Psychoanalytic psychotherapy is a new development in the treatment of people with learning disabilities and mental health problems, which traditionally has utilised behavioural management and limited counselling. The papers collected here have evolved from the work of the pioneering Learning Disabilities Service at the Tavistock Clinic, London, which is made up from specialised professionals from the fields of psychology, psychiatry, child and adolescent psychotherapy, adult psychotherapy and social work. The service mainly offers individual psychotherapy but also provides group work, parent work, family therapy and consultative work with professionals where necessary.