This article updates and adds to the literature on graduate trainee impairment provided by L. Forrest, N. Elman, S. Gizara, and T. Vacha-Haase (1999) in their comprehensive literature review. Based on recommendations by Forrest et al., a program model for dealing with impaired trainees is proposed. The 5-step therapeutic process model includes (a) informed consent, (b) intake and assessment, (c) evaluation, (d) treatment planning and follow-up, and (e) termination. Each step is explained within the context of graduate training programs, and key points to consider are discussed.