11/03/2025
I'm a neurodiversity affirming therapist 😊
WHY MIGHT MENTAL HEALTH THERAPY FALL SHORT FOR AUTISTIC PEOPLE?
Given the social and sensory traumas that many Autistic people experience, it is no surprise that the majority of us, up to 80%, suffer from anxiety and/or depression at some point in our lives.
Adult Autistics may describe anxiety as the biggest challenge they deal with, or say they cannot remember a time in their life without it. We are four times more likely to experience clinical depression at least once in our lifetime than the general population, and 2.5 times more likely to have an anxiety disorder.
It also should not be surprising that many Autistic people seek therapy to help them manage these mental health challenges. Why, then, do so many Autistic people report that therapy was a negative or unhelpful experience?
One big reason is that many therapists lack a deep enough understanding of autism to make the therapeutic relationship successful.
If you are an Autistic adult seeking therapy, you deserve to work with a professional who understands and respects your neurotype. You have every right to expect your therapist to modify their approach to meet your unique needs.
Here are five things to look for in a neurodiversity affirming, autism positive professional:
1. The space feels autism friendly
Sensory issues must be taken seriously.
If the waiting area is busy, noisy, or full of harsh lighting and strong smells, it can immediately raise anxiety. Radios, televisions, fluorescent lights, and scents from perfumes, cleaners, or coffee can be overwhelming or even painful.
A sensory friendly environment shows that your therapist understands that comfort and accessibility are part of emotional safety.
2. They understand Autistic communication
A good therapist recognizes that Autistics and non Autistics communicate differently.
They will not misread your slower response time as disinterest, your flat expression as lack of feeling, or your avoidance of eye contact as untrustworthiness. They know that these are normal Autistic traits, not signs of resistance or disengagement.
Being constantly misunderstood in therapy can be deeply discouraging. You deserve someone who listens with curiosity, not judgment, and who sees your communication style as valid.
3. They recognize and support alexithymia
Up to 50% or more of Autistic people experience alexithymia, difficulty identifying and describing emotions.
If you struggle to answer “How does that make you feel?”, a supportive therapist will not take that as refusal or defiance. Instead, they will understand that it might be a real barrier and help you build emotional vocabulary gently and collaboratively.
A good therapist sees alexithymia not as a wall, but as a starting point for learning and growth.
4. They build trust with warmth and patience
Many Autistics carry the scars of bullying, rejection, and misunderstanding. Therapy works best when the relationship feels safe.
A neuro affirming therapist takes time to build rapport before diving into hard topics. They understand slow processing speed and wait for you to respond instead of rushing or rephrasing, because doing so restarts your processing time.
They might offer text or email options for communication between sessions. Most importantly, they treat you with genuine kindness, respect, and interest.
5. They make the process predictable and clear
Autistic people do not thrive in uncertainty. A neuro affirming therapist will explain what to expect, both from sessions and from therapy as a whole.
They will tell you what their role is, what your role is, and what kinds of progress you can expect to work toward, whether that is self awareness, reducing anxiety, or learning self advocacy skills.
They will give clear timelines, avoid overloading you with long monologues, and use visuals or written supports when needed.
Knowing what to expect reduces anxiety and helps you stay engaged.
A tip before you start
If you are searching for a therapist, consider reaching out by email first instead of making a phone call or in person inquiry. You can ask important questions, such as their experience with Autistic clients, communication preferences, or sensory accommodations, without the pressure of an immediate response. Writing also gives you time to think clearly and avoid the stress or social anxiety that live conversations might bring.
This is a short list of things a neurodiversity affirming therapist will do to provide meaningful, respectful therapy to Autistic clients.
There are professionals out there who understand autism deeply, and some specialize in working with Autistic adults, especially those who identify as women or girls.
Help is out there. Just make sure the person you choose truly understands what being Autistic means before you invest your time, energy, or money.
