Mission Impossible?

The development of music therapy education in Ukraine in spite of pandemic and war.

Elena Fitzhum shares and reflects on how Austrian music therapists helped set up the first training courses in Ukraine in very challenging circumstances.

First published in: “Musik und Gesundsein” No. 42, edited by Hans-Helmut Decker-Voigt, Petra Jürgens, Hans Ulrich Schmidt, Reichert-Verlag, Wiesbaden 2022.

Translation: Elisabeth Kaczynski

The question is simple: how do you build a teaching structure that will survive a pandemic and a war; for people, some of whom you have never met; in a language you neither understand nor speak; and in a country where you don’t know English in an academic context?

How did this adventure begin? Actually, once upon a time, Lemberg (today’s Lviv in Ukraine) and Vienna belonged to a common socio-political-cultural circle. Architects for the Habsburg monarchy worked in both places, creating similar cityscapes. For example, a tramway circles Lviv city centre and creates connections to the suburbs, as in Vienna. Nowadays it takes only 10 hours and 50 minutes to cover the 667 kilometres between the two cities by train. A car trip is only attempted by those who absolutely want to try it or have something to transport. Starting from Vienna, one drives either via the Czech Republic and Poland or via Hungary. What only a few people in Europe are aware of is that Vienna is very far to the east, and it is actually only 586 kilometres from Lviv as the crow flies, a little more than the distance to Austria’s western border with Switzerland. You can still feel the connection between the two cities when walking through today’s Lviv, because it somehow feels like Vienna. It’s just that everything is a little smaller. Lviv is simply a wonderful city and the completely renovated city centre invites residents and visitors alike to walks and coffee house visits – just like in Vienna.

Departure Gate at Vienna International Airport

In 2017 I was asked if I would be interested in helping to set up a music therapy training in Lviv. One month later along with my Viennese colleague Dr. Dorothee Storz, the adventure began! In May 2022, five years later, the first graduates completed their training.

It was clear from the beginning that Austria had much to share with a country where music therapy was still in a fledgling state. Viennese music therapy education, as the oldest in Europe, draws on more than 60 years of experience, and we were sure that our years of lobbying for recognition of our profession, both on national and international levels, would be helpful to a country that was still in the pioneer stage.

Leaders from Lviv with lecturers from Vienna. Left to right: Natalya Zhabko, Dorothee Storz, Alexander Lvov, Elena Fitzthum.

When establishing music therapy in Ukraine it was important to set up a professional association with statutes and a code of ethics that met international standards. Using existing documents from the Austrian Professional Association for Music Therapy (ÖBM) and the EMTC. These objectives were achieved, with the aim of becoming a full member of the EMTC and in 2022, the Ukrainian Association (AMU) participated via Zoom for the first time as an “observing member” in the EMTC General Assembly in Edinburgh, meaning that Ukraine had become one of 30+ European countries that are in regular exchange and are working on jointly binding quality standards. [Editorial note: In 2023, the AMU became a full member country of the EMTC and attended the General Assembly in Latvia in person.]

In the course of our development work, another partnership was added between the Ukrainian Catholic University (UCU) and the University of Music and Performing Arts Vienna under the direction of Prof. Dr. Thomas Stegemann and Professor Dr. Monika Smetana. Erasmus+ mobility funding for lecturers was approved for a number of years and intensive collaboration began. However, in spite of funds being available, no exchange visits actually took place, as first the Covid pandemic and then a war completely changed our well-laid plans.

On the morning of February 24, 2022, the Russian army invaded Ukraine and a war that continues to this day began. I remember we had held a Zoom lecture on the evening of February 23 in which a Viennese colleague, Ev-Marie Grünenwald, shared her work with older adults, including those with dementia. Work with this client group is of great interest to Ukrainians, as the demographic situation means that many young people who would have cared for the older generations have gone abroad, either in search of work, as before the war, or now, as refugees. Older people often insist on staying behind and many are not cared for. adequately.

