PSYCHOLOGICAL HELP PREFERENCES TEST AND MOTIVATION OF UKRAINIAN VETERANS WITH THE USE OF DESIGNED TEST NAMED “10 Questions from Voronin” AND ZEIGARNIK EFFECT

In the article a new test to investigate preferences of Ukrainian veterans in receiving psychological help was presented. It is designed by a war veteran and young scientist to be as simple as possible for veterans, so as not to consume their time. Named “10 Questions from Voronin” (10 QV). It is also designed to motivate veterans to think of help to prevent suicide by the means of the Zeigarnik eﬀect. Pilot study based on 43 randomly tested Ukrainian war veterans is also introduced. Possible conclusions from this study are brieﬂy presented and analysed.


Introduction
One of the serious problems that may lead to an increase in suicide rates in war veterans can be absence of their motivation to request psychological help by various means that are provided for them or absence of motivation to participate in rehabilitation activities.In the research by Michele R Spoont et al. (Spoont, M. R., Nelson, D. B., Murdoch, et al., 2014) it was found that after receiving a diagnosis of PTSD "Of veterans who were given a diagnosis of PTSD, only about two-thirds received some VA mental health care in the six months after the diagnosis.Only about half of those who received any mental health care received a minimally adequate treatment trial."It means that veterans were not engaged highly into the treatment.Reasons were not identified clearly.On the other hand, successful strategies leading to lower suicide rates were introduced for Ukraine particularly in 2002 (Rozanov, V. A., Mokhovikov, A. N., Stiliha, R. 2002) by Rozanov et al.However, the conclusion was made that "it is important to have constant contact with the targeted unit" while there is a need "to continue to implement this program of suicide prevention."Latest research in Germany (Niemeyer, H., Knaevelsrud, C., Schumacher et al. 2020) concerning "the efficacy of a therapist-guided internet-based cognitive-behavioral therapy" identified that "improvements were small" and dropout rate was "high", to be exact 32.3 %, which is close to results received among United States veterans by Michele R Spoont et al. (Spoont, M. R., Nelson, D. B., Murdoch, et al., 2014).But recent results received in Germany "demonstrate the need to identify factors influencing treatment engagement and efficacy in veterans."(Niemeyer, H., Knaevelsrud, C., Schumacher et al. 2020) These various research papers show that understanding reasons why veterans engage or do not engage in psychological help is very important, as well as understanding the most convenient ways of receiving it.For better understanding of the mentioned reasons a test named "10 Questions from Voronin" (10 QV) was designed.❏ Yes.All veterans must be consulted.

The test
❏ No. Veterans must decide for themselves whether they need psychological help.
3. Do you think that it is a shame to go to a psychologist?
❏ Yes.It's a shame.
❏ No.This is normal practice.

Would you receive help from a psychologist after the service?
❏ Yes.There is nothing wrong with consulting a psychologist.
❏ No.I do not need psychological help.This can mean that almost all veterans who took part understand that psychological help is needed.
31 veteran of 43 preferred mandatory psychological help instead of seeking it on their own (Table 3).Table 3. Answers to the second numbered question of 10 QV distribution.
This question was asked not to legalise unethical mandatory treatment of veterans, but to understand how deeply veterans feel the need to obey orders as if they were inside a military structure where decisions are made by higher commanders.The distribution may show that 31 of 43 veterans still need an order to obey for psychological help receiving.
Answering the third numbered question "Do you think that it is a shame to go to a psychologist?"40 of 43 veterans answered "No.This is normal practice."(Table 4) 3. Do you think that it is a shame to go to a psychologist?
Yes. It's a shame.
No.This is normal practice.
3 40 Table 4. Answers to the third numbered question of 10 QV distribution.
This distribution may indicate that most veterans don't have issues with stigma and treat psychological help normally but more detailed analysis described in article "Stigma to psychological help among Ukrainian ATO/OJF veterans analysis: pilot study."(Voronin M. 2020) shows that stigma bothers Ukrainian veterans and it can be seen from answers like this (Picture 1): "That I answered it is not a shame."(Voronin M. 2020) Picture 1. Answer "Is it a shame to approach a psychologist" to the first question "What question do you remember the most?" and a proud answer "That I answered it is not a shame."for the second question "Describe what you remember from it:" in Ukrainian.(Voronin M. 2020) The question number 4 "Would you receive help from a psychologist after the service?" distribution (Table 5) may show that 72% of veterans engaged in the pilot study would receive help from a psychologist after the service.

Would you receive help from a psychologist after the service?
Yes.There is nothing wrong with consulting a psychologist.
No. I do not need psychological help.

