Psychiatrists and other mental health professionals can offer much in the care of patients with intellectual disabilities, including state-of-the-art medication regimens, psychotherapy, and other behavior therapies. Individuals with intellectual disabilities experience the full range of mental illnesses, but are often thought to be incapable of participating in or responding to psychotherapy. The following composite cases illustrate some of the psychotherapy techniques employed in a community psychiatry setting that serves patients with intellectual disabilities and co-occurring mental illness.