Back to our work. It feels strange to be a witness of an event that probably changed the entire world order. On the evening of February 23, 2022, the world was still in order; on the 24th, we were already on the phone, worried about how our colleagues in Ukraine were doing. The consequences of the war were drastic: from one day to the next, the entire male population was subject to the mobilization criteria, which resulted in a reduction of teaching staff and male students. It was hard for us to comprehend; from one day to the next almost all male colleagues were missing! Our female students immediately went back to their families and were thus scattered all over the country. Others fled to neighbouring countries to relatives or friends. Most did not go voluntarily; they were persuaded to do so by their husbands, who said they could only fight for their fatherland if they knew their wives and children were safe. Those who stayed at home immediately looked for ways to support their beloved homeland with actions and went where they were needed. The whole country was suddenly out of joint, everything was disrupted, and yet I observed a strong will to live – a resilience – that fascinated me. Where did this force come from? How could everything change so fundamentally and yet I continued to meet the students regularly and reliably on the Internet? I asked myself what kind of world are were now living in? Could it be explained in terms of patriotism, national pride, or maybe even nationalism, which is considered so uncool in our part of Europe?

There was no longer any thought of teaching in person, and this was despite the fact that the money we had waited so long for had now been made available. However, we all already had experience with another exceptional situation: In the course of the COVID crisis, which had been ongoing since the end of 2019, teachers all over the world had to reorganize their teaching. So, the time of video conferencing via Zoom and the transmission of teaching material via the Moodle platform had begun even before the war. Nothing worked (and still doesn’t work) without the Internet and Wi-Fi. To this day, Internet connections to Ukraine are relatively stable, which may surprise you. So, we continued to work consistently.

Due to the shortage of teachers at UCU, on March 27th, 2022, the head of the Department of Psychology and Psychotherapy, Prof. Dr. Kechur, asked me to organise a series of lectures every Tuesday until the end of the semester. These online lectures worked very well, although there was one limitation: if someone received a bomb alert via an app on their cell phone (incidentally, with a siren wail that goes through your spine even over Zoom), they had to go to the air- raid shelter! At this time the students were very exhausted because during the night there were often bomb alerts.

Everyone on the course was working for their country, helping the mentally and physically injured, and their experiences mingled more and more into our lessons. I will probably never forget a supervision session with our music therapist and specialist for PTSD, Dr. Edith Wiesmüller:

One student talked about her work with orphans, another about a counseling center for people traumatized by war, yet another spoke about her work at one of the many telephone counseling centers. She told of conversations with a psychotic woman who had fled alone with her baby and was lost in her new living situation. There was never any face-to-face contact with this woman, they did not even know where she was, but: she still called regularly, and we all hoped she would continue. Many worked with children, others distributed food or other necessities. I suddenly got an insight into a highly complex civil society, in which everyone immediately found a new place and started fighting for their country as they were able. Again and again, the refrain sounded: “We will win!”

Thinking back to the beginning of our seminar activity in Lviv in March 2018, our Ukrainian colleagues’ passion and spirit for improvisation surprised us. For example: We “Western” music therapists have a rich set of instruments at our workplaces which our patients appreciate very much. In Lviv there was nothing except for a few self-made drums and, what impressed us most, old keys hanging on a metal bar to make a kind of (wind)chimes. We were very impressed, but this situation could not continue! Back in Vienna, we initiated a collection campaign among our colleagues and, in Spring 2019 an Austrian Agency for Education and Internationalization (OeAD) bus transported a considerable set of instruments to Lviv. What a joy! In the same year, again with the support of the OeAD, the first volume of our Vienna textbook was translated into Ukrainian. In the Carinthian dialect, there is a fitting saying for this: “When it runs, it runs!”

First exploration of the donated instruments from Vienna.

In the week of May 2nd to 7th, 2022, two of the four invited Ukrainian colleagues were finally able to come to Vienna for a first exchange. Prof. Kechur had to remain in Lviv because of the mobilization law. On May 5, we presented our project together at the Vienna Music Therapy Lecture Series – with our interpreter in Lviv translating via Zoom. A further step was the visit of Alexander Lvov, who was a guest at the Institute for Music Therapy; Professor Stegemann succeeded in accommodating him in a strictly timed schedule and so, among other things, Mr. Lvov offered workshops for our students, which allowed insights into his work with musical psychodrama. This time we found a Ukrainian student who speaks both English and Ukrainian, but not German. So, we translated from German into English, and she then translated into Ukrainian, a procedure that required a lot of patience from all involved and in which we were sure that many subtleties were lost.

