{"id":15133,"date":"2025-06-19T15:02:58","date_gmt":"2025-06-19T14:02:58","guid":{"rendered":"https:\/\/www.pdasociety.org.uk\/?page_id=15133"},"modified":"2026-02-04T17:35:25","modified_gmt":"2026-02-04T17:35:25","slug":"healthcare-foundations","status":"publish","type":"page","link":"https:\/\/www.pdasociety.org.uk\/pda2025staging\/research-professional-practice\/health-and-social-care\/healthcare-foundations\/","title":{"rendered":"Healthcare foundations"},"content":{"rendered":"\n[et_pb_section fb_built=”1″ module_id=”healthcare-specific-adjustments-personal-practice” _builder_version=”4.27.4″ _module_preset=”default” background_color=”gcid-d4d84b5e-d061-48e7-894c-a52b4e3d47de” locked=”off” global_colors_info=”{%22gcid-d4d84b5e-d061-48e7-894c-a52b4e3d47de%22:%91%22background_color%22%93}”][et_pb_row _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_heading title=”Adopting a PDA – friendly mindset” _builder_version=”4.27.4″ _module_preset=”default” title_text_align=”left” custom_margin=”0px|0px|0px|0px|false|false” custom_padding=”0px|0px|16px|0px|false|false” hover_enabled=”0″ title_text_align_tablet=”left” title_text_align_phone=”left” title_text_align_last_edited=”on|desktop” locked=”off” global_colors_info=”{}” sticky_enabled=”0″][\/et_pb_heading][et_pb_text _builder_version=”4.27.4″ _module_preset=”default” custom_margin=”0px|0px|0px|0px|false|false” custom_padding=”0px|0px|16px|0px|false|false” custom_padding_tablet=”32px|0px||0px|false|false” custom_padding_phone=”0px||16px||false|false” custom_padding_last_edited=”on|phone” hover_enabled=”0″ text_orientation_tablet=”” text_orientation_phone=”left” text_orientation_last_edited=”on|phone” locked=”off” global_colors_info=”{}” sticky_enabled=”0″]For autistic people with a PDA profile, traditional support approaches can often cause more harm than good. Things like firm routines and hierarchical relationships can increase anxiety and reduce trust.\n\nFor professionals, the right mindset is an important first step in helping manage the anxiety and resistance demands can create. Focusing on understanding, compassion, and co-regulation rather than control or compliance is important. It’s about more than tactics; it\u2019s a philosophy that will help you choose the right approach at the right time. Understanding that stress caused by demands can impact on every area of a PDAers life is a good start. As is knowing that this anxiety gets in the way of being able to do things to keep themselves safe and happy \u2013 and that this is not a choice.\n\nAs a professional working within a system, there may be limitations in the changes you can influence about how your service runs. But anyone can work to build values into the relationships they have with people they support.\n\nThese are three fundamental values that will help you work effectively with PDAers:\n\n1. Trust<\/strong>\nConsistency, warmth, and honesty are key. Treating anxious behaviour as communication (rather than defiance) builds security. When PDAers trust that they\u2019re safe, anxiety subsides, and daily tasks become more manageable.\n\n2. Equity<\/strong>\nRelationships grounded in shared power reduce anxiety. It\u2019s about letting go of control, listening deeply, and negotiating decisions. This approach reassures individuals that you respect their autonomy, reducing tension and the urge to avoid.\n\n3. Compassion<\/strong>\nRecognize distressed behaviour as an anxiety response. This mindset shift can be difficult, but viewing meltdowns or refusal through a compassionate lens fosters more effective engagement.\n\nPDA Society\u2019s PANDA mnemonic outlines ways to introduce the kinds of flexible approaches that tend to help. These aren\u2019t separate strategies to apply one by one but overlapping ideas that support each other.\n\nThe letters stand for:\n
    \n\t
  • P \u2013 Prioritise and Compromise<\/li>\n\t
  • A \u2013 Anxiety Management<\/li>\n\t
  • N \u2013 Negotiation and Collaboration<\/li>\n\t
  • D \u2013 Disguise and Manage Demands<\/li>\n\t
  • A \u2013 Adaptation<\/li>\n<\/ul>\nIt’s helpful to think of PANDA not as a checklist, but as a gentle guide – especially helpful if you\u2019re new to PDA support. The real work happens through connection, curiosity and trial and error.\n\n\u201cHaving a big toolkit means you can be more adaptable in the moment.\u201d\n\nYou can find our guide to PDA approaches for everyone here. It covers the fundamentals that will help you support PDAers you come across. The rest of the information in this guide is healthcare specific.<\/span>[\/et_pb_text][et_pb_heading title=”Mindset change \u2013 challenges & responses” _builder_version=”4.27.4″ _module_preset=”default” title_level=”h2″ title_text_align=”left” custom_margin=”0px|0px|0px|0px|false|false” custom_padding=”0px|0px|16px|0px|false|false” hover_enabled=”0″ title_text_align_tablet=”left” title_text_align_phone=”left” title_text_align_last_edited=”on|desktop” locked=”off” global_colors_info=”{}” sticky_enabled=”0″][\/et_pb_heading][et_pb_text _builder_version=”4.27.4″ _module_preset=”default” custom_margin=”0px|0px|0px|0px|false|false” custom_padding=”0px|0px|16px|0px|false|false” custom_padding_tablet=”32px|0px||0px|false|false” custom_padding_phone=”0px||16px||false|false” custom_padding_last_edited=”on|phone” hover_enabled=”0″ text_orientation_tablet=”” text_orientation_phone=”left” text_orientation_last_edited=”on|phone” locked=”off” global_colors_info=”{}” sticky_enabled=”0″]Moving away from traditional methods-where authority figures give orders and expect compliance-can be hard in health and social care. Staff shortages, strict protocols, and a culture of deferring to professional expertise can send a message that people must \u201cdo as they\u2019re told.\u201d This can be especially difficult for individuals with PDA, who feel high anxiety about demands.<\/span>\n

