Facilitators and Treatment Fidelity
METRA was delivered by facilitators (community members with a health or education background) with minimal training; each facilitator received 8 hours of training (two 4-hour sessions). Facilitators received supervision from a clinical psychologist. A random 25% of the audio-recorded sessions were rated for manual adherence using a Therapist Adherence Scoring sheet. To reduce group contamination, participants were asked not to discuss the treatment with others.