Qouta 2012.

Methods	Cluster‐randomised trial of teaching recovery techniques vs wait list in 10‐ to 13‐year‐old boys and girls in heavily bombarded areas
Participants	Included (n = 482) Children in 5th and 6th grades from 2 randomly selected schools in heavily bombarded areas. Mean age: 11.29 years. Female: 49.4%. 86% lived in urban areas, 12% in refugee camps, 3% in villages; 49% had unemployed fathers. Clinically significant post‐traumatic stress symptoms: 64% intervention group, 43% control group Excluded Not stated Setting Schools in heavily bombarded areas in North Gaza and Gaza City, Palestine, after the Gaza War in 2008 to 2009
Interventions	Teaching Recovery Techniques (n = 242) The Teaching Recovery programme was modified to suit a war situation. It incorporated trauma‐related psychoeducation, CBT methods, coping skills training and creative‐expressive elements such as dream work and drawing. Problem solving, storytelling and role play techniques were also applied Four groups of 15 children were also attended by family members. Two weekly sessions of 2 hours over 4 weeks Four psychologists (2 male and 2 female) were trained in Teaching Recovery Techniques and had weekly preparatory and supervisory meetings with the primary author. Supervision covered case consultation, therapeutic elements, guidance through role playing and review of field diaries and sessions Wait list (n = 240) After 6 months, the control group was provided the same intervention for 1 month
Outcomes	PTSD symptoms Scale: CRIES (13‐item) Rater: child/adolescent Depression Scale: Depression Self‐Rating Scale (18‐item) Rater: child/adolescent Behaviour Scale: SDQ Rater: child/adolescent When Post treatment and at 6‐month follow‐up
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Four schools were randomly sampled from a Ministry of Education list. Two girls’ and two boys’ classes were randomly sampled at each of the 4 schools. Classes were randomly allocated (stratified by gender) to intervention and control groups
Allocation concealment (selection bias)	Unclear risk	Not described
Blinding of participants (performance bias	High risk	“Children, families, teachers, and research assistants were not aware of the intervention status of children at the baseline”, but it is likely they would have known whether they received treatment, once the study started
Blinding of outcome assessment (detection bias) All outcomes	High risk	Outcomes were self reported
Incomplete outcome data (attrition bias) All outcomes	High risk	Loss to follow‐up between post treatment and 6 months: 16.2%
Selective reporting (reporting bias)	Low risk	Alll outcomes appear to have been reported
Other bias	High risk	Clinically significant symptoms were significantly greater in the intervention group (64% vs 43%)