Trial Implementation

Recruitment began in March 2022, ended on 31 December 2024, and trial completion is expected in July 2026. Session fidelity is monitored using encrypted audio recordings and separate checklists for PES and EMDR. The process evaluation follows UK Medical Research Council guidelines and assesses implementation, fidelity, adverse events, dropout reasons, and acceptability. The COVID-19 pandemic severely disrupted the trial and delayed research resumption across sites into 2022 and early 2023.