What NeuroDivergent Clients Might Need From Therapy
One Therapist’s Observations of Factors That Might support a Better experience of Therapy For People with Autism, ADHD, and Trauma-related Neurological Differences.
In my emotion-focused/experiential therapy practice, I’ve chosen to work with a lot of neurodivergent folks. For many reasons, I find I have good therapeutic chemistry with people living with autism, ADHD, and trauma-related neurological differences. Because of this, my clients have taught me a lot about what accommodation can look in the therapy space.
Of course, I hope it goes without saying that all neurodivergent people’s needs and preferences aren’t identical. However, there are still practices that can set both client and therapist up for a more effective encounter.
If you’re neurodivergent and curious about what a relevant and comfortable counselling experience might look like for you, maybe my observations will be helpful. If you’re part of this community, ask yourself if you might benefit from:
1. An Empowering Intake Process
Would having some control over your therapeutic environment from the outset be helpful? An intake process that acknowledges and respects your comfort levels—such as preferences for communication style, seating arrangements, or the use of sensory tools—can help build trust and ease. For example, when I meet clients for the first time, I ask how much eye contact they want. Lots? None? A little bit every now and then to sharpen focus?
2. Accommodations That Flout Norms When Necessary
Traditional therapy settings often feature quiet rooms, stationary seating, and minimal distractions. In fact, some therapists believe these elements are key to a successful session. However, neurodivergent clients may benefit from accommodations that break these norms. I’ve had clients who need to move around constantly, lay on the floor, play music, hold stuffed animals, or use fidgets. These accommodations aren’t distractions; they’re tools for accessing thoughts and emotions more freely.
3. Trust That Your Unconventional Communication Style Won’t Be An Obstacle
You may communicate in ways that diverge from conventional norms. For example, do you tend to speak at length, with conversations that branch off in numerous, subtly connected directions? The right therapist should be able to pick up on these threads of meaning and navigate the conversation.
4. Your Therapist’s Awareness of What’s Generally Irrelevant or Unhelpful
Conventional approaches may not always apply to neurodivergent clients. For example, it is not uncommon for autistic clients to have alexithymia (Kinnaird et al, 2019), which means they might struggle to label emotions. So, someone asking you “how do you feel” might be more stressful than helpful. If this is you, you might benefit from more creative methods of expression. Maybe you won’t be able to say that you feel afraid, but perhaps you can explain that “jagged bits of steel wrapped in wire” are filling up your stomach. Again, with the right therapist, this will be enough to convey the meaning of your experience.
5. Your Therapist’s Lived Experience of Neurodivergence
Having a therapist with lived experience can offers a level of empathy that goes beyond theoretical knowledge. Without denigrating the amazing work that allistic clinicians do, therapists who have navigated neurodivergence themselves often have truly targeted insights and strategies. Although I have not been diagnosed (due to the high financial cost for adults), I know there are clinical advantages to my own neurodivergence. For example, I can sit in profound empathy with a client struggling with the heartbreaking loneliness of being chronically misunderstood. I get it.
