Graduate Psychology Education Programs - The proposed project, Community-Responsive Empirically supported Substance Use Treatment Training (CRESTT) Program, addresses the well-documented need at statewide and national levels to establish a pipeline of diverse, highly trained psychologists who can provide evidence-based, trauma-informed, and culturally responsive integrated services for youth substance use disorders (SUD) and mental health (MH). This initiative specifically targets publicly insured youth with limited access to quality mental health care. In California, nearly 60% of children are publicly insured through Medi-Cal; however, access to MH care remains severely inadequate. In San Francisco County, fewer than 5% of children receive specialty MH services, despite significant psychological distress among low-income youth. This issue is exacerbated by inadequate training in integrated substance use and mental health treatments, particularly for Black and Latinx youth. Doctoral internship programs, such as the APA-accredited UCSF Child and Adolescent Services Multicultural Clinical Training Program (MCTP), aim to bridge this gap by training culturally competent psychologists in community settings. Indeed, the MCTP qualifies for Funding Priority Qualification 1: High Rate. The proposed targeted training in this Competing Continuation (Award D40HP45680) will enhance access to care and improve outcomes for publicly insured youth and families. Over three years, funding will support twelve positions (four per year) in the MCTP, for which Zuckerberg San Francisco General Hospital, an urban safety net Federally Qualified Health Center is the hub. Positions will focus on three established training tracks that provide integrated behavioral health to publicly insured youth with co-occurring substance use and mental health needs in high-need underserved areas. Experiential training combined with didactic instruction will strengthen existing rotations for interns, postdoctoral fellows, local counseling, marriage and family therapy, and social work students who train under the MCTP. This approach promotes interdisciplinary practice among psychology interns, psychiatrists, pediatricians, and nurses. The MCTP will continue top train in trauma-informed telebehavioral health to ensure that youth facing socioeconomic inequities have access to care. MCTP interns receive comprehensive training in early assessment, prevention, and treatment of co-occurring SUD and MH disorders in youth. The training experiences provide unique multidisciplinary team interactions in primary care, with San Francisco Unified School District schools, wellness centers and local legal system actors. To achieve the project goal, the following objectives are proposed: a) Recruit twelve doctoral interns from diverse backgrounds committed to pursuing a clinical concentration in trauma-informed and culturally responsive integrated behavioral health treatment and assessment for publicly insured, multi-systems-involved youth. b) Provide stipend support along with tuition, conference travel, and bilingual supplements to attract competitive applicants. c) Offer trainees didactic and experiential training curricula, including trauma-informed care and SUD)/opioid use disorder prevention and treatment services alongside interdisciplinary training. d) Provide training in interdisciplinary behavioral health care in community settings. e) Train in trauma-informed care. f) Provide training in measurement-based care for SUD, MH, and social determinants of health. g) Offer training in culturally and linguistically appropriate SUD and MH services. h) Ensure interns dedicate at least twenty-five percent of their time to experiential training in delivering services for OUD and other SUDs. i) Continue supporting academic and clinical partnerships. j) Provide ongoing faculty development and staff training. k) Disseminate project outcomes to key target audiences.
