ABSTRACT
The field of intellectual disabilities presents a number of unique challenges to the work of the clinical psychologist. The broad cultural, social and professional environment, or ‘macro-system’, in which the person with an intellectual disability exists has many individual and interrelated components within multiple layers of complexity. Even taking the relatively straightforward context of a person with an intellectual disability who lives with his or her family, there are a range of systemic and professional issues with which the psychologist should be familiar and which must be taken into account in arriving at clinical decisions. This chapter will orientate the reader to some of these systemic variables and provide guidance on consultation and other models for working within complex systems, whilst maintaining the client or service user at the centre of the decision-making process.
