Introduction
anxiety, adolescence, psychiatric, PTSD, depression
SECONDARY
Adolescents exposed to conflict in humanitarian settings in low- and middle-income countries (LMICs) experience concerning levels of psychiatric distress.Compounding the issues facing Afghan adolescents, the United States and its allies left Afghanistan and the Taliban regained control in August 2021. The United Nations reported that “the needs of children of Afghanistan have never been greater”Addressing psychiatric concerns during adolescence is imperative,Those with depression and PTSD, including war-affected adolescents,This study conducted a randomized clinical trial (RCT) to investigate the efficacy, feasibility, and acceptability of METRA in addressing psychiatric concerns among adolescents in a humanitarian context. The study originally planned to recruit both boys and girls. However, after the change in government, it was identified by local nongovernment organizations (NGOs) that there was a particular unmet need regarding the psychiatric needs of girls. Thus, we focused on adolescent girls. The primary objective of the study was to investigate the efficacy of METRA in improving PTSD and depression symptoms in adolescents living in an LMIC humanitarian context. The secondary objectives were to investigate (1) the efficacy of METRA in improving general psychiatric symptoms (anxiety, Afghan idioms of distress, psychiatric difficulties); (2) whether improvements in symptomatology were maintained at 3-month follow-up; and (3) the feasibility and appropriateness of METRAs.