Stereotypes About Clients With Intellectual Disabilities in Addiction Care: Evidence From Flemish Health Care...

Substance use among individuals with intellectual disabilities (ID) remains an underrecognized concern in addiction care. This population faces dual exclusion due to both their disability and their substance use. While clinical guidelines emphasize person-centered approaches, little is known about how addiction care professionals evaluate clients with ID and co‑occurring substance use problems.

Eighty-two addiction care professionals in Flanders (Belgium) completed an online study in which they rated 2 fictional client vignettes, 1 describing a client with ID and 1 without, on clinically relevant treatment evaluations (eg, willingness to accept the client into treatment, perceived motivation, expected adherence, and perceived adequacy of the treatment program the participant uses). Participants also completed a brief set of items assessing general beliefs about people with ID in the context of substance use.

Client ID status was associated with lower ratings of expected treatment adherence and appointment keeping, as well as lower perceived adequacy of the treatment program, and lower perceived sufficiency of knowledge and treatment tools, despite identical clinical information. No group differences emerged for perceived motivation, relapse risk, or behavioral predictability. General belief ratings showed significant disagreement with several negative stereotypes (eg, low motivation, poor prognosis), while participants agreed with items reflecting functional autonomy and normative rights.

ID status influenced several clinically relevant evaluations in substance use treatment contexts. These differences were not accompanied by lower ratings of motivation or higher ratings of behavioral risk, but clients with ID were expected to show lower adherence and participants perceived their current knowledge, tools, and treatment programs as less adequate for supporting these clients. The findings highlight the need for disability-inclusive provider training and better support for adapting addiction care to clients with intellectual disabilities.