Randomization and Blinding
After eligibility was confirmed and baseline data collected, the study coordinator randomly assigned participants in a 2:1 ratio to METRA or TAU, using a computer-generated randomization sequence. Following the change of government, there was increased insecurity, and most international agencies withdrew from Afghanistan. Thus, at the time of the study there were very few youth health interventions available that could be considered TAU. We changed our randomization approach and adopted an unequal randomization approach for resource and ethical reasons to maximize the number of girls in the treatment group. This unequal randomization approach has been used in previous trauma-focused RCTs, including those in LMICs.