Ukraine’s ongoing war has caused deep and widespread collective trauma, reflected not only in individual PTSD but also in moral distress, loss of shared dignity, and weakened social bonds. Arts therapy provides culturally familiar and non-verbal ways to support emotional regulation, but scientific evidence of its effectiveness in wartime settings is still limited. This article aims to substantiate and empirically verify a predominantly online, multimodal arts therapy program for treating collective trauma in Ukrainian communities. This study evaluated a 12-session multimodal arts therapy program for 192 adults across Ukraine using a pragmatic, predominantly online stepped-wedge cluster randomized trial. Primary outcomes were PTSD symptoms (PCL-5) and moral injury (MISS-M-SF); secondary measures included resilience (CD-RISC-10) and collective self-esteem subscales (CSES). A war-contextualized psychosemantic differential was analyzed with a Bayesian hierarchical mixture of factor analyzers (BH-MFA) to estimate probabilities of four latent response styles to collective trauma. Assessments were conducted at baseline, mid- and post-intervention, and at 3- and 6-month follow-ups. Compared with control periods, the intervention produced small to moderate reductions in PTSD and moral injury, increases in resilience, and selective gains in collective self-esteem. BH-MFA analyses indicated a reliable shift toward a normalizing-progressive (sublimating) response style without heightened aggression. A culturally adapted, online arts-therapy model is thus feasible and beneficial under wartime conditions, improving psychological symptoms and fostering adaptive collective coping.
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