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The purpose of this study was to gain firsthand qualitative information about the experience of self-injurious behavior (SIB) by asking the 79 participants to describe their experiences before, during, and after SIB. Students with a history of SIB were separated into two groups: those students who self-injured only once and those who had harmed themselves multiple times. The most common experiences for both groups directly before SIB were feeling depressed, angry, and out of control, but the two groups reported different experiences during and after SIB.

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Accessible summary• People with profound learning disabilities can find it difficult to talk about someone they love who has died.• This study is about how we used a memory box to help a bereaved young woman with profound learning disabilities.• The memory box helped the bereaved young woman, her mother and paid carers to explore memories about important relationships in her life.• It might be helpful to talk about relationships when helping someone with profound learning disabilities who is bereaved. SummarySupporting bereaved people with profound learning disabilities still remains an under-researched area. Moreover, the barriers of communication and disenfranchised grief mean that they often do not receive the support they require, leading to emotional and behavioural difficulties. This article describes research using a case study design, which explored how memory box work was used to support the bereavement process with one young woman, Claire and the outcomes for Claire and her family. Exploring the history of the relationship between Claire and her brother, the work also benefitted her mother and her paid carers.

Engaging people with profound intellectual and multiple disabilities (PIMD) in relation to issues of bereavement and loss may be seen as a complex therapeutic challenge. The author examines the barriers preventing them from engaging with therapeutic approaches and note that the extent to which the person engages with the grieving process partly depends upon how they are enabled to overcome these challenges. Through the lens of Worden's (2008) model, the author provides an assessment of the social, emotional and physical constraints that affect the person's experience of bereavement. Within this framework, suggestions and approaches for support are offered. This conceptual paper can be used to bridge the gap between theory and therapeutic practice, and provides the basis for future research involving this group.