Increasingly, clinicians are encountering Autistic clients who are difficult to engage using traditional therapeutic approaches. Often described as ‘resistant’, ‘non-compliant’, or ‘unmotivated’, these presentations may be better understood through the lens of Pathological Demand Avoidance (PDA), or a persistent drive for autonomy. This profile is characterised by an elevated sensitivity to perceived demands, where everyday expectations can trigger significant threat responses and avoidance.
Following on from their earlier webinar, Identifying PDA, this presentation explores what this profile means in practice. Supporting clients with a PDA profile often requires clinicians to reconsider assumptions about engagement, motivation, and progress in therapy. Approaches that rely heavily on structure, direct questioning, or graded exposure may, at times, contribute to increased distress or disengagement if not flexibly applied.
This presentation will provide a practical, clinically grounded framework for engaging and supporting clients with a PDA profile. It will explore how to build rapport while minimising perceived demand, use indirect and flexible communication strategies, and respond to avoidance in ways that reduce escalation. Adaptations to commonly used therapeutic approaches, such as graded exposure and behavioural activation, will be discussed, with a focus on when and how these can be applied without compromising the client’s sense of autonomy.
In addition to in-session work, the presentation will address the clinician’s role in supporting broader systems. Guidance will be provided on working with families and schools to shift from compliance-based approaches toward more collaborative, autonomy-supportive strategies, reducing escalation cycles and improving understanding and consistency across environments.
Attention will also be given to clinician variables including flexibility, expectation management, and our own nervous system regulation. Participants will be encouraged to reflect on their own practice and consider small but meaningful adjustments that can support more effective therapeutic relationships.
Learning Outcomes
By the end of this webinar, participants will be able to:
- Identify why traditional therapeutic approaches may be less effective
- Apply practical strategies to support engagement and reduce threat responses
- Adapt therapeutic techniques to better suit PDA presentations
- Working more effectively within systems to support our PDA clients
About our presenters: Dr Theresa Kidd and Dr Miriam Kirby
Dr Theresa Kidd is a psychologist with clinical endorsement, a research fellow, and clinical director of The Kidd Clinic, a private, bicoastal psychology and allied health practice across Melbourne and Perth. Her work focuses on Autism, Pathological Demand Avoidance (PDA), ADHD, and mental health across the lifespan. Dr Kidd works to support Autistic people and the larger community by providing affirming psychological services, education, and advocating for inclusive, strengths-based approaches. Her experiences as a neurodivergent parent within a neurodivergent family, including children with PDA, shape her commitment to enhancing the well-being of neurodivergent families.
Theresa is dedicated to equitable education and employment and practical, research-based psychological services. Her early work was in disability and employment services before her honour’s degree where she researched the experiences of mothers’ home educating their Autistic children. Her PhD focused on adapting a family-based, cognitive-behavioural therapy program to help Autistic adolescents manage anxiety. Concurrently, she co-developed and directed the Curtin University Autism Peer Mentoring Program, supporting Autistic students in navigating university life and beyond. Later, during her postdoctoral fellowship at Macquarie University, she led a national trial aimed at reducing anxiety and bullying victimisation among children.
As a respected speaker, Theresa presents both nationally and internationally on Autism, PDA, ADHD, mental health, and the transition to adulthood for Autistic and PDA young people. She supervises clinicians in neurodiversity-affirming practices and has co-authored several publications, including her recent book, Helping Autistic Teens to Manage Their Anxiety, a valuable resource for families and allied health professionals alike.
Dr Miriam Kirby is a psychologist with clinical endorsement who has worked within the areas of Autism and Mental Health for over 20 years. She is committed to helping neurodivergent individuals of all ages to understand their identity, identify and advocate for supports and accommodations, and manage co-occurring mental health conditions across different settings.
Miriam has a particular interest in supporting Autistic women and girls from a neurodiversity affirming perspective, including those who have been identified as Autistic later in life, inspiring her to pursue her own late diagnosis. In this space, she undertakes Autism assessments, provides therapeutic support (individually and in group settings), and provides training and development opportunities to other clinicians, educators, parents, and community members. Miriam also has experience with identifying and supporting individuals who present with the Pathological Demand Avoidance (PDA) profile associated with Autism. She provides parent support sessions, problem solving sessions and consultancy to assist parents and educators to more fully understand the young person they are supporting and provide PDA-informed recommendations to improve educational engagement, social connection, emotion regulation, positive self-identity, transition into adulthood, and burnout prevention.
In addition to her clinical work, Miriam is the Training and Consultancy Lead at The Kidd Clinic, and regularly facilitates training for parents, educators and professionals on topics such as Autism and co-occurring mental health conditions, Pathological Demand Avoidance, and neurodiversity in the workplace.
Webinar timing: 1:00 – 2:00 PM AEST
Access to the recording of this webinar: A recording of this webinar will be available through the CPD Webinar Library, but for the best experience and the opportunity to ask your questions, join us live. Everyone who registers will be advised via email as soon as the recording is available. Members have unlimited access to the recording, and non-members will have access for 6 months.