A Threat to Children’s Mental Health: Examining War Experiences Through the Lens of Choice Theory and Reality Therapy

Children in war zones face emotional deprivation, physical danger, and isolation. Despite armed conflict’s profound impacts, qualitative research exploring children’s experiences through unmet basic psychological needs remains scarce. This study examined how war-related trauma affects children’s inner worlds by adopting Choice Theory and Reality Therapy as an interpretive framework; this perspective helps reframe the focus from trauma-induced pathology toward an exploration of children’s internal agency, providing a pragmatic lens for understanding how they navigate and respond to extreme environmental restrictions. The study involved 53 children (aged 6–17) from two distinct geopolitical contexts: Palestine (n = 29) and Ukraine (n = 24). Data collected via trauma-informed, semi-structured online interviews were analyzed using an abductive, theory-informed thematic analysis. Findings revealed five superordinate themes aligned with the framework: Basic Needs, Control, Responsibility, Quality World, and Total Behavior. Results indicate that survival needs (n = 46) dominate children’s narratives, followed by critical deficits in love and belonging (n = 29) and freedom (n = 21). The analysis highlights pervasive erosion of children’s Quality World driven by systematic external control; however, participants demonstrated significant internal agency by employing Total Behavior cognitive coping, social support, and religious practices as purposive attempts to satisfy their need for power. These findings challenge the passive victim trope by redefining wartime behaviors as goal-directed efforts toward need-satisfaction. Ultimately, these qualitative findings contribute to the ongoing discourse on shifting from deficit-based clinical models toward choice-oriented, culturally sensitive interventions that prioritize the restoration of perceived control and psychological dignity in war-affected youth.