Memory-focused therapy: an integrated intervention to reduce trauma symptoms, maladaptive cognitive processes, and emotional distress in Afghan youth.

Background: Afghan youth continue to face chronic war-related trauma, terrorist violence, and severe disruptions to education and social support systems, resulting in high rates of posttraumatic stress disorder (PTSD), depression, anxiety, and hopelessness. There is a critical need for culturally responsive, low-intensity, and feasible psychological interventions that can be delivered in low-resource and unstable settings. Objective: This study conducted a preliminary evaluation of the efficacy, acceptability, and mechanisms of change associated with Memory-Focused Therapy (MFT), an integrative intervention targeting autobiographical memory processing, acceptance-based regulation, and future self-construction among youth affected by the Kaaj Education Center attack in Kabul, Afghanistan. Methods: A single-group repeated-measures design was used with 26 participants assessed at baseline, post-intervention, and three-month follow-up. Standardized measures of PTSD, depression, anxiety, stress, cognitive avoidance, cognitive fusion, resilience, and posttraumatic growth were administered. MFT was delivered in 12 structured group sessions. Additionally, qualitative data from semi-structured interviews and therapist field notes were analyzed using thematic analysis. Results: Quantitative analyses showed significant reductions in PTSD symptoms, depression, anxiety, stress, cognitive avoidance, and cognitive fusion from baseline to post-intervention, alongside significant increases in posttraumatic growth. Several of these improvements were maintained at follow-up. Qualitative findings reflected four overarching themes: (1) facilitator experiences and implementation challenges in high-risk contexts, (2) improvements in cognitive and emotional processing, (3) growth in meaning, relationships, values, and future orientation, and (4) exposure to traumatic memories and reduced avoidance. Conclusion: Findings provide preliminary evidence that MFT is a feasible, acceptable, and potentially effective intervention for trauma-affected Afghan youth. By integrating trauma memory processing, present-moment emotional regulation, and future-oriented meaning-making, MFT appears to support improvements in psychological coherence, self-continuity, and resilience. Further controlled and longitudinal studies are needed to confirm these effects and examine underlying mechanisms.