What Helps (and What Doesn’t) for Neurodivergent Clients in Therapy

Therapy can be life-changing—or disheartening—depending on how deeply we’re met.

For neurodivergent people, therapy may be approached through a narrow lens. Some models try to fix, manage, or normalise us—missing the richness, nuance, and intelligence of how our minds and bodies work. But a person-centred approach can offer something different: space to be fully human without shame.

This post is a reflection—from both therapist and client perspectives—on what helps and what doesn’t in supporting neurodivergent folks in therapy.

First, what do we mean by neurodivergent?

Neurodivergence includes (but isn’t limited to) people who are autistic, ADHD, AuDHD, dyslexic, dyspraxic, have Tourette’s, OCD, or who experience complex trauma that shapes cognition and perception. It also includes those with sensory integration differences, PDA (pathological demand avoidance), social anxiety, and people who process the world in non-linear, intuitive, creative, or non-normative ways.

Many of us move through the world constantly adapting—translating ourselves, masking, adjusting to systems not made for us. Therapy can either replicate those systems… or offer a rare space of relief.

What Helps (Therapeutically)

Pacing & Spaciousness

Neurodivergent people often think, feel, and process differently, not less. Slower pacing, breaks, and silence-as-welcome make space for reflection without pressure.

“Please don’t rush me.”
“Please don’t mistake stillness for nothing happening.”

Sensory Awareness

Therapy rooms—and therapists themselves—can be overloading. Fluorescent lights, intense perfumes, ticking clocks, too much visual clutter. Online therapy can be helpful, but even there, sound and screen fatigue matter.

What helps: calming textures, warm tone of voice, optional cameras, noticing how the body feels in session. Fidgeting, lying down, or stimming should be welcome.

Client-Led Language & Framing

Words matter. Some of us are hyper-literal, some poetic, some allergic to jargon. Asking clients how they prefer to name and understand their experience is key.

“Do you prefer the term ‘autistic’ or ‘person with autism’?”
“Do you want me to offer reflections, ask questions, or just witness today?”

Relational Safety & Non-judgement

Many neurodivergent people have experienced invalidation, rejection, or being misunderstood—even by therapists. Safety means we don’t feel analysed or handled, but accompanied.

Co-regulation—offering a steady nervous system in the room—is often more powerful than any technique. Being real, warm, and human goes a long way.

Flexible Structure with Consistency

Some of us find structure soothing. Others need a very loose frame. Many need both at different times. Allowing us to shape the therapeutic frame increases trust.

For example:

  • Agreeing on rituals to open/close sessions

  • Using written summaries or visuals

  • Following up with clear reminders

  • Checking in about how therapy is working—not just what’s being said

Contextual & Trauma-Informed Thinking

Many of us carry trauma—not just personal but systemic. Being queer, trans, racialised, disabled, poor, or multiply marginalised intersects with neurodivergence. Therapy must recognise the impact of exclusion, medical trauma, and being mislabelled.

What Doesn’t Help

Forcing Eye Contact, Fast Responses or “Participation”
Processing time varies. Some of us go quiet to think. Some need movement to focus. Don’t interpret this as avoidance.

Standardised Techniques Applied Rigidly
Some approaches (like traditional CBT) assume everyone thinks in neat, linear thoughts. This doesn’t work for those who spiral, visualise, or sense-feel their experience. Therapy should adapt, not expect us to.

Assumptions Based on Diagnosis
Not all autistic people are shy. Not all ADHDers are bouncy. Not all trauma looks dramatic. Get to know this person, not the label.

Correcting or Policing Behaviour
Neurodivergent people often spend a lifetime being told to sit still, talk “normally”, stop fidgeting, “just do it”. Therapy must not replicate this.

Excessive Focus on “Coping Strategies” Without Validation
Strategies can help, yes. But without naming the injustice of how hard life can be, they can feel like gaslighting. Empathy comes first. Tools follow.

In Summary: Therapy That Works for Neurodivergent Clients Is...

  • Slow and sensory-aware

  • Co-created and flexible

  • Rooted in real, affirming connection

  • Open to the unknown and non-linear

  • Willing to unlearn

  • Deeply respectful of difference

A Final Word

If you are neurodivergent and seeking therapy, you deserve a space where your individuality and sense of self are fully welcome.

You deserve to be understood on your own terms.

You deserve rest from masking, and recognition without pathologising.

And if you’re a therapist: know that working with neurodivergent people isn’t about mastering a technique. It’s about showing up—curious, respectful, human—and being willing to be changed by the relationship.

Thank you for reading.


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