Feasibility and acceptability of modular empowerment group therapy in Ukrainian adult outpatients: A pilot study

Following the full-scale Russian invasion of Ukraine, scalable psychological interventions that can be delivered flexibly are urgently needed, yet evidence on implementing group psychotherapy remains limited. This pilot study evaluated the feasibility, acceptability, and preliminary clinical outcomes of a culturally adapted, modular Empowerment group therapy delivered in face-to-face and online formats.

We conducted a single-arm feasibility pilot with N = 56 Ukrainian adult outpatients recruited into five groups (3 face-to-face; 2 online). Feasibility was assessed via retention rate, dropout and protocol adherence using predefined progression criteria. Acceptability was assessed using the CSQ-4 and qualitative feedback. Secondary outcomes included depressive symptoms, anxiety, and stress (PHQ-9, DASS-21), symptoms of post-traumatic stress disorder (PTSD) (PCL-5), somatic symptoms (SSS-8), quality of life (SF-36), and resilience (BRS).

Feasibility outcomes met "go" progression criteria with a retention rate of 96.4%, a dropout rate of 3.6% and protocol adherence of 93%. Acceptability was high (CSQ-4 total M = 12.07, SD = 1.04). Secondary outcomes showed large and sustained improvements. The largest effects were observed for depressive symptoms (PHQ-9: d = 1.44), mental health-related quality of life (SF-36 Mental Health; d = 1.28), DASS-21 depression (d = 1.25), PTSD symptoms (PCL-5: d = 1.18), and somatic symptom burden (SSS-8: d = 1.16). Improvements were generally larger in face-to-face groups.

This pilot shows the implementation of Empowerment group therapy is feasible in Ukrainian outpatients during an ongoing war. Preliminary clinical outcomes show substantial improvements across multiple symptom domains and quality of life. Findings support progression to a randomized controlled trial to evaluate effectiveness, durability of outcomes, and cost-efficiency, and to clarify optimal delivery conditions for in-person versus online formats.