Examining MEmory Training for Recovery-Adolescent among Afghan adolescent boys: a pilot randomised controlled trial

<b>Objective:</b> To conduct a pilot randomised controlled trial examining the feasibility, acceptability and efficacy of MEmory Training for Recovery-Adolescent (METRA) in improving psychological symptoms among Afghan adolescent boys following a terrorist attack. <b>Method:</b> A pilot randomised controlled trial compared METRA to a Control Group, with a three-month follow-up. The study occurred in Kabul (June-November 2022). Fifty-eight boys aged 14–19 years (<i>Mage = </i>16.70, <i>SD </i>= 1.26) with heightened posttraumatic stress disorder (PTSD) symptoms were recruited through a local school that had recently experienced a terrorist attack. Participants were randomised 1:1 to receive METRA (<i>n </i>= 28) (10 session group-intervention) or Control (<i>n </i>= 30) (10 group-sessions of study skills). Primary outcomes were self-reported PTSD symptoms at post-intervention. Secondary outcomes included self-reported anxiety, depression, Afghan-cultural distress symptoms and psychiatric difficulties. <b>Results:</b> There were challenges in youth participation related to security and competing education demands. For those who did complete METRA, METRA was deemed feasible and acceptable. Following the intent-to-treat principle, linear mixed effects models found at posttreatment the METRA group had a 20.89-point (95%CI −30.66, −11.11) decrease in PTSD symptoms, while the Control Group had a 1.42-point (95%CI −8.11, 5.27) decrease, with the group over time interaction being significant (<i>p </i>&lt; .001). METRA participants had significantly greater reductions in depression, anxiety, Afghan-cultural distress symptoms and psychiatric difficulties than did Controls. All gains were maintained at three-month follow-up. <b>Conclusions:</b> With some modifications, METRA appears a feasible intervention for adolescent boys in humanitarian contexts in the aftermath of a terrorist attack. Very few adolescents in Afghanistan receive evidence-based psychological interventions.MEmory Training for Recovery-Adolescents was associated with significant reductions in psychological symptoms.With some modifications, MEmory Training for Recovery-Adolescents appears a feasible intervention for adolescent boys in humanitarian contexts in the aftermath of a terrorist attack. Very few adolescents in Afghanistan receive evidence-based psychological interventions. MEmory Training for Recovery-Adolescents was associated with significant reductions in psychological symptoms. With some modifications, MEmory Training for Recovery-Adolescents appears a feasible intervention for adolescent boys in humanitarian contexts in the aftermath of a terrorist attack.