Mixed-methods were used to investigate treatment outcomes for youth enrolled in an innovative sports-based group therapy intervention. Chart review was conducted for 65 youth, aged 5 to 13 years over one academic year at an elementary school serving high-needs youth in an urban district. Analysis revealed symptom reduction for 72% of participants. For a subset of students (n = 34) with available Child and Adolescent Needs and Strengths (CANS) Assessments, the average number of adverse experiences was 2.74 (SD: 2.11). Qualitative coding of progress notes and discharge summaries was used to assess symptom presentation and treatment outcomes. This sports-based group therapy intervention promotes access to services while minimizing stigma.