Evaluation of the METRA + intervention on mental health and social functioning in Afghan refugee adolescents in Pakistan: a pilot study.

Résumé

Afghan adolescents have been exposed to decades of war, displacement, and limited access to mental health care. Memory Training for Recovery-Adolescent Plus (METRA+) was developed to address posttraumatic stress (PTSD), depression, and social functioning through a brief, culturally adapted, and scalable approach. This pilot study evaluated the feasibility and preliminary efficacy of METRA + among Afghan refugee adolescents in Pakistan. A single-arm mixed-methods design was used, with 41 Afghan adolescents (27 girls, 14 boys; mean age = 15.4 years) completing a 13-session METRA + programme integrating compassionate communication, memory specificity, and written exposure. Quantitative measures assessed PTSD symptoms, depression symptoms, anxiety, and social functioning, administered at baseline, after each module, and at two-month follow-up. Data were analyzed using repeated-measures analysis of variance (ANOVA). Post-intervention focus groups explored participants' experiences and emotional changes, with thematic analysis conducted using MAXQDA 2024, following Braun and Clarke's (2006) framework. Significant reductions were observed in symptoms of PTSD,