In recent years, an increasing number of practitioners in the UK have applied systemic approaches in their work within intellectual disabilities services. Set within a postmodern paradigm, systemic approaches explore the beliefs and contexts that inﬂuence and give meanings to people’s actions and interactions. The approach assumes that all parties are acting in a way that makes sense from their perspective, however problematic the behaviour of any person in the system may appear to others. Practitioners aim to understand the perspectives of the people involved before exploring possibilities for change. Systemic approaches have wide applicability and can be used in a variety of settings: with individuals; families; paid carers; networks of professionals; and with staff teams. Evidence from a variety of sources including, importantly, service users themselves suggests that this approach has a lot to offer. In this roundtable we are aiming to initiate discussion and reﬂections around different ways of incorporating systemic approaches into service contexts and to share examples from our practice that have invigorated and inspired us as well as those that have presented challenges and dilemmas. Haydon will set the context for the discussion; Baum will describe how different services have found ways of applying the systemic approach in their local context; Rikberg Smyly will share the knowledge that has been accumulated by a range of practitioners; and ﬁnally, Lynggaard will highlight some common dilemmas that may arise in this work. Further discussion will be shaped by the questions and interests of participants.