    Reasons mindset change could be difficult include:<\/span><\/h4>\n<\/span>\n
      \n\t
    • Resource pressures and strict protocols.\n<\/span><\/strong>Many services have rigid schedules and standardized treatment plans. Staff may feel they must push ahead without flexibility. But when a PDAer is anxious or uncertain about giving consent, rigid protocols can worsen resistance and harm trust. Spending time building rapport and adjusting approaches may seem costly at first. In the long run, it prevents missed appointments, stops crises from growing, and improves outcomes.<\/span><\/li>\n\t
    • Assumed compliance.\n<\/span><\/strong>Many services assume that people needing help will obey instructions. There is also an expectation that parents or carers will enforce this compliance. Yet for PDAers, forcing them to comply fails to ease the anxiety driving their avoidance. It can also damage the therapeutic relationship. In social care, it can confirm fears that professionals use power without listening or empathy.<\/span><\/li>\n\t
    • Shifting perspectives on parenting<\/span><\/strong>.\nFamilies of PDAers are often blamed for being \u201clax\u201d or \u201cpermissive\u201d when they choose gentle, cooperative approaches. But Luke Clements warns that parent-blame can hide problems in the system. He points out that professionals sometimes underestimate how hard things are for families. As a result, they judge parents and weaken the partnership needed for effective support. With a PDA profile, less rigid and more inventive parenting is not just a choice; it helps lower anxiety and keep connections strong.<\/span><\/li>\n<\/ul>\n\u201cWhen professionals assume poor parenting rather than acknowledging systemic limitations, the real needs of the child are overlooked, and families can be unjustly blamed.\u201d <\/span>-Adapted from Luke Clements\u2019 discussions on institutional bias<\/span>\n\nFor PDAers, \u201cgood parenting\u201d might look very different from the usual. Parents may use unusual routines, negotiate boundaries, and offer a lot of freedom. While this can clash with older ideas about \u201cfirm authority,\u201d it often reduces stress and supports the child\u2019s wellbeing.<\/span>\n

      Practical suggestions for changing mindsets include:<\/span><\/h4>\n<\/span>\n
        \n\t
      • Reflecting on authority<\/span><\/strong>.\nEncouraging team discussions about who holds power and why. Ask if your protocols can allow more flexibility.<\/span><\/li>\n\t
      • Acknowledging pressures.\n<\/span><\/strong>Recognising that staff and resources are limited. Brainstorm creative ways-like shorter appointment slots or remote options-to meet PDAers\u2019 needs.<\/span><\/li>\n\t
      • Promoting empathy.\n<\/span><\/strong>See anxiety, not defiance. Collaborative approaches reduce stress for both individuals and systems.<\/span><\/li>\n\t
      • Respect parental expertise<\/span><\/strong>.\nParents adjusting their style for a PDA child\u2019s needs are not \u201cfailing.\u201d Invite their insights to shape support plans instead of blaming them.<\/span><\/li>\n<\/ul>\nMoving to a mindset which centers a respect for each person\u2019s anxiety, autonomy, and lived experience can take time. Yet this shift fosters true engagement, lessens stress for everyone, and honours shared decision-making in health and social care.<\/span>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]\n","protected":false},"excerpt":{"rendered":"

        For autistic people with a PDA profile, traditional support approaches can often cause more harm than good. Things like firm routines and hierarchical relationships can increase anxiety and reduce trust. For professionals, the right mindset is an important first step in helping manage the anxiety and resistance demands can create. Focusing on understanding, compassion, and co-regulation rather than control or compliance is important. It’s about more than tactics; it\u2019s a philosophy that will help you choose the right approach at the right time. Understanding that stress caused by demands can impact on every area of a PDAers life is a good start. As is knowing that this anxiety gets in the way of being able to do things to keep themselves safe and happy \u2013 and that this is not a choice. As a professional working within a system, there may be limitations in the changes you can influence about how your service runs. But anyone can work to build values into the relationships they have with people they support. These are three fundamental values that will help you work effectively with PDAers: 1. Trust Consistency, warmth, and honesty are key. Treating anxious behaviour as communication (rather than defiance) builds […]<\/p>\n","protected":false},"author":19,"featured_media":0,"parent":11126,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"course_tag":[352,356,355],"class_list":["post-15133","page","type-page","status-publish","hentry","course_tag-cpd-for-professionals","course_tag-healthcare","course_tag-healthcare-professionals"],"_links":{"self":[{"href":"https:\/\/www.pdasociety.org.uk\/pda2025staging\/wp-json\/wp\/v2\/pages\/15133","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pdasociety.org.uk\/pda2025staging\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.pdasociety.org.uk\/pda2025staging\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.pdasociety.org.uk\/pda2025staging\/wp-json\/wp\/v2\/users\/19"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pdasociety.org.uk\/pda2025staging\/wp-json\/wp\/v2\/comments?post=15133"}],"version-history":[{"count":0,"href":"https:\/\/www.pdasociety.org.uk\/pda2025staging\/wp-json\/wp\/v2\/pages\/15133\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.pdasociety.org.uk\/pda2025staging\/wp-json\/wp\/v2\/pages\/11126"}],"wp:attachment":[{"href":"https:\/\/www.pdasociety.org.uk\/pda2025staging\/wp-json\/wp\/v2\/media?parent=15133"}],"wp:term":[{"taxonomy":"course_tag","embeddable":true,"href":"https:\/\/www.pdasociety.org.uk\/pda2025staging\/wp-json\/wp\/v2\/course_tag?post=15133"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}