May 17th was the final date for our mini-lecture series, for which a program had to be put together in a very short time. We didn’t have a speaker for our last date, but Zoom was still available and suddenly, this connection to Ukraine seemed to me to be something very, very valuable. So, I met with about 25 Ukrainian students for a last meeting via Zoom, as so often before on a Tuesday. The common introductory question, “How are you?” did not cross my lips. Is it even allowed to ask that to people who are in a war? Do they feel ridiculed by me? A confusing rush of thoughts swirled in my head, and in that moment I felt sympathy for patients who experience such confusion. Ultimately, of course, I could find no quick answers to my torrent of questions so I started as usual: “I hope, you’re fine!” How absurd! And yet: on the Ukrainian side, they were happy with my greeting, weren’t they?

Our liaison from UCU was Prof. Kechur’s assistant, Ms. Anastasiia Shyroka. I never got to meet her personally, but she was our emotional support during the mini-lectures. She was always there, and I could write to her about organizational details, which was very helpful. We didn’t have an interpreter that day and if I learned anything from my Ukrainian colleagues, it was how to improvise! I announced in English (which not all of them speak very well) that the next 1.5 hours would be available for a joint reflection and that due to the lack of a translator, I would now leave them alone with Anastasiia. This time was only for them, I would now say goodbye. What was I thinking? I left the call and had the feeling of saying goodbye to loved ones forever, of leaving them alone. A week later, I dared to write to Anastasiia to ask how they had been during the reflection. Promptly came the following answers (translated by me):

  1. Many students had previous therapeutic experience with diverse populations in individual and group settings. They were able to immediately implement what was offered in the lectures in their work (“real live experience”).
  2. There was some ambivalence about music therapy interventions. On one hand, music helps to communicate without words, on the other hand, war produces a lot of dangerous sounds (explosions, sirens, etc.) so some prefer silence. Many sounds from music therapy can overwhelm people.
  3. The participants were happy to attend the lectures and they came at the right time.

On May 18th, one day later, we had our final reflection with the students of the first music therapy training year from Lviv. These trainees had attended our mini-lecture series but were part of a private training course, rather than the UCU university program. Most of them refused to take an exam because they said they could not concentrate in such a difficult situation. So Dorothee Storz and I improvised and had a reflection conversation with them. Again via Zoom and this time with Halyna, our interpreter. In response to the usual closing question, “With which clientele can you, and would you not like to work in the future?” came answers such as:

“I can’t work with people who attack us!”

“Not with people who have been sexually violated,” referring to the many rape victims of the war.

We asked if any of them had already had positive experiences with the implementation of what they had learned during the war. One student said:

“Yes! When you have to sit longer in the shelter, singing helps!”

First year students at the Catholic University of Lviv and University of Lviv

As I write this article on 1st June 2022 my contribution is coming to an end. The end is open and there may well not be a happy ending – also something we have to endure.

My special thanks go to the following people: our interpreter Halyna Salahan, who did more than just translate for us from day one. Andreas Wenninger, the head of the Lviv Cooperation Office of the OeAD, without his knowledge about Ukraine and its funding nothing would have worked. Anita Taschler from our international office at the University of Music and Performing Arts, who guided us through the Erasmus process in a committed, patient, and knowledgeable way. Anastasiia Shyroka from the UCU, who is still waiting for a scholarship to Austria. She doesn’t know how important she was for me. My special thanks go to my colleague Dorothee Storz, with whom I was able to work side by side for over five years, partly planning, partly improvising this complex task. Alone? That would not have been possible at any time! Forget it!

Elena Fitzthum, Dr., Musictherapist, Psychotherapist, Lecturer at the University of Music and Performing Arts in Vienna; music therapeutic and psychotherapeutic work in private practice.

Postscript: July 27, 2023: Since Elena wrote this article, two colleagues from the MDW Department of Music Therapy have continued Elena and Dorothee’s long-standing developments by taking care of exchange and collaborations within the Erasmus project. The first Master’s student from UCU arrived in March and staff training was carried out with Anastasiia Shyroka and Iryna Semkiv in May. Bilingual publications in German and English about the “Recovery Project” and a songwriting project in a children’s shelter are in progress and include a lively exchange about scientific, theoretical and practical issues related to trauma-oriented music therapy and the role of music in supporting public health in times of war.