Pathological Demand Avoidance (PDA) – Reviewing Client Progress

In Episode 336 of the Counselling Tutor Podcast, your hosts Rory Lees-Oakes and Ken Kelly take us through this week’s three topics:

Firstly, in ‘Ethical, Sustainable Practice’, we look at building your counselling CV – including key features to include, ways to stand out, and how to present yourself professionally.

Then in ‘Practice Matters’, Rory speaks with Nicola Durrant about working with clients who have Pathological Demand Avoidance (PDA) – a profile on the autism spectrum that requires a unique and flexible therapeutic approach.

And lastly in ‘Student Services’, Rory and Ken look at how to review a client’s progress in therapy – and why it’s an important part of ethical and effective practice.

Building your Counselling CV  [starts at 03:31 mins]

A counselling CV is your first professional impression – and it should reflect not only your qualifications but also your values and personal qualities. In this section, Rory and Ken explore what makes an effective and authentic CV:

Start by making sure it’s well-structured and no more than 2–4 pages.

Tailor it to each job, making sure you reflect the ethos of the organisation you’re applying to.

Be honest about your experience, but also include transferable skills such as active listening, communication, and resilience.

Include professional memberships, ethical awareness, and a commitment to personal development.

A personal statement can be a great way to communicate your motivation, values, and readiness for the role.

If you’ve done any research or CPD, mention this too – especially if it aligns with the organisation’s client group or focus.

Ask a peer or supervisor to read your CV and give feedback – having a second pair of eyes helps spot anything you may have missed.

Pathological Demand Avoidance (PDA) [starts at 29:46 mins]

In this week’s Practice Matters, Rory speaks with Nicola Durrant about Pathological Demand Avoidance (PDA) – a profile on the autism spectrum characterised by a high level of anxiety around everyday demands.

The key points of this conversation include:

PDA is a survival response to perceived demands – it is not about control or defiance.

People with PDA often mask their anxiety, especially in school or social environments, and release it later in safe spaces like home.

Therapy must be collaborative and low-pressure – avoid direct demands and use invitational language like “I wonder if…”

Strategies such as co-regulation, emotional literacy, and flexible structure help support clients with PDA.

Trauma-informed practice is essential – the behaviours often resemble trauma responses such as fight, flight, or freeze.

Adults with PDA don’t outgrow it – they learn how to manage demands and environments that help them feel safe and in control.

Reviewing Client Progress [starts at 54:29 mins]

Reviewing client progress is a core part of ethical practice, particularly in short-term therapy or student placements. In this section, Rory and Ken look at why reviews are important and how to approach them:

Reviews allow the client to reflect on progress, clarify goals, and express what has been helpful or challenging.

This also supports therapist development and helps guide future sessions.

You can carry out a review through conversation or using tools like the CORE-10 assessment.

Let clients know at the start that a review will happen mid-way through the work – this makes it feel natural and expected.

Adapt the review timing to the client’s progress and needs – it doesn’t have to be exactly session six.

Ask questions like “How do you feel things are going so far?” or “Is there anything you’d like to change or focus on more?”

Use supervision to reflect on what comes up in client reviews – this can strengthen your awareness and planning for the second half of therapy.