Arguably, the most important outcome measure for services to people with intellectual disabilities is quality of life. Quality of life has been defined in numerous ways and may consist of many aspects, including physical, material, and emotional well-being, as well as interpersonal relationships, personal development, self-determination, social inclusion, and civic rights. However, the most important aspect is social inclusion. People with intellectual disabilities who show challenging behavior, however, often make other people uncomfortable so that social inclusion is more difficult, and evidence suggests that both children and adults with intellectual disabilities and challenging behavior (and their families) have poorer quality of life and more restrictions in their lives than others with intellectual disabilities. Examination of the psychosocial aspects of quality of life indicates that modern services are still not good at providing people with challenging behavior with opportunities for making relationships, employment, and social inclusion. We need to improve our ability to target these areas of quality of life, particularly social inclusion for people with challenging behavior.