Wednesday, 28 July 2021

PDA in the Therapy Room (Book Review)

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I was recently sent a copy of the book PDA in the Therapy Room to review and I wondered if it might not be particularly relevant for me or other parents, given that the subtitle is 'A Clinician's Guide to Working with Children with Pathological Demand Avoidance'. However, I would totally recommend it to other parents, carers and educators and I will attempt to explain why below....
Book cover with picture of a child and adult in a painting session, with text of book title PDA in the therapy room

I'll freely admit, therapy is not something I ever thought my girls would need, given that I haven't ever had any myself. It's not that I didn't believe in it, more that it wasn't on my radar. I've often described this blog as free therapy, so maybe it's just that I've been lucky to have this as an outlet.

In the last few weeks, our daughter with PDA began having some art therapy. Art therapy is something that she initially accessed many years ago, thanks to a very understanding and supportive primary school. Talking can be difficult for children who have communication difficulties and therapy may need to be approached in different ways - especially for those with PDA. 

There was no point in me trying to persuade Sasha to go for therapy; she had to want to do it herself. During a recent car journey back from school, where she's been having some trial sessions, she had become upset about there being no other children in the lesson with her. She so desperately wants to mix with other children her own age and to feel like she is part of a community and sadly that opportunity has not yet been offered to her. I can tell there's a lot of emotion and thoughts going on in her head about this, but conversation is not her strong point and our chances to chat openly are limited. When she voiced her feelings that she would like it if someone could read her mind and everything that is going on in it, and for that person to tell her she is not weird, I figured that suggesting some therapy might be worth a try.

We found a great team in our county who are very experienced in dealing with autistic children, and those with social and emotional difficulties. Their website states

Alongside of ASD / ADHD - the co morbidity of having a mental health disorder is around the 90% mark. That means that 90% of children whom are autistic, or have ADHD suffer with a mental health condition such as anxiety disorders, depression, OCD, Psychosis , eating disorders etc. Through my research, experience and also my own lived experience as an SEN parent I know that waiting lists for mental health services is long , and when the support arrives it is often generic and short term...

Even though the therapy rooms are a 30 minute drive away from us, Sasha has been happy to go there for the past few weeks - and this is nothing short of amazing for a girl who finds leaving the house at all very challenging. I think there is more art than talking taking place currently but it's all a process and I am willing to take the time to see what happens.

Back to the book. PDA in the Therapy Room was written by Raelene Dundon, an educational and developmental psychologist based in Australia. She has a range of experience of working with children with developmental disabilities as well as typically developing children. This book is a guide to effective strategies or ways of helping children with PDA, adapting conventional modes of therapy to suit their needs. Indirect techniques such as play based therapy or trauma-informed approaches enable the child to process their experiences on their own terms.

There are ten chapters, beginning with 'What is PDA?' and 'How might therapy assist individuals with PDA?', onto what to consider when working with children with PDA, how to support families and practical therapy activities. There's also a whole chapter on 'troubleshooting' and what to do when things are not going as you hoped.

The first paragraph in the introduction jumped out at me:

When I first learned about Pathological Demand Avoidance (PDA), it was a true light bulb moment. I had been specializing in supporting Autistic children and their families for over 10 years, but every so often I would see a child who wouldn't respond to the supports I had usually found effective.

Adult PDAers such as Kristy Forbes and Harry Thompson, along with others, have shared their unique insights and knowledge for this book and there is a great appendix full of links, information and resources on PDA. There's also so much more in this book which parents and carers might relate to, such as the following text from the chapter about supporting families:

Another area in which parents often need considerable support is when advocating for their child in education settings. One of the biggest difficulties families seem to face in schools is convincing educators that PDA is a real condition, and that PDAers need different supports to more classically presenting Autistic students.

I can already see in my mind many parents and carers nodding along to this. There are some case studies in the troubleshooting section which give an idea of how to put some approaches into real life. Raelene is someone who really 'gets' PDA and who understands the challenges posed by others rather than by the children themselves. Honestly there is so much good in this book that I'm sure I will be reading it more than once! Available to purchase from Amazon via this link: PDA in the Therapy Room

Back cover of PDA in the therapy room book






For more information about PDA, please read the book shown below: 
* this is an affiliate link and I may receive a small commission if you click and go on to buy anything. It won't cost you any extra.
Book cover for Understanding pathological demand avoidance syndrome in children, by Phil christie, margaret duncan, zara healy and ruth fidler
(Other PDA books can be found in my 

To find out more about our experiences, please check out our 'About Us' page or the summary of our experience in Our PDA Story Week 35. If you are looking for more online reading about Pathological Demand Avoidance, the posts below may help.


What is PDA (Pathological Demand Avoidance)?


Ten things you need to know about Pathological Demand Avoidance


Does my child have Pathological Demand Avoidance?


The difference between PDA and ODD


Strategies for PDA (Pathological Demand Avoidance)


Pathological Demand Avoidance: Strategies for Schools


Challenging Behaviour and PDA


Is Pathological Demand Avoidance real?


Autism with demand avoidance or Pathological Demand Avoidance?




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