Trauma systems therapy for refugees (TST-R) is a trauma-focused, culturally responsive mental health prevention and intervention model designed to meet the needs of children and families who are fleeing their home countries and seeking humanitarian refuge. TST-R provides trauma-focused mental health treatment and addresses problems in part exacerbated by harsh U.S. immigration policies (e.g., poor mental health, stigma, fear) that have implications for the psychosocial well-being of immigrant children and families, especially those who have experienced migration-related trauma. Informed by a community-based participatory research approach, TST-R was developed as an adaptation of trauma systems therapy to address common barriers to care experienced by those of refugee and immigrant backgrounds, including mental health stigma, distrust of service systems, and cultural and linguistic barriers. TST-R is a multitiered and phase-based intervention that strategically addresses stressors and needs across levels of the social ecology. Most TST-R services are delivered in easily accessible, nonstigmatizing settings (e.g., school) by a cultural broker and a clinician who work in partnership. TST-R has been disseminated and implemented with multiple cultural groups (e.g., Somali, Bhutanese) across the United States and Canada. Given the unique stressors, strengths, and needs of immigrant children and their families, mental health services must be equitable, community based, and sustainable. TST-R demonstrates promise as a prevention and intervention model especially for those experiencing immigration policy-related stressors and may serve as a guide for developing child mental health policies and immigration policies that promote mental well-being for immigrant families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).