This qualitative research project looked at the issue of exploitation and abuse in the lives of women with developmental disabilities. The research considered the issue related to the construct of self-determination, a concept that considers both internal and external factors in determining a persons agency in acting in a self-determined manner. Eight women with cognitive disabilities participated in 12 focus group sessions, designed to gain information about internal and external factors related to self-determination that mediated the experience and aftermath. To gather information about internal factors, the participants were queried about personal qualities and characteristics that helped them deal with abuse and exploitation, as well as skills they believed would have been helpful. To look at the external factors that impacted their ability to act in self-determined ways, they were asked aboutwhat help they received from others as well as what barriers they encountered. The participants identified a number of personal qualities that helped them deal with the abuse and its aftermath. They also targeted skills they felt would have helped them better deal with the issue. They also identified significant attitudinal and systemic barriers that negatively impacted their ability to make decisions or deal with issues related to the abuse and exploitation. The research found that while some attention should be given to individual skills development to enhance capacity for self-determination, there is significant work to be done at community and systemic levels. As long as the external barriers remain in place, it will be hard for women with cognitive disabilities to exercise true decision making across of a range of options that could mediate the exploitation and abuse.