While the majority of opioid overdoses and deaths in the United States are in the transitional age youth or emerging adult population (18-26 years old), overwhelmingly those who develop Substance Use Disorders (or SUDs) began their substance usage in their early to middle adolescent years. Interventions designed for young adults dealing with opioid and other SUD concerns are costly, reactive, and in short supply. Proactive and prevention-focused programs based in middle and high schools, led by trained clinicians, have much greater potential of addressing the scourge of SUDs and related mental health concerns in an effective manner. Unfortunately, historically psychology training programs have not required students to learn about SUD assessment and intervention, as it has not been a part of the licensure process (with the exception of those working towards an LMHC license). Our next generation of clinicians need to be familiar with individual, group, and system-wide interventions, as well as relevant family- and community-based interventions, to be more effective at helping pre-initiation and early-initiation youth related to substance using behaviors.

Many individuals with mental health concerns are also impacted by challenges linked to the use of legal and illicit substances. Due to additional stress from the COVID-19 pandemic there has been an increase in substance usage by young people and adults and the need for psychological support in this area has grown even greater. Unfortunately, there is a shortage of psychologists equipped to deliver these needed services, both on the assessment and the intervention sides of the equation, especially for younger clients in the community, as the majority of clinicians trained to address dual-diagnosis concerns focus on adult patients or clients. Youth from traditionally underserved populations are at even greater risk, especially if there are language and cultural barriers not being addressed by providers who are limited in their training in these areas. One of the best places to reach these at-risk youth is via use of screening and interventions at schools, if there is proper awareness and training of evidence-based intervention tools and strategies designed in particular to help youth.

More needs to be done at the school-based level to help clinicians be better trained to assess and treatment risk behaviors, before full substance use disorders develop, and greater awareness of screening tools for use in schools along with knowledge of ways to foster cultural/community connectedness can also prove key in helping reduce adolescent early initiation and usage rates.

Historical and recent psychological research has told us that youth who are “feeling connected” (e.g., school-, community-, cultural-connectedness) and supported have lower rates of risk engagement with a variety of self-destructive acts, including substance usage. Historically, many schools have offered frontal education programs on risks of substance usage that have limited lasting impact, have punishment-based interventions in place for students engaging in substance using behaviors, and reactive responses after problems have already developed. None of these foster connectedness effectively, and research has shown that proactive, preventative, and interactive models that promote resilience have a better chance of helping adolescents address their mental health and behavioral concerns more effectively than choosing to self-medicate.

In  this session we will look at methods and practices useful to decrease substance use risk of youth in schools from an overview perspective by looking at up-to-date, evidence-based research on motivations behind youth substance usage and on strategic assessment and programmatic options designed to effectively address these concerns. We will also examine evidence-based ways of gaining information on key bilingual and bicultural factors impacting adolescent risk and protective factors, and the connectors to substance usage risks in particular. We will also touch on ways psychologists, and other school-based mental health professionals, can make the best combined use of SUD research and screening tools (e.g., CRAFFT-II, SASSS, ASAGC) and cultural values measures (e.g., Bicultural Self-Efficacy Scale, Cultural Values Scale) to help adolescents in need. The hope is that participants will leave this training with awareness of key directions to movie in to adopt strategies that can actually be used in schools to begin the crucial process of more effectively addressing substance and dual diagnosis challenges facing our students, in terms of proactive and protective treatment options.