Limitations
depression, PTSD, trauma
RECRUITMENT
This study has limitations, including changes to the protocol reflecting sociopolitical changes. However, all changes occurred prior to recruitment commencing. Flexibility in RCT and intervention delivery is essential in humanitarian contexts and needs to be accommodated to address the concerning gaps in the literature. Second, we focused on adolescent girls and recruited from Kabul. Thus, generalizability may be limited. Third, the lack of long-term follow-up precludes us from knowing whether METRA treatment gains were maintained beyond 3 months after treatment. Additionally, while previous research has identified the efficacy of module 1 in improving PTSD and depression, researchers have noted that a subsequent module targeting the trauma memory may be beneficial.