In a 2021 position statement, the Substance Abuse and Mental Health Services Administration asserted that Cognitive Behavioral Therapy for psychosis (CBTp) “should be implemented within our mental health system, and CBTp-informed care at a minimum should be implemented in primary care, correctional, forensic, and educational settings.” Around the same time, the American Psychiatric Association recognized that “medications are a complement to psychosocial treatment [like CBTp] and an equally important part of the overall care process.” The past five years have thus reflected a sea change in American psychiatric leadership that has been driven by education and advocacy. Yet, in routine care settings across the U.S., psychological treatments for serious mental illness continue to be inaccessible. This talk will describe innovative efforts to implement and deliver psychological care for individuals with psychosis, including engaging caregivers and diverse disciplines in “low intensity” interventions; addressing structural impediments through implementation and policy work; and leveraging recent technological advances to support training and clinical quality improvement.