This preliminary investigation examined the efficacy of a game-based cognitive-behavioral therapy group program for elementary school-aged children who have experienced sexual abuse. Treatment aimed to improve: (a) internalizing symptoms, (b) externalizing behaviors, (c) sexually inappropriate behaviors, (d) social skills deficits, (e) self-esteem problems, and (f) knowledge of healthy sexuality and self-protection skills. Results indicate that game-based cognitive-behavioral therapy was effective for improving internalizing and externalizing symptoms, reducing sexually inappropriate behaviors, and improving children's knowledge of abuse and self-protection skills. Although results pointed in a positive direction for social skills and self-perception, these findings were not statistically significant. Clinical significance was also evaluated to assess the clinical utility of treatment effects. Treatment implications of the findings and future research directions are discussed. (Contains 8 tables.)