Discussion Summary: This Growth Group explored Dr. Ross Greene's Collaborative & Proactive Solutions (CPS) model as a framework for understanding and addressing challenging behavior through collaboration rather than compliance. Members discussed how the model shifts the focus from managing behaviors to identifying the underlying unsolved problems and lagging skills contributing to those behaviors. The discussion emphasized that CPS is a model rather than a therapy, making it applicable across a variety of settings, including parent coaching, schools, and clinical practice. Members reflected on how the approach aligns with neurodiversity-affirming practice by prioritizing perspective-taking, empathy, and collaborative problem solving. Key Discussion Points: CPS emphasizes identifying unsolved problems rather than focusing solely on challenging behaviors. -The Empathy Step is foundational and requires genuine curiosity about the individual's perspective before attempting to solve problems. -Defining the unsolved problem clearly is often one of the most challenging aspects of implementing the model. -CPS requires flexibility; if an individual is highly dysregulated, the empathy conversation may need to wait until they are ready to participate. -Parent involvement is essential for successful implementation across environments. -The group discussed using future Growth Groups to practice writing unsolved problems and role-playing the Empathy Step using real clinical scenarios. Clinical Reflections: Members discussed how CPS represents a shift away from traditional skill-based or compliance-focused interventions toward collaborative problem solving. The conversation highlighted the importance of perspective-taking, recognizing that behavior reflects underlying challenges rather than intentional noncompliance. The group also acknowledged that implementing CPS requires practice and that even experienced clinicians continue refining their skills. Rather than striving for perfection, the emphasis is on maintaining curiosity, empathy, and collaboration throughout the problem-solving process. Further Learning: -Dr. Ross Greene's Collaborative & Proactive Solutions (CPS) model -The ASAP framework and Empathy Step -Free CPS training materials and videos available through Lives in the Balance

Discussion Summary: This Growth Group explored the current evidence surrounding Pathological Demand Avoidance (PDA) in response to increasing numbers of families seeking information or identifying their children with a PDA profile. The discussion centered on a 2021 systematic review and examined the strengths and limitations of the existing research. Members discussed the lack of consensus regarding PDA as a distinct clinical entity, concerns about research methodology, and the importance of distinguishing observable behaviors from underlying factors such as anxiety, executive functioning challenges, trauma, sensory differences, or autistic experiences. The group also explored how clinicians can acknowledge families' experiences while remaining grounded in current evidence and maintaining therapeutic rapport. Key Discussion Points: -PDA is not currently recognized as a diagnosis in the DSM or ICD. -Existing research remains limited, with much of the literature relying heavily on parent-report data and self-selected samples. -Many behaviors described as "demand avoidance" may reflect underlying anxiety, sensory differences, executive functioning challenges, trauma, or environmental mismatches rather than a distinct disorder. -Removing all demands may reduce distress in the short term but may also limit opportunities for developing independence, coping skills, and executive functioning. -Supporting parents through validation, education, and collaborative problem-solving may be more helpful than focusing solely on diagnostic labels. Clinical Reflections: Members discussed the challenges of balancing evidence-based practice with compassionate communication. Families often seek explanations that help make sense of difficult experiences, and clinicians play an important role in validating those experiences while exploring underlying needs rather than assuming a single explanatory framework. The discussion also highlighted the influence of social media and online communities in shaping public understanding of PDA and reinforced the importance of critically evaluating emerging clinical concepts. Resources Discussed: -2021 Systematic Review of Pathological Demand Avoidance -Current literature examining PDA and autism