All programs that are involved in training professionals have some experience with impaired trainees. A study was conducted to examine how different American Psychological Association (APA) approved pre-doctoral internship and graduate programs in psychology handle trainee difficulty and impairment. A 62-item questionnaire was completed by approximately 26% of the directors of training of internship and graduate programs in clinical, counseling, school, and scientific-professional psychology accredited by the APA. The results indicated that letters of reference were the most important consideration in admissions selection. The majority of programs (80%) assessed psychological suitability of applicants, although 96.52 percent of these programs did not use validated tests. The majority of programs reported the right of due process for trainees who were dropped; however, adequate due process procedures were in place for less than half of the reporting internship programs. Most of the programs reported having had impaired trainees within the past 5 years who had experienced emotional problems, academic deficiency, personality disorders, or social problems. Emotional therapy, termination, lighter work load, leave of absence, medical therapy, and transfer to another field were all used in resolution of the problems. Prevention strategies included supervision of clinical experience by faculty, assigning a faculty advisor for each student, and rating of faculty by students. The majority of APA internship programs had a non-proactive model. Complaints were made that letters of reference did not accurately describe strengths and weaknesses of applicants, possibly because of fear of legal defamation. Efforts to prevent impairment and to support impaired trainees are needed. (ABL)