In the field of learning difficulties, there has been a revolution in professional understanding and user aspirations towards delivery of services. Institutional models no longer prevail; language, attitudes and practices have been transformed. And yet these achievements often remain frozen in demonstration projects and special initiatives. This book explores how to turn services and professional practice "inside out", as a means of embedding this culture shift within mainstream services. In the context of an increasingly technocratic and managerialist environment, this book aims to assist practitioners to: apply changing thinking and knowledge to their own practice and facilitate the development of inclusive and fulfilled lives for people with learning difficulties; focus on the creation of a dynamic for change that draws strength from an alliance with the service-user movement; consider how the social work role might be developed to meet the challenge of "making a difference" in the lives of people with learning difficulties. The user voice is emphasised through collaboration between the author and a service user consultancy and training organisation to illustrate key themes. Aimed at social work students and professionals entering the field of learning disability, the text encourages readers to think and question rather than simply providing a manual of good practice. The book will also be of value to more experienced professionals as a review of current practice informing their continuing professional development.