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Chapter 8202Intellectual Disabilities, Challenging Behaviour and Involuntary CarePeople with intellectual disabilities have significant limitations in intellectual functioning and adaptive behaviour. Due to these limitations they experience difficulties in expressing their wishes and needs. They often rely on nonverbal communication, which can be ambiguous and challenging for care professionals to interpret accurately. It is up to care professionals and family members to notice and interpret communication and tailor care and support to clients%u2019 needs and wishes. Matching these interactions between clients, their relatives and care professionals can be difficult, often leading to miscommunication, distress, and challenging situations with extreme forms of problematic behaviour. Within the field of intellectual disability care, this type of behaviour is called challenging behaviour, which includes both internalizing behaviour (like anxiety and self-harm) and externalizing behaviour (such as aggression). To prevent people with intellectual disabilities and challenging behaviour from harm care staff use involuntary care, such as restrictive and coercive measures. However, people with intellectual disabilities often rated the use of these forms of involuntary care negatively, because these measures caused increased feelings of powerlessness, distress, anxiety, and frustration. Moreover, these feelings often exacerbate the behaviour that prompted the application of involuntary care.The Care and Coercion Act (CCA) in the Netherlands strengthens the rights of clients with intellectual disabilities to self-determine the nature and form of their care. The act emphasises that care must be provided as voluntary as possible and aims to reduce involuntary care. However, implementing this law is challenging due to its complexity and the demanding nature of documenting compliance. Care professionals often struggle to balance safety and autonomy, sometimes resorting to restrictive measures out of fear and frustration. To aid care organisations in doing their work in accordance with the law, three innovative methods have been developed:1 Needs Assessment Framework (NAF): An online tool to help care professionals consider the perspectives of clients with intellectual disabilities when deciding on involuntary care.2 Multi-Disciplinary Expertise Team (MDET)-method: Aimed at reducing involuntary care by providing multi-level interventions.