Disasters continue to result in significant losses in developed and developing countries. The impact becomes more severe when the disaster has the potential to topple the nation- economically and socially. This is the case of Small Island Developing States (SIDS) and is of more concern in view of climate change projected impacts from extremes in rainfall, temperature and sea level rise. This paper focuses on the integrated approaches to Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) or DRR-CCA in SIDS. This is arguably the most rational approach for addressing hazards of common interest from future and current climate extremes. DRR-CCA has had some traction in SIDS, nonetheless the scale of operationalisation at the national level to influence marked reductions in risk has been deficient.This paper investigates the effect of risk governance processes for DRR-CCA. Using the case of Barbados a thematic analysis is presented of 40 interviews and surveys with representatives of 27 CCA and DRR organisations operating at different levels. The absence of an overarching framework and shallow engagement of community, scientific, private and social sectors was found to reduce the potential for DRR-CCA. At all levels it was found that misconceptions concerning roles, mandates, and required inputs were inhibiting progress in deriving sustainability. A prevailing response culture and an embryonic risk reduction discourse that had not sufficiently transitioned beyond development planning control were found to be inhibiting factors for DRR-CCA. Notwithstanding this it was found that providing response connections was a necessary bridge for effective DRR-CCA.