12
Table 5. Answers to the fourth numbered question of 10 QV distribution.
The question number 5 "Which psychologist do you think should consult after the service: civilian or military?"distribution (Table 6) may show that almost 60.5 % of veterans engaged in the pilot study would prefer a military psychologist to a civil one after their service.Table 6.Answers to the fifth numbered question of 10 QV distribution.
The question number 6 "Is it enough to consult via the Internet or phone or do you think it is better to meet a psychologist in person after your service?" distribution (Table 7) may show that most veterans engaged in pilot study prefer personal meetings over online advice or consultation by phone after the service.One veteran did not pick suggested answers and added his own answer "I am veteran psychologist" (Picture 2).
Picture 2. Answer "I am veteran psychologist" to the seventh numbered question of 10 QV.
The question number 8 "Which psychologist do you think should consult during the service: civilian or military?"distribution (Table 9) may show that almost 74.5 % of veterans engaged in pilot study would prefer a military psychologist to a civil one during their service, which is 14 percent more than the same question after the service (Table 6).
8. Which psychologist do you think should be consulted during the service: civilian or military?Civil Military 11 32 Table 9. Answers to the eighth numbered question of 10 QV distribution.
The question number 9 "Is it enough to consult via the Internet or phone or do you think it is better to meet a psychologist in person during the service?" distribution (Table 10) may show that most veterans engaged in the pilot study still prefer personal meetings over online advice or consultation by phone during the service, but more veterans allow other than personal meeting choices (compared to Table 7).Table 10.Answers to the ninth numbered question of 10 QV distribution.
One of the most interesting questions "How can veterans be saved from suicide?", which had no proposed answers, was left unanswered in 24 cases and 19 veterans decided to give their own answers (Table 11) without paying attention to the obstacles that were made by 10 QV author (no space for answer was left).
named "10 Questions from Voronin" (10 QV) The 10 QV test was designed by young scientist and veteran at the same time after some friends of his committed suicide upon being discharged from military service in Ukraine and participating in the recent/ongoing war against Russian Federation in the east of Ukraine.The author resigned from serving as a sniper at 73rd Ukrainian marine center of special operations.Actively participated in the war of Ukraine against Russian Federation from 2014 to 2021 in different roles: as an active military serviceman or volunteer combatant at volunteer battalion.Test author successfully finished a brief version of the Common Elements Treatment Approach (CETA) in Ukraine (Murray, L.K., Haroz, E.E., Doty, S.B. et al. 2018) and realised the need of understanding reasons why veterans do not engage in the different treatments and psychological programs designed for helping them.Or after engaging they dropout never to finish.For instance, MMPI-2 test can make a veteran seeking psychological help never return because it is too massive and complicated, although it can be effective for PTSD identification(Arbisi, P. A., Ben-Porath, Y. S., McNulty, J. 2006) it can not be used for identification of veterans preferences in receiving psychological help or in motivating them.So the new simple ten question test was designed to fit in one A4 standard page.The test was designed to fit in two pages A4.On the first page after disclaimer, gender and age request ten numbered questions were presented.First page contained:The survey is conducted anonymously, as part of a study of veterans' you think that psychological counseling should be mandatory after the end of the service, or should veterans seek psychological help on their own?

6.
Is it enough to consult via the Internet or phone or do you think it is better to meet a psychologist in person after the service?

9.
Is it enough to consult via the Internet or phone or do you think it is better to meet a psychologist in person during

Table 1 .
10 QV соnsists of 10 numbered questions placed on one side of an A4 sheet and two additional questions placed on the other side of an A4 sheet.The study is anonymous and no personal data is taken into account.The only thing that is taken into account is age and gender of the respondent, the answer to these requests can be filled in before answering the numbered questions in the appropriate places on the first page of A4.The survey was conducted as follows: respondents were asked to fill in the first page, answer ten numbered questions, after finishing the first page it was proposed to turn the sheet and answer two additional questions and until the questions of the second page were Veterans age distribution.
(Reeve J., Cole S.G., Olson, B.C. 1986)ld consult after your service: civilian or military?❏Civilian.❏Military.6.Is it enough to consult via the Internet or phone or do you think it is better to meet a psychologist in person after military service?❏ enough online advice ❏ enough consultation by phone ❏ it is better to meet in person 7. Would you like to get psychological help right now? ❏ Yes.I feel the need for psychological counseling.❏enoughonlineadvice❏ enough consultation by phone ❏ it is better to meet in person 10.How can veterans be saved from suicide?The survey was developed by Mykola Voronin as part of a study of veterans' motivation and the "Care Together" initiative to help veterans.On the second page two unnumbered questions were asked: answered it was not allowed to look back at the previous page.The 10 QV test contains on the first page two unnumbered questions, where the respondent can indicate his age and gender.It also contains ten numbered questions, nine of these questions -test questions, tenth question was constructed without a proposed answer in order for respondents to face some difficulties while attempting to answer it (no room for answer was left).Theoretically the respondents were supposed to make a decision "leave it unanswered."Thisquestion is based on the Zeigarnik effect: the questions that were not answered are better remembered(Reeve J., Cole S.G., Olson, B.C. 1986).The tenth question is more motivational.Designed to motivate veterans think how to solve

Table 2 .
Answers to the first numbered question of 10 QV distribution.

Table 7 .
Answers to the sixth numbered question of 10 QV distribution.

Table 8 .
Answers to the seventh numbered question of 10 QV distribution.