Interventions
depression, anxiety
SESSION, EVENTS, ADVERSE REACTIONS, SLOW BREATHING
The basic structure and content of the intervention was developed following focus groups with people affected by the pandemic. Before the group programme commenced, participants took part in an individual 15 min online session to explain the programme and ensure they understood the rules for the group participation. Brief prerecorded webinars were used in group discussions. Session 1 comprised education about common reactions to COVID-19, including anxiety, depression, worries, loss of pleasure and focused on strategies to heighten awareness of ways to savour positive experiences participants can have. The latter strategy instructed participants to use their imagination to rehearse and focus on positive elements of activities that they do engage in. Session 2 reviewed participants’ experiences of savouring events since the previous session, and instructed participants on how to recount prior positive experiences to elevate their mood. This recounting involved heightening awareness of affective, sensory and cognitive aspects of the experience. Participants were also assisted to identify meaningful activities that they could engage in, despite the limitations of lockdown. They were encouraged to identify and engaged in at least one activity per day, and to rehearse the savouring exercise with each activity. Participants were also instructed on the nature of rumination and worry during the pandemic, and the stress this way of thinking can cause. Participants were taught to discriminate between controllable and uncontrollable worries, and to engage in simple mindfulness exercises to not focus on uncontrollable worries. Slow breathing exercises were taught to augment this approach. Sessions 3 through 5 continued to review the activities previously taught, with a focus on trouble-shooting on how to savour activities and structure meaningful activities. Session 6 focused on reviewing the strategies and relapse prevention (for full programme, 
Participants in the EUC condition were emailed handouts that contained the same education and coping strategies provided in the intervention arm, however participants in EUC were asked to rehearse these strategies in a self-paced manner over 6 weeks. We adopted this form of comparator because self-help coping strategies have been a very common mental health outreach initiative during the pandemic.Sessions were audiorecorded and an independent psychologist rated 20% of sessions for treatment fidelity using a prescribed checklist. There was a high level of treatment fidelity, with 88% of rated sessions reflecting perfect adherence to the protocol. Treatment quality was also rated highly with a mean rating of 6.7 (possible range: 0–7). Adverse reactions, which were monitored each session by group facilitators and also on the basis of scheduled assessments, were referred to the Data Safety Monitoring Committee.