Emily J. Graesser is a 2014 graduate of the PsyD Program in Clinical Psychology at Antioch University, New England .


intellectual disability, dual diagnosis, training, health disparities, health care disparities, competence, psychotherapy

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People with intellectual disabilities (ID) experience mental health problems at a higher rate than the general population, yet encounter significant barriers in accessing quality mental health services and have poorer mental health outcomes. Disparities in both psychology research and practice contribute to these barriers, and few mental health practitioners are willing and competent to treat people with ID. Lack of training availability has been suspected as an underlying factor, yet no previous investigation of training has been conducted in the United States. This study utilized a 20-question self-administered internet survey to explore the quantity, quality, and types of training APA-accredited doctoral level clinical and counseling programs provide their students with respect to serving clients with ID. Students' self-perceptions of competence with the population and their likelihood of future service provision for clients with ID were also studied. Current predoctoral psychology interns were recruited by emailing each internship training director listed in the APPIC database and asking them to forward a request for research participation. A total of 265 clinical and counseling psychology interns participated, resulting in an estimated response rate of 8.5%. Results revealed that, while more students reported training than expected, overall training was typically minimal, of low quality, and with little emphasis on service provision. Approximately half of the respondents reported a modicum of competence with this population and moderate likelihood to provide future services. An analysis of mediation revealed that perceived competence fully mediated the relationship between training quality and likelihood of future service provision. Without widespread reforms in APA-accredited programs in training for serving clients with ID, people with ID and mental health needs will likely remain an underserved population.