Aim: To compare the nature and use of procedures employed to treat and manage CB in community settings for people with intellectual disabilities and severe CB: non-congregate settings where the minority of residents have CB and congregate settings where the majority have CB. Method: Longitudinal matched groups (n = 25) design. Outcome measures: the nature and prevalence of use of procedures used to treat and manage CB, observed and reported severity of CB. Results: Both types of setting was associated with low prevalence of use of behavioural technologies for the reduction of CB (>15% of residents). High proportions received anti-psychotic medication in non-congregate (56%) and congregate (80%) settings. Congregate settings were associated with the increased use of physical restraint as a reactive management strategy (50+% of residents received physical restraint by two or more members of staff). Change over time in reported and observed CB was slight but suggested better outcomes were associated with non-congregate settings. Conclusions: The use of evidence-based behavioural technologies for the reduction of CB in the place of anti-psychotic medication may have led to better outcome.