Adolescents with intellectual disability are at significant risk for developing concomitant mental health and behavior problems. Youth who experience “dual diagnosis” face great challenges, and require interventions that will promote their autonomy, self-determination, and adaptive functioning. In this article, we devote attention to innovative components that have received less focus, but that we suggest have great relevance for this population, namely those related to attachment and trauma. We review research examining attachment- and trauma-informed care, and highlight practical approaches for which evidence is emerging. We suggest that a comprehensive treatment model must integrate well-validated and innovative treatment approaches, in order to address the complex clinical concerns of this population.