Engaging with parents and caregivers of children and teens with PDA through regular sessions is crucial for overall efficacy of play therapy with PDAers. The sessions begin by helping them understand how PDA shows up for their child and what approaches and techniques might help them better support, understand, and build a stronger relationship with their child. The therapist can share perspectives, benefits, and resources related to non-directive play therapy and other adjunctive therapy services to help create a wrap-around supportive environment for them and their child. With direct rapport built with parents, the therapist can directly share information and troubleshoot challenges in the necessary shifts to low demand and agency-centered parenting approaches. It also offers the therapist an opportunity to provide compassion and encouragement to the parents in ways that then help them better provide it to their child, thus improving the parent-child relationship.

Burnout is a very common experience for clients of all ages with PDA to struggle with, and may show up as intense behaviors and emotions like school or work avoidance, severe anxiety, compulsive body focused behaviors, treatment resistant depression, self-harm, and suicidality. There are also unique recovery challenges for the PDA neurotype because approaches commonly recommended for these challenges may reduce the necessary sense of agency and backfire by increasing burnout symptoms. The use of play therapy and creativity can uniquely help identify PDA burnout, as well as support them in burnout recovery and moving towards growth.

Demands, limits, and boundaries are often one of the most challenging aspects in the relationship between parents and PDAers, and for PDAers across the lifespan with themselves. Demand avoidance and the need for a strong sense of agency in life can connect with PDA burnout and make it difficult to meet personal, relational, larger life goals. Concepts of limit testing, ACT limit setting from Child Centered Play Therapy, and approaches from low demand parenting for PDAers can be utilized to support both parents of PDAers and PDAers themselves in better understanding how to meet their needs for agency while also identifying and moving towards their goals.