Background Sexual abuse has been associated with trauma, low self-esteem, anger, depression and challenging behaviours. This pilot study builds on a small published literature by evaluating a survivors group (SG) for women with an intellectual disability and an educational support group (ESG) for their carers. Method The SG was delivered weekly over 5 months for 20 sessions and the ESG ran concurrently for their seven carers in a separate room within the same communitybased building. Participants were helped to build trust and rapport, provided with education about sexual abuse designed for their level of ability, and helped to reprocess the trauma of their sexual abuse. Results Both the SG and the ESG were evaluated using a repeated-measures design (double baseline, mid-treatment, post-treatment and follow up), to see whether there was any improvement in relevant clinical dependent variables associated with the consequences of sexual abuse (i.e. trauma, self-esteem, anger, depression and challenging behaviour). Improvements occurred in sexual knowledge, trauma and depression. Neither self-esteem nor anger improved for most of the SG and challenging behaviour worsened at first before improving. Conclusions The SG seemed to be successful in improving sexual knowledge and in reducing trauma and depression, although challenging behaviours worsened at first before improving. There is a need for more sexual abuse/sexual education groups for men and women with intellectual disabilities.

Accessible summary• People with learning disabilities are more likely to experience sexual things happening to them when they do not want them to. This is called sexual abuse. • A group was started to help women who have been sexually abused. The group met once a week and lasted for 20 weeks. • Women who were interested in attending this group were given information about it and asked on three separate occasions if they wanted to attend. • Seven women with learning disabilities took part in the group and their carers helped them travel to the group and then went into a separate carers group upstairs. After the groups had finished the carers helped the women get home again. • Some of the women found it very difficult to talk about the sexual abuse that had happened to them. At first they felt very upset and two women hurt themselves. Everybody felt angry about what had happened and it was good to hear they were not alone. • After several months the group helped the women feel less scared and depressed and helped the women's carers understand them better. • This research matters because it helped the women move on with their lives and will help others who want to start a survivors' of sexual abuse group.

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This paper examines society's unconscious refusal to welcome people with intellectual disabilities from the margins of society, with particular focus on a specific manifestation of this enactment of social exclusion by the psychotherapy profession. I form connections between a societal disavowal of the human rights of people with intellectual disabilities and the psychotherapy world's paranoid fears of inviting the socially and cognitively excluded into its consulting rooms. Through an examination of the notion of social exclusion and cognitive deficit being mutually sustaining phenomena, I explore the detaching of people with intellectual disabilities from social relations and institutions, using as my main example the relative failure of contemporary psychotherapy in its various forms to include this patient group in its range of possible beneficiaries. Using various aspects of intersubjective, object relational and organisational perspectives, I consider the improbability of people with mild, moderate and severe intellectual disabilities reaching the apex of our globalised western society, and the various social ruptures that conspire to deny those with cognitive deficits a place at the social, economic, political and psychological table. I compare some literary representations of intellectual disability with more contemporary televisual portrayals, and consider the possibility of social inclusion through a rejection of a social model of disability that creates an artificial boundary between the 'disabled' and the 'non-disabled'.

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