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How To Create A Neurodiversity-Affirming Therapy Space? A Clinical Psychology Podcast Episode.

How To Create A Neurodiversity-Affirming Therapy Space? A Clinical Psychology Podcast Episode.

When it comes to working with autistic individuals so we can support them, decrease their psychological distress and improve their lives, their perceptions are critical. Since we can have all the knowledge in the world but if our clients don’t think that the space supports them or if our therapy space distresses them, then this will hurt the therapeutic alliance. In turn, this will increase the chance of the therapy not being successful, so this is why creating a neurodiversity-affirming space is so important. Therefore, in this clinical psychology podcast episode, you’re going to learn why is this important, how to create a neurodiversity-affirming therapy space and essentially not simple changes can really benefit our clients. If you enjoy learning about autism, mental health and psychotherapy then this is a great episode for you.

Today’s clinical psychology episode has been sponsored by Working With Children and Young People: A Guide To Clinical Psychology, Mental Health and Psychotherapy. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.

Why Is Creating A Neurodiversity-Affirming Therapy Space Important?

I’ve already briefly mentioned in the introduction that when we want to support the needs of our autistic clients, we need them to have positive perceptions of us and our therapy space. This helps our clients, who often struggle with social connection, to trust and like us more so this topic is critical so we can have a good therapeutic alliance with them and the therapy is more likely to be successful.

In addition, Mauzek et al. (2023) did research on autistic clients and the researchers found that a lot of autistic clients struggled talking in therapy and integrating the strategies they discussed with their therapist into their lives. This was typically down to their neurodivergent-specific needs.

Furthermore, Norby et al. (2021) looked at the effectiveness of a group intervention for adults with ADHD and the researchers found that a lot of clients felt burdened given the demands of the group. Yet they found the sharing of personal experiences to be helpful.

Overall, it’s important to note here that neurodivergent clients do find therapy useful, helpful and it works, but group settings are difficult because of the stimulation, social skills and the other challenges that being neurodivergent brings. As well as individual psychotherapy can be challenging too for similar reasons.

This is why a therapist being accepting, understanding and willing to accommodate the needs of an autistic client is so important to the outcome of the therapy.

Now we’ll look at five ways how a therapist can create a Neurodiversity-Affirming therapy space.

Create A Sensory-Friendly Space

There are certain things you just shouldn’t do when you have neurodivergent clients, but you might do this for other clients without a second thought. There is no generally correct answer, but there are better situations for different clients.

For example, it is best not to have clutter, bright lights, music, a white noise machine and other overstimulating things in your waiting room or your own therapy space. This reminds me of why my best friend doesn’t like my bedroom at my parents’ house too much because I have really bright lights because they don’t bother me as an autistic person, but I know the lights are too overstimulating for them.

Which is fine as we’re close friends but this wouldn’t be ideal if this was a therapy space, because it would be too much for my friend, they would hate it and it wouldn’t help us form a therapeutic alliance at all.

As a result, you can create a more Neurodiversity-Affirming therapy space by having a variety of fidget tools nearby, having a range of seating options at different distances to the therapist and this includes something on the ground like a bean bag, as well as muted lights. All these options can help a therapist to create a more welcoming space where the client can feel supported and not distressed about how overstimulating the space is.

Never Assume Something Related To A Client’s Neurodivergence Is A Problem

If you’re a long-time listener to the podcast or a reader of my books then you know I flat out hate the term “problem” because it is blaming, judgemental and it is so medical model anyway.

Therefore, when working with autistic clients, therapists should realise that being Neurodiversity-Affirming means you need to take a perspective that autism is not a problem and autism does not need to be treated. I think there are a lot of lessons for all mental health conditions there, because autistic people might benefit from assistance in working through the challenges that pop up because of a mismatch between their environment and the emotional and social challenges it causes.

In addition, a lot of neurodivergent people find that their behaviours that help them cope have been historically pathologized. For example, “stimming”, these are repeated motions and sounds they do for self-soothing like rocking, humming and hair twirling, or pacing as my friend did the other night. These stimming behaviours are critical for neurodivergent people because it helps them to have a sense of comfort, so these behaviours aren’t a problem whatsoever.

So please, do not think these behaviours need to be treated.

Moreover, Anderson (2023) found that clients that went through Applied Behavioural Analysis, a therapy that seeks to decrease neurodivergent behaviour, universally felt negative about the intervention.

Overall, when in a therapy setting, don’t try to fix or cure autism because you shouldn’t, it’s wrong and that isn’t a helpful idea in the slightest. Instead focus on the difficulties and situations that are harming the client and that will help to improve the life of your client.

You Need To Listen To Understand

A lot of psychotherapy modules involve some kind of fixed, very rigid structure and Cognitive Behavioural Therapy is a good example of this problem. Yet the majority of modules stress the need for the importance of making the therapy contextual and adaptable for the client. This is even more important for neurodivergent clients because each of them come with their own unique stories, perspectives and presentations, which is why I think these clinical populations are so interesting. Granted I come under this clinical population too, but still.

Anyway, the key for therapists in creating a Neurodiversity-Affirming therapy space is to listen to the accounts of their clients with a drive to understand rather than jumping towards challenging what might be mislabelled as unhelpful thoughts or cognitive distortions. Since it is critical for therapists to suspend their judgement and they should validate the client’s outlook on their life.

One example of this in research is Babb et al. (2021) who found that a lot of the autistic clients’ neurodiversity-specific needs like having a different experience to hunger cues or sensory sensitives compared to neurotypical people often got ignored by therapists. This is flat out wrong and this should never have happened because as a therapist, we’re meant to listen, acknowledge and try to understand how our client sees the world so we can help them. We should always try to understand how our autistic clients see and experience the world so we support them and have a more effective course of therapy.

Personally, I didn’t expect to have anything personal to say about this podcast episode because my therapy wasn’t really related to my autism, except all the friendship trauma and the nightmare that is trying to navigate social relationships. But my therapist was very good at acknowledging, listening and affirming my autistic identity because we did need to talk about it and we did need to focus on the friendship aspect and social challenges of autism because it does cause me a lot of psychological distress. Yet my therapist was so good at affirming this and not ignoring my autism that I didn’t even notice she was doing this, because it was so natural to her. And I seriously appreciated this.

Overall, you can create a more Neurodiversity-Affirming therapy space by simply listening, respecting and trying to understand your clients so they feel listened to. Never ignore what your clients say or are going through.

Provide Your Client With Multiple Ways Of Communicating

As a result of autism being a massive spectrum, talking will be great for some clients, like myself and my best friend, but it will not be for a lot of clients. Due to not everyone can process and communicate effectively with words, some clients will need pens, musical instruments and even digital communication tools to have meaningful conversations. This doesn’t mean the client is bad, wrong and messed up in any fashion but if you want to create a Neurodiversity-Affirming therapy space then you need to give your client alternatives to speech.

In addition, in education settings, visual supports can be very effective in helping autistic people to learn new information (Hu et al., 2021) as well as communicating whilst moving about is easier for people with ADHD too.

On the whole, when it comes to creating a Neurodiversity-Affirming therapy space, it’s important that you give your client other ways to communicate or you outright say at the beginning that it’s okay if they need to stim, move about or do anything so they can communicate effective and self-soothe too.

Be Kind To Yourself and Ask For Feedback

None of us are perfect people and there is no such thing as a perfect therapist, or even a perfect therapy session. As a client, there are brilliant, extremely helpful and really good therapy sessions but I think if a therapist analysed a therapy session there would always be minor things to improve.

Therefore, Bachelor (2013) showed that the therapists’ reviews of therapy sessions as well as the therapeutic alliance can vary a lot. And if we think about it, this gap is likely to be even larger when the therapist and client have different neurotypes. This is why therapists should ask for feedback about how the client feels the session went, the relevance of the tools discussed and then following up on the integration of these tools at the beginning of the next session.

Doing these things helps to bridge this gap.

However, most importantly, you need to remember that you aren’t perfect and as long as you do the best job you possibly can then that is enough. You need to be kind to yourself because all therapy work is challenging but it is wonderful and rewarding