Accessible summary One in four people with a severe learning disability harm themselves. This affects their health and quality of life. This study looks at research on helping people who harm themselves. More research needs to be done to find better ways of helping people who harm themselves. SummaryEstimates suggest that up to one quarter of people who have a severe learning disability engage in self injurious behaviour (SIB). SIB poses serious risks, both to the person’s physical health and their quality of life. Behavioural approaches have made a contribution to supporting people who engage in SIB, although the last review of these approaches was completed in 2001. The current study provides an update to this review, and has considered papers published over the last 10 years. A systematic search of peer reviewed journals and the ‘grey’ literature identified 34 relevant documents, the majority of which were single case studies. These papers tended to report only on changes in the frequency of SIB during the intervention; one cannot conclude, therefore, about the long term efficacy and generalisability of these approaches. Reductions in SIB were highly variable, often produced in controlled environments and with the use of aversive interventions. The current study presents implications for research and clinical practice and highlights the need for more research reporting on the effectiveness of new interventions such as positive behavioural support.