Procedures
STRESSFUL EVENTS, ADVERSE EVENTS
Adult (18 years or above) Arabic-speaking Syrian refugees were recruited through community centres, non-governmental organisations, reception centres, language schools and social media. With ‘Syrian refugees’ we refer to individuals from Syria who requested asylum after the start of the war in 2011 regardless of current resident status. Oral and written informed consent (IC) was obtained from all participants before screening. Participants were included if they reported elevated levels of psychological distress (Kessler Psychological Distress Scale; K10 >15)The baseline assessment included questionnaires on demographics, clinical outcomes, daily functioning, stressful events and health service utilisation (reported elsewhere). Participants were reassessed 1 week and 3 months after the intervention (ie, 6 weeks and 4.5 months after baseline). Assessments were conducted in the online questionnaire tool Survalyzer. For each assessment, participants were contacted by an Arabic-speaking assessor who sent a secured online link for the self-report questionnaires, conducted a brief phone-based interview on health service utilisation and assisted in case of lower literacy. Participants were remunerated €8.50 for each follow-up assessment. Assessors had at least a university degree and were trained on questionnaire administration, general interview techniques, CMDs, psychological first aid and research ethics. Serious adverse events (SAEs) were recorded and monitored throughout the study.After baseline, participants were randomised 1:1 into PM+ in addition to care as usual (PM+/CAU) or CAU alone. A randomisation list with permuted block sizes 4-6-8 was generated in R