How I Adapt Therapy for Neurodivergent Clients
- kevynhopkinshall
- Apr 30
- 6 min read
During Autism Awareness Month, there’s often a lot of information shared about what autism is, but much less about what actually makes therapy feel supportive, accessible, meaningful, or even safe for neurodivergent people.
Neurodivergence isn't something that needs to be fixed, instead it as part of natural human variation. An approach, often described as the neurodiversity paradigm, shifts away from seeing difference as disorder and towards recognising it as diversity, which is something I try to bring to my practice.
Why doesn't therapy always fit?
There are a number of things that are important in therapy, and counsellor and therapists will argue about what this is, endlessly. But for my mind, it's the relationship. Part of building that relationship, is providing the time and space to unsure it can work for people, in a way that they need.
Many neurodivergent people come to therapy having had experiences where they’ve felt:
Misunderstood
Overwhelmed
Pressured to communicate in ways that don’t feel natural
Having to prepare for certain interactions
Or like they are “too much” or “not enough”
Traditional therapy often assumes:
Quick verbal processing
Comfort with prolonged eye contact
Linear reflection
Comfort in physical introspection
But these expectations don’t work for everyone.
There is growing recognition that therapy has historically been shaped around neurotypical norms, and that adaptive therapeutic approaches can significantly improve outcomes for all clients, not just neurodivergent ones. Treating everyone as an individual, and tailoring the experience and support to your needs.
So part of my role is to adapt therapy to you, rather than expecting you to adapt to therapy. Ultimately, you are not doing therapy wrong.
What Adapting Therapy Can Look Like
There isn’t one right way to work with neurodivergence of any kind, but there are many ways therapy can be shaped to help make it feel safer and more accessible.
Communication at Your Pace
You don’t have to find the “right words” straight away. We can take time, pause, revisit things, or communicate in ways that feel more natural to you. Even making up language that fits with you. Maybe anxiety doesn't register as a real sensation, but you might feel "fuzzy" or "breathless", and not everything has to be described in terms of experience, or even in words, perhaps pictures or a piece of music helps describe what is going on for you better.
Flexibility in How We Work
Some sessions might be more structured, others more open. We can adjust depending on what you need that day. I will always give you the option to work on what you want each session, that may be something we have already worked on, it may be something new. It could be a session to vent or a session to celebrate something in your life. And if it helps, you can always email or reach out before hand to say what you would like to talk about so it feels planned and prepared, or I can support bringing up a topic that may be hard for you to talk about.
Times can also be adapted, for some the idea of 50 minute sessions feels overwhelming, so we can look at reducing that and can revisit the length of the sessions at a later date to ensure it's still working for you.
Sensory Awareness
Therapy can take into account sensory needs, whether that’s thinking about the
environment, online sessions, or how you experience the space. I have no problem with you using fidget toys or playing with your phone if it helps, I even have a range of fidget toys in my room for you to use. I am happy to take batteries out of the clock and work from my watch for time if the ticking feels uncomfortable, we can even rearrange the room, swap seats or move outside if that's what you need at any given time. And if you want to switch between in person and online sessions, that is OK too. My main consideration will be that you are safe, and in a safe place to talk, other than that, we can make it work for you.
Understanding Masking
Many neurodivergent people have learned to mask parts of themselves to feel safe or accepted.
Masking has been described as the “exhausting effort of concealing traits” that don’t fit neurotypical expectations, and over time it can lead to burnout and disconnection.
Therapy can be a space where that isn’t required, where you can begin to explore what feels authentic. I will be honest with you, it can feel uncomfortable or difficult sometimes to let someone see parts of you that you have worked so hard to adapt or conceal, but know I hold no judgement about who you are and welcome you to show up in any way you want.
Non-Linear Exploration
You don’t have to present your experiences in a neat, structured way.
We can follow threads, revisit topics, and make sense of things in a way that reflects how your mind actually works. If that is changing topics at a moments notice, or being aware that you may be experience difficult awareness's of your body or feelings, then we adapt then we work with that to may therapy useful to you.
Space To Tell Me What You Need
With all my clients, I offer them the space and time to express how they would like to work. This could be at the beginning or the end of a session, or even outside of sessions. I can't be aware of everything that will be helpful to everyone, so it's important to me that you feel you can make suggestions on adaptions that could be useful to you.
Time To Prepare
Sometimes the idea of coming in and just jumping into stuff can feel overwhelming. There are a number of ways we can work with that. The first is to designate time at the start of the session to talk about interests, TV, games, anything, as well as having that time at the end to allow you to leave feeling regulated.
I am also aware that sometimes it can feel really hard to know where to start, particularly when in front of someone, so you can set out what you want to talk about in advance by emailing me and even asking me to start the conversation. You can of course change your mind in the session and move to something else if you want. You should be able to talk about and explore anything in ways that feel safe.
Neurodivergence, Identity, and Relationships
Neurodivergence doesn’t exist in isolation, it is just one aspect that shapes who we are and how we experience the world. Research increasingly highlights a strong overlap between neurodivergence and LGBTQ+ identity, with estimates suggesting a significant proportion of neurodivergent people also identify as queer.
This has led to the concept of “neuroqueer”, a way of understanding how neurodivergence and queerness can intersect and shape each other.
You might experience this in how you:
Understand identity
Experience relationships
Communicate or connect with others
I work particularly with clients where neurodivergence intersects with:
Queer identity
Polyamory or non-traditional relationships
Kink and alternative communities
And it's not just neurodivergence and queer identity, but cultural, spiritual, disability and more, all intersect to make you, you.
Therapy can be a space where all of these parts are welcomed, not separated or simplified. It's about understanding that we are all more than just our parts, that they intersect and impact each other.
You Don’t Have to “Do Therapy Right”
There isn’t a correct way to be in therapy. Neurodiversity-affirming approaches emphasise that people don’t need to be “fixed,” but supported in ways that respect their differences and strengths.
You don’t need to:
Make perfect sense
Be consistent every week
Know exactly what you want to say
You’re allowed to:
Take your time
Change your mind
Not have the words
Show up exactly as you are
Get it wrong
Ask for what you need or not know what you need
A Space That Works With You
At its best, therapy should feel like a space that adapts to you, not somewhere you have to fit yourself into.
There is a growing shift within psychology towards more tailored, neurodivergence-informed approaches to therapy, recognising that flexibility, collaboration, and respect for difference are essential to effective support.
If you’re neurodivergent and considering therapy, it’s okay to look for someone who understands that your way of thinking, feeling, and communicating is valid. It is also OK to ask for what you want and advocate for your needs.
Get in Touch
If you’re looking for a neurodivergent-affirming therapist, particularly if this connects with identity, relationships, or how you experience the world, you’re welcome to get in touch.
We can arrange an initial conversation to see if working together feels like the right fit, and even if you don't feel I am the right counsellor for you, I am always happy to help you find one that is.
[4]- Neuroqueer Heresies: Notes on the Neurodiversity Paradigm, Autistic Empowerment, and Postnormal Possibilities - By Nick Walker
Comments