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Summary The evidence base for interventions for people with learning disabilities who have experienced a bereavement is sparse. This article reviews current theoretical understandings of bereavement and loss and describes the assessment, formulation and psychological treatment of a woman with learning disabilities with close reference to these understandings. A psychological intervention is described, which utilizes both psycho‐educational and psychodynamic approaches.

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Background People with intellectual disability experience a higher prevalence of dementia, at an earlier age, than the general population. The aim of this review was to establish the psychological interventions and outcomes for individuals with intellectual disability and dementia. Methods A search of eight electronic databases and reference lists of all included articles was conducted using PRISMA guidelines. Data were synthesized using an integrative method. Results Initial searching produced 2,331 papers. Twenty‐one studies met the inclusion criteria. Interventions were deductively categorized into behavioural, systemic and therapeutic. All studies reported positive findings for individuals and for the systems which support them, but limited by methodological issues and neglect of the direct experience and impact on individuals themselves. Conclusions The findings are discussed in relation to the wider literature and evidence base. Future research should aim to adopt methodologically robust designs that are inclusive of the individual experience of people with intellectual disability.

Accessible summary Systemic practice is about working with all the people who are important in someone’s life. Important people, such as friends and family, are seen as the ‘system’ around a person. This way of working does not see the problem as belonging to one person, but as belonging to the whole system. Psychodynamic psychotherapy is about trying to understand what’s happened in someone’s past and how this might be affecting their life today. People sometimes find themselves getting into the same difficulties in relationships again and again. This way of working tries to understand why the person has become ‘stuck’ in this way. The therapist will think about the client’s feelings and wishes about their life and their relationships. They will also think about the relationship that grows between therapist and client. Talking about the relationship between therapist and client can help people to understand problems that they have in other relationships. This case study shows how psychological theory can help the therapist to decide what to do in therapy and how best to work with the client/s in understanding the problem. SummaryThis paper describes the process of couple therapy with a client who has a mild learning disability and cerebral palsy, and her partner, who also has cerebral palsy (all information has been anonymised and pseudonyms are used throughout). Informed consent was gained from both individuals for the purposes of writing about their case. Therapy spanned twelve sessions and was informed by systemic and psychodynamic ways of thinking. Formulations are discussed, and psychological theory is linked to what happened in the therapy room. The current study takes a reflective stance and discusses the process of therapy, which includes successes as well as pitfalls. Pertinent issues for people with learning disabilities are discussed in terms of power dynamics, the impact of physical disability, capacity to consent to therapy and the effects of abuse.