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Creative Therapy Adelaide


Music Therapy and PDA

Author: Rowan Harding, Registered Music Therapist

Music Therapy and PDA

This photograph is for illustrative purposes only and does not represent the person featured in this case study.

Participant’s Situation

Autism Spectrum Disorder with A Profile of Pathological Demand Avoidance.

Therapy Goal

For Jake to develop and build his self-confidence to relate to others. 

Areas of Intervention

Songwriting, therapeutic singing

Benefits Gained Through Therapy

Built the confidence to first express himself and to show himself to others, then subsequently felt safe enough to explore singing in front of others, followed by singing with others.


Jake is a quiet and reclusive 15-year-old navigating adolescence alongside a recent diagnosis of the autistic profile of pathological demand avoidance (PDA). PDA is used to describe a profile of individuals who exhibit extreme resistance to everyday demands and requests. This behavioural pattern goes beyond what is typically observed in individuals with autism, characterised by an intense need to avoid and resist demands or expectations from others. Individuals with PDA may engage in strategies such as defiance, avoidance, or negotiation as a way of coping with perceived demands, which can significantly impact their daily functioning and interpersonal relationships. 

Digitally creating songs using the app GarageBand in collaboration with the Registered Music Therapist, became the space for Jake to explore self-expression within a safe and contained space. The RMT built upon Jake’s thoughts and ideas, particularly his affinity for crafting self-created monster sounds, which evolved into full compositions, with harmony and orchestration.

Collaborative music-making sessions became a space for shared creation, reducing the isolating barriers accompanying PDA. In this inclusive musical space, Jake began to explore singing in front of the music therapist. Over a series of weeks, Jake’s confidence grew and was willing to sing in front of the RMT and his support workers, and now Jake was open to singing in front of multiple people.

In the safe context of a therapeutic relationship with his RMT, music therapy not only provided Jake with a means of self-expression, but also served as a catalyst for personal growth and social connection. Through collaborative music-making and the guidance of his therapist, Jake found a pathway to navigate the complexities of adolescence and embrace his identity with confidence using tools that leveraged on his strengths and interests.

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