Comparative Effectiveness of SPARCS and Unified Protocol for Youth With Chronic Medical Conditions and Trauma-Related Distress

Inclusion Criteria: * Youth (aged 8-18 years) who received a SPIRIT program psychological trauma screening and were deemed clinically appropriate for SPIRIT group therapy. Clinically appropriate means the youth can historically engage in a group setting (e.g., school, camp, therapy group) without significant disruption to the group process or other participants. * Youth and parent/legal guardian are willing and able to provide informed consent/assent for randomization. * Youth and parent/legal guardian are fluent in English or Spanish. * Youth is not currently engaged in individual therapy at the time of enrollment (per patient/parent report). Exclusion Criteria: * Wards of the state or DCFS youth in care. * Youth with reported or observed symptoms that would significantly impair group therapy engagement, including but not limited to: intellectual disability, moderate-to-severe autism spectrum disorder, active suicidal ideation, uncontrolled psychosis, or other acute psychiatric symptoms that could disrupt the group process. * Regular use of alcohol or other substances that interfere with participation or disrupt the group process. * Youth requiring immediate higher-level psychiatric care (e.g., intensive outpatient programming, partial hospitalization, inpatient psychiatric admission, or residential treatment) at the time of first randomization.