Allegheny General Hospital's Center for Traumatic Stress in Children and Adolescents is applying to continue as a Treatment and Service Adaptation Center in the National Child Traumatic Stress Network (NCTSN) with national expertise in Evidence-Based Treatments for Traumatic Stress Reactions. The developers of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT) will address behavioral health disparities for children who develop traumatic stress reactions including: 1) African American children who experience racial trauma; 2) children with parental substance abuse; and 3) children with traumatic grief (CTG) related to COVID-19. In addition to other traumatic events, African American youth experience high rates of racial trauma, traumatic stress reactions, and are over-represented in the child welfare and juvenile justice systems. We will conduct a learning community with five NCTSN Community Treatment and Services (CTS) Centers to adapt TF-CBT for racial trauma. We will also develop a TF-CBT Implementation Manual for Racial Trauma and a related Information Sheet, with a focus on treatment retention issues, clinical outcomes and behavioral health disparities. Children with parental substance abuse (PSA) are at increased risk for child maltreatment and for developing traumatic stress reactions including traumatic separation and/or CTG. We will conduct a learning community with six CTS Centers in order to adapt TF-CBT for youth with PSA, develop a TF-CBT Implementation Manual for Youth with PSA and develop a podcast for caregivers of youth with PSA, with an emphasis on retention issues, clinical outcomes and behavioral health disparities. Thousands of children with COVID-19-related CTG have unique clinical manifestations that are under-recognized and under-treated. We will collaborate with the University of California at San Francisco Early Trauma Treatment Network to develop three training modules describing an integrated conceptual and developmental approach to recognizing and responding to COVID-19-related CTG, present these in three NCTSN webinars, and train 1000 professionals in these concepts. We will also increase TF-CBT and AF-CBT dissemination and sustainability by: 1) training 40 new TF-CBT supervisors through our existing TF-CBT Train-the-Supervisor Program and 20 new TF-CBT trainers through our existing TF-CBT Train the Trainer program, with a focus on addressing behavioral health disparities, 2) developing six new AF-CBT training videos to create a new online AF-CBT training course for greater cross-system dissemination and sustainability of this model; 3) providing TF-CBT or AF-CBT training to 5000 professionals; and 4) providing TF-CBT training, consultation or technical assistance to 500 trauma or disaster-affected individuals.