Some individuals with intellectual disabilities experience pervasive patterns of feeling and thinking that affect the way in which they relate to others and understand themselves – sometimes so overwhelmingly that they find it difficult to navigate the daily challenges of life. These people can be very complex to support and few learning disability-trained staff have the skills to address their needs. This new and revised edition includes updated content to reflect developments over the last decade towards trauma-informed care, the neurodiversity movement and considering the term ‘personality disorder’. Section one will focus on diagnosis, psychologically-informed approaches, how to provide positive support and facilitate collaborative working relationships between teams and services. Section two will provide practical, proven strategies for addressing specific issues such as suicidal behaviour, emotional distress and regulating impulses, and for promoting wellbeing for staff and those they care for.