Finding a Neurodivergent or Neurodivergence-Affirming Therapist
It’s so hard to find the right therapist! I know because I’ve tried with variable results. I’ve had a lot of practice looking, and for the first 25 years of my life, I didn’t really find what I was looking for. Becoming a therapist and finally confirming my autism both made it easier to know what I want. Today I want to share some what I have learned.
Talk is not enough.
When I was first in therapy, sessions would often consist of me sharing what I had been ruminating on over the past week with the therapist for the first 30 minutes and then crying for the last 20 minutes. I wasn’t gaining any insight because I was simply repeating what had already been going through my head. And I often left the session more dysregulated than I had started. I gained some helpful advice here and there from the therapists I saw, but it wasn’t until I worked with an expressive arts therapist that I really felt like I was accomplishing something during therapy. Being able to express myself in ways other than talk helped me understand the parts of me that don’t have words. And it was also more fun, which motivated me to keep coming to therapy. Looking back, I know that using creative expression is also very regulating for my nervous system, so I was less likely to become dysregulated even when accessing strong emotions.
Another game changer in my own healing journey was learning more about nervous system regulation. If the therapists I worked with early on had educated me about that, I would have been spared many tearful train rides home after therapy. I tend to have an overwhelming amount of interoception and sometimes synesthesia. One consequence is I learned to dissociate from my sensations and emotions. Either way, I was often unable to describe what I was feeling in a way that other people could understand. Mindfulness sometimes increased my overwhelm because of my sensory processing differences. I had to learn how to help my nervous system shift out of crisis mode before any of the processing of thoughts and trauma would have a lasting change. Now I seek out therapists who also have this basic understanding so they can help when I am too dysregulated to remember my skills.
Learning more about my sensory triggers and other neurodivergent needs was also key to my ongoing recovery. One of the early therapists I saw gave me some clues when she reccommended The Highly Sensitive Person, so I thought of myself as an HSP with chronic depression and anxiety. I found The Depression Workbook: A Guide for Living with Depression and Manic Depression and used it to try to make a Wellness Recovery Action Plan. For years I was seeking a therapist to help me with that process. I wanted to create what I would now call a “Neurodivergent Recovery and Prevention Plan.” No one I met with seemed to understand what I was asking for. I now understand that I may have been looking for an occupational therapist who specializes in working with sensory processing differences. Unfortunately, occupational therapists who work with adults are hard to find, much less get covered by insurance. Understanding neurodivergent needs and making a plan to support them is one of the things I help people with now both as a therapist and through the Create Your Burnout Recovery Plan Course included in the World Too Full To Talk Community.
Evne if your goal for therapy is not exploring and understanding your neurodivergent needs, your therapist must affirm them for therapy to be safe and effective. Here are some examples of ways a potential therapist can show they are affirming:
If meeting in person, an office environment that can flexibly accommodate your sensory needs and a willingness to find a way to accommodate needs that arise. For example, if you have photosensitivity, they have dimmable lights or are willing to turn them off.
Availability to meet online when leaving the house is challenging.
Willingness to communicate through chat, text, or alternative augmentative communication ( AAC) tools.
Willingness to engage with you about special interests and understanding of how they are relevant to therapy.
The Right Therapist for the Right Goal
What do you want to change as a result of therapy? Most therapists specialize in supporting certain types of people or problems. At the minimum, knowing what you want to be different as a result of therapy is a key to finding the right person to help you make that change. It can be worth it to ask a therapist who you might want to work with how they would approach your problem, even if you aren’t sure it’s something they specialize in. If the therapist uses a modality that you haven’t heard of, ask them what that means. It might also be a good idea to ask them how they do things differently for neurodivergent clients. Most therapeutic practices were not designed to be neurodivergence affirming. At best, they will be ineffectual without modification to include supports for neurodivergent people. Some modalities, like Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and some forms of social skills training can be harmful because they encourage masking and internalized ableism. Without a foundation of support for nervous system regulation, trauma-focused modalities can be re-traumatizing and trigger potentially harmful coping strategies. If a therapist has an answer about how they would assess your neurodivergent needs in relationship to the modalities they use, that’s a good sign.
Your Therapist’s Identify and Life Experience Matter
Using the words “neurodivergence-affirming” is not enough! Your therapist needs to understand your neurodivergent needs and be willing to affirm how neurodivergence impacts your experience. Even if your therapist doesn’t share the specific ways they relate (or don’t relate) to your experience, it will impact the relationship, the interventions they choose, and the environment they create for you to heal within. It’s a positive sign if a therapist you are considering is willing to name differences between you and check in about how you are feeling about them. It’s a myth that therapists leave their own needs, emotions, and experience out of the room when meeting with clients. It would be impossible to have an authentic relationship if that were true. What’s important is that your therapist is aware of their own biases, able to assess how they are impacting the therapeutic relationship, and willing to take action to make sure that your needs are centered even if that means supporting you in not working with them. If you do determined together that you need to end the relationship, the therapist should help you in finding a different therapist that will be a good fit if you want to continue therapy.
Advocate for Yourself
Once you’ve considered some of the self exploration questions I asked above, you’ll not only have more to look for as you review therapists websites and profiles, you’ll also have more information to bring to an introductory session. Knowing what you want to work on, needs they will have to accommodate, and more about how you want to work will help you both understand whether you’re a good fit. It’s okay if you aren’t sure about some of these things. Tell the potential therapist that, too. Then the therapist can take that into consideration when planning for your sessions.
If something is bothering you about what’s happening in therapy, talk with your therapist about it. How your therapist responds will help you decide whether the problem is something that can be repaired. A good therapist will use this as an opportunity for the relationship to become stronger and for you to grow. If the therapist has a response that isn’t helpful, you will still have gained some practice in speaking up for yourself and advocating for your needs.
I wish you all the best in your search for the right therapist for you! If you think I might be the one, the best way to test the hypothesis is to schedule a free introductory session through my client portal or by contacting me. If you’re still looking, here are some directories that can help you find a therapist who is neurodivergent or neurodivergence affirming.
Directories
Neurodivergent Therapist Directory
Neurodivergent Practitioners Directory
Neurodivergent Insights Directory
Therapist Neurodiversity Collective
Inclusive Therapists Directory - This is not ND focused, but they have really comprehensive filters you can search on. I don’t know anywhere else you can search specifically for all your intersecting identities.
Thanks to the Autistic Culture Podcast: Autistic-Centered Therapy, for getting me thinking about writing this long overdue post. There’s more information in this podcast about what a therapist can do to be truly supportive for autistic people.
