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As of 22 February 2024, the conflict in Ukraine has lasted two years. The war ‘has had a disastrous impact on civilian life, killing thousands of civilians, injuring many thousands more and destroying civilian property and infrastructure’.¹ An estimated 3.7 million people are internally displaced, while 6.2 million refugees have been recorded globally.² In response, the UK Government launched the Homes for Ukraine Scheme in March 2022, whereby UK-based sponsors provide accommodation for at least six months to Ukrainian refugees who have fled the conflict. The majority of these are women and children.

The Refugee Council is a national charity offering a range of support services to refugees and people seeking asylum in the UK. We work within the Ukraine Therapy Project team at the Refugee Council in Sheffield, which was established in 2022 to support Ukrainian refugees experiencing mental health distress who have settled in the city via the Homes for Ukraine Scheme or the Family Visa scheme. The service offers psychological therapy to Ukrainian adults and young people, and play therapy to children under 13. The project is supported by a small team of interpreters, some of whom arrived in the UK in 2022 having fled the conflict in Ukraine.

This article explores my experiences of working as a play therapist with Ukrainian children and young people, sharing my observations, reflections and changes I have made to the way I work since the project began. Included in the article is the voice of the interpreter Krystyna Shkandrii, who shares her experience of working alongside me and reflects on some of the challenges of her role.

Children and families

The Ukrainian children and families referred to the project continue to be separated from their loved ones, homes and schools, as well as living with uncertainty about the future. Some have experienced or seen violence or witnessed the destruction of their homes. Most have struggled with loneliness, anxiety and loss of a sense of self. Refugee children are affected by the almost constant news streams about the war in Ukraine, and the fears about the safety of their loved ones is ever present. Inevitably, they absorb the pain and worries of their parents. The mounting financial pressures refugee families face, plus imminent homelessness for many, as host arrangements come to an end, can make day-to-day life extremely challenging. Ìý

The child’s voice can often get lost among a sea of adult voices. The expectations, hopes and fears of significant others within their lives can sometimes leave children feeling as if they have no control, or as if they are merely bystanders, listening to stories created by others and told on their behalf. ‘A child is only confused by questions that have been answered by someone else before he is asked’.³ The therapeutic intervention allows the child the opportunity to reflect, make sense of and speak about their experiences in their own words, so they feel less confused. Ìý

For Ukrainian children, an important part of the therapy sessions has been to share experiences and explore who they are and want to be in a way that feels safe for them. Using play as a developmentally appropriate means to communicate, helps me to gain an insight into a child’s world and the ways in which they perceive it. Play therapy gives children a space where they become narrators of their own stories. Their experiences, wants and needs can be heard, validated and understood. When given time to explore freely, without being controlled, most children grow in confidence and go on to display this beyond the therapy room.Ìý

Working with an interpreter

Working with an interpreter enables children to express themselves in their mother tongue, but their presence also contributes to creating safety by providing cultural familiarity. On entering the room and meeting yet another stranger, the child encounters an adult who speaks their language, and this can help to forge connections. The pressure of talking in a second language is removed and they are free to express themselves verbally with someone who speaks like them, which is empowering. In my experience, most Ukrainian children speak Ukrainian exclusively to begin with, and then, as their confidence grows, they begin to alternate between English and Ukrainian, and sometimes Russian and Ukrainian. For me, the experience of working with an interpreter is a unifying one which feels integral to the success of the therapy. Initially, I was nervous about working alongside someone else in the therapy room. I felt it could be a distraction and affect the therapeutic relationship. However, I have found that the interpreter’s presence can help therapeutically. Ìý

For example, if we have had a prolonged conversation, while the interpreter is translating, I have time to digest, evaluate and give a more considered response. In addition, subtle changes in the children’s tonality or language, which I could miss so easily, and which can be so important, can be picked up by an interpreter and relayed to me, adding a deeper level of insight.

Changes to the way I work

‘A therapist has to develop their capacity to dare to imagine different world views and experiences, while assessing whether their imaginative constructions connect with their clients’ realities’.⁵ In addition to learning about Ukrainian culture, parenting styles and education, it was important for me to have some training on working with interpreters in therapeutic settings. I also had to give some thought as to how I explained play therapy to Ukrainian parents, who were often unfamiliar with therapy, and sometimes anxious about yet more external organisations becoming involved with their family. Given the complexities of working with displaced children and the multi-layered nature of the systems involved in their welfare, a crucial element to my work has been to consider the impact of external factors on children’s wellbeing from a systemic approach. As a play therapist who has usually worked alone in a school setting, this has been a new challenge for me, but one which I see as being crucial to supporting the child. It is the family and systems around the child which support continued development, and so it is important that I facilitate this, while maintaining the confidentiality of the therapy itself. I now work closely with schools to educate them about the issues facing Ukrainian refugee children and how trauma may manifest.

Personal reflection

Before I began working with Ukrainian refugee children, I had preconceptions about how the children would present in therapy, but the actual experience has been very different. While every child and every session are unique, what they bring is not necessarily what might be expected, and is not always directly related to their experiences of war. What is clear though, is how important the sessions are to them.

An interpreter has provided a cultural familiarity and sense of safety, enabling the children to express themselves in their mother tongue. It has given them the freedom to share experiences and make sense of them at their own pace. It has allowed them to create and control their own narrative, and created a space where they can laugh and play. People who are an integral part of the children’s lives are afforded a greater understanding of their needs so they can support them holistically beyond the therapy room. ‘We all have personalities that grow and develop as a result of our experiences, relationships, thoughts and emotions. We are the sum total of all the parts that go into the making of a life’ (p194).³