says. "He behaves much better now."

Because of Bucha's experiences, the regional administration requested that the psychological centre open.

"People were very stressed after the occupation," says Nataliya Zaretska, a combatant psychologist who is overseeing the creation of the Bucha psychological centre. "When you're under occupation, you learn to survive in a hostile environment, relying only on yourself. That's why we thought of creating a centre that would work full-time."

She would like to see a network of centres such as this one set up in areas occupied by the Russians such as Irpin and Hostomel that would be available to children and adults.

Parents should also be given a helping hand, she adds.

"I think parents should get treatment too. I see a lot of parents think, of course, of their children first, but should think of themselves too," she says.

A spokesperson for Ukraine's Ministry of Health told the BBC that it is working on a national strategy for psychological help. The ministry is in discussions with NGOs experienced in mental health.

Ms Zaretska says that while Bucha has been though trauma, it's already showing signs of recovery.

As Anna leaves the centre clutching her teddy bear, what are her hopes for the future?

"That the war will end this year and I will be a veterinarian when I grow up."

Additional reporting by Svitlana Libet.