ABSTRACT This study explored the effectiveness of Trust-Based Relational Intervention® (TBRI®) Nurture Group© to improve social-emotional development among preschool aged students who experienced economic hardship and the COVID-19 pandemic. A mixed-methods approach using the Strengths and Difficulties Questionnaire (SDQ) and focus group interviews with teaching staff were used to determine effectiveness of the intervention on pre-kindergarten and preschool students. Significant improvements in social-emotional development among pre-kindergarten children occurred, including reduced conduct and peer relationship problems, decreased emotional behavioral difficulties, and increased prosocial behavior. Preschool children showed positive changes in social-emotional development, though not statistically significant. There was a significant difference in the changes that occurred between classes in the domains of conduct problems and prosocial behaviors, as the pre-kindergarten children experienced significantly larger improvements in these domains. Qualitative findings indicated enhanced empathy and self-regulation skills among children participating in the Nurture Group© and consistency between TBRI® principles and the center’s curriculum. Overall, this study confirms the theory that TBRI® Nurture Group© positively impacts children’s social-emotional development, with implications for occupational therapy practitioners to promote trauma-informed approaches and protective factors through collaboration with educators.