Background  Historically, adults with intellectual disabilities have had little access to individual psychotherapy. Over the last 20 years an increasing body of literature has described psychotherapy with this client group and reported methods for adapting traditional psychotherapeutic techniques. Method  The current review identified the frequency of adaptations suggested by Hurley et al. (1998) [Journal of Developmental and Physical Disabilities, vol. 10, pp. 365–386] within cognitive behavioural and psychodynamic studies with adults with intellectual disabilities. Twenty‐five studies were reviewed, 10 cognitive–behavioural and 15 psychodynamic. Results  A total of 94 adaptations were identified. Within cognitive behavioural therapy (CBT) studies, flexibility in method was the most frequently considered adaptation whilst transference and countertransference issues were most frequently considered within psychodynamic studies. Across the two approaches, disability and rehabilitation issues were given the least consideration. Conclusions  Implications for practitioners and services are highlighted along with recommendations for future research.

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Acting on voices can be conceptualized as a form of safety seeking, associated with maintaining beliefs about voice omnipotence and distress.