Table 3. Discrepancy between the original protocol and the characteristics of the target population, and preliminary adaptation of the protocol.

Issues Identified	Description	Preliminary Adaptation
Translation of English phrases	The UP uses some English phrases that do not have direct translations in Urdu such as “non-judgemental”, “Present-focused”, “subtle avoidance”.	Workbook: The terms are clearly explained in the text to help the reader understand their use.
	Psychiatric labels, terms, and phrasal expressions were identified as difficult and not commonly used.	Replaced by simple language and more culturally relevant terms and phrases.
Understanding of concepts	People with lower levels of formal education and familiarity with reading material might not understand the concepts in the English language.	Workbook: Translated in Urdu language for better understanding of the content.
Cultural relevance of examples	Examples were not relevant to our target population.	Workbook: Examples relevant to the cultural experiences and characteristics of the population were added.
Visual aids	Module 1: Making treatment motivation simpler for patients, considering the initial distress, and planning future actions.	Workbook: Chapter 4 ‐ Incorporated visual aids for easier understanding of motivation and goal setting.
	Module 2: Understanding emotions; Use visuals for better emotion comprehension.	Chapter 5: pictorial illustrations added to explain a three-component model for emotion regulation.
	Module 6: Understanding Physical Sensations; Images needed for exercises like push-ups, burpees, and squats.	Chapter 10: Pictures indicating how to perform each interoceptive exposure were added.
Audio exercises	Module 3: Emotional awareness; Some individuals may not find music appealing, other audio/video exercise alternatives are essential.	Workbook: Chapter 7: Exercises with music, videos or movie clips, and natural sounds were included in sessions and as homework based on personal preferences.