A narrative systematic review of the literature focused on how shame and shame-based processes may play a significant role in the development and maintenance of psychological distress in adults with ID. The review identified 17 relevant studies that had investigated shame in some form. Findings indicated that adults with mild to moderate ID appear to experience both external and internal shame, and that this was associated with elevated levels of psychological distress. However, the scope of the review was limited by the fact that many studies were cross-sectional in nature, and that very little research involved clinical populations. The review concluded by attempting to synthesise the current available research into an explanatory biopsychosocial model of how shame develops in adults with ID, and recommending the development of compassion-focused interventions that might alleviate shame in this population. The empirical study utilised a mixed methods design to investigate the feasibility and acceptability of adapting group CFT for adults with mild ID. Six participants completed session-by-session feasibility and acceptability measures, attended focus groups, and completed pre and post-intervention measures of self-compassion, psychological distress, and social comparison. Focus groups were analysed using thematic analysis, identifying four main themes: (1) motivations for attending; (2) direct group experiences; (3) difficulties in being self-compassionate; and (4) positive emotional changes. Significant increases in overall self-compassion, and significant reductions in self-criticism and unfavourable social comparison, were found. Results indicate that CFT can be feasibly adapted for adults with ID, and is experienced as a helpful intervention. Some issues remain surrounding level of understanding of some conceptual aspects of CFT, and whether this is relevant to outcomes. Implications for future research and clinical practice are further explored.