Crisis to Collaboration: Why Traditional Services Fail Demand Avoidance – And What We Must Implement Now

A single residential placement: £250,000 per year. Multiply that by just five children cycling through breakdowns, and you’re looking at over £1 million in avoidable costs.

The demand avoidance crisis isn’t a resource problem. It’s a framework problem.

For commissioners and children’s service leads, this failure shows up as skyrocketing costs, placement breakdowns, and the revolving door of crisis-driven interventions. For educators and social care teams, it’s the deep frustration of seeing distressed children repeatedly escalate — despite everyone’s best efforts.

We can no longer afford to treat resistance as defiance.

The evidence is clear: Demand Avoidance is an involuntary neurophysiological threat response.And the enduring solution lies not in control, but in Trauma-Informed Practice (TIP).

The problem: When policy lags behind neurobiology

Across the UK, policy now promotes person-centred approaches — yet the legacy of compliance-based systems still shapes many environments, from rigid timetables to punitive crisis management protocols.

At its core, a Demand Avoidant profile describes a persistent and marked resistance to the demands of everyday life, driven by an intense need for autonomy and high anxiety (Lumsden, 2023). When professionals issue a direct instruction, the individual’s body often registers it not as a request, but as a threat.

From a neurobiological perspective, this is explained through the Autonomic Nervous System and Polyvagal Theory. Feelings of safety or danger are determined by internal physiological states regulated by this system (Porges, 2022). A demand can therefore trigger an involuntary fight, flight, or freeze response.The observable behaviours — aggression, withdrawal, or shutdown — are panic responses to overwhelming anxiety when every avoidance strategy has been exhausted.

Yet services often revert, unintentionally, to overly rigid systems that intensify the perceived threat.The result is predictable: escalation, breakdown, exclusion.

Research by Lumsden (2023) found these challenges in education manifest as an inability to follow instructions, complete tasks, or attend classes. Green (2024) further highlights that mismanaged support leads to elevated risks of trauma, self-harm, and suicidal ideation.

This mismatch between evolving neurobiological understanding and outdated operational frameworks leaves staff trapped between policy rhetoric and real-world constraints.Trauma-Informed Practice offers the structural bridge between the two.

The solution: Trauma-Informed Practice (TIP) for systemic relief

Trauma-Informed Practice isn’t a soft alternative to behaviour management — it’s a neuroscience-aligned framework proven to reduce crisis, stabilise placements, and preserve relationships.

The core principles of TIP — Safety, Trustworthiness, Choice, Collaboration, and Empowerment — provide a road-map for sustainable support.These principles are now embedded in national and international frameworks, from SAMHSA’s (2014) Trauma-Informed Care Guidelines to the UK Government’s (2023) Trauma-Informed Practice Framework for education, health, and social care.

TIP in action

• Safety (Reducing demands) → Lowers threat response, prevents crisis

• Trustworthiness (Indirect communication) → Builds trust without confrontation

• Choice & Empowerment (Collaboration) → Validates autonomy, reduces defensiveness

• This alignment is essential for front line services — particularly education, CAMHS, and social care.

In education: Applying the principles of Choice and Collaboration helps staff move away from direct demands (“You must…”) towards indirect, invitational language (“I wonder if we might try…”). This preserves autonomy, prevents defensive responses, and drastically reduces school refusal.

In CAMHS and social work: By prioritising Safety and Trustworthiness, professionals can stabilise the system before intervention. This reduces the need for high-cost reactive crisis management and builds relational safety across networks.

Building flexibility within the support network

Even with the right environment, these children experience cognitive inflexibility and executive function differences. These aren’t deficits to fix — they’re neurological realities requiring adaptation.

Here, the principles of Acceptance and Commitment Therapy (ACT) become vital — not primarily for the individual, but for the adults around them.

ACT provides a structured way for educators, parents, and practitioners to develop psychological flexibility, allowing them to remain consistent and compassionate even under stress.

Three processes that build systemic flexibility

Acceptance (of reality and distress): Practitioners and parents learn to stop fighting the chronic uncertainty inherent in this profile. Acceptance reduces the pressure that fuels escalation, making low-demand practice sustainable.

Defusion (separating the person from the panic): Staff learn to reframe “They are being difficult” as “This is an involuntary neurophysiological threat response.” This shift preserves empathy and deescalates conflict.

Commitment to valued action: Teams identify shared values — such as safety, dignity, and stability — and use them to guide consistent trauma-informed responses even in moments of high emotion.

Systematic reviews confirm that ACT significantly reduces distress by improving psychological flexibility (Jiang et al., 2024). For children with a Demand Avoidant profile, this means the adults stay grounded — and the environment remains predictable, calm, and safe.

To make this approach sustainable, leaders should:

• Embed TIP principles into supervision and performance frameworks.

• Integrate ACT-based reflection into staff wellbeing programmes.

• Use co-production with parents to define low-demand strategies within EHCP reviews.

This is how flexibility becomes systemic — not just personal.

A call to action for leadership

The financial and human cost of maintaining the status quo is indefensible.The pathway to stability lies in low-demand, high-autonomy environments, grounded in the ethics and evidence of Trauma-Informed Practice.

Your next steps

• Mandate TIP training across education, social care, and CAMHS.

• Audit policies for low-demand language, embedding indirect communication.

• Invest in ACT and flexibility training for the wider support network.

Moving from crisis management to collaborative support is not optional —it’s the only sustainable route to protect these young people, their families, and your workforce.

Want the full implementation roadmap?

This article covers the “why” and the principles.The full guide on my website breaks down the “how” — including:

✅ Phase-by-phase implementation timelines (0–6 months, 6–18 months, 18+ months)

📖 Read the complete article here

Download the full Article

If your service is experiencing recurring placement instability, escalating costs, or staff struggling to maintain effective interventions, let’s talk. I work with local authorities, health partnerships, and education providers to implement trauma-informed frameworks that actually stick.

Systemic compassion is not an aspiration; it is an operational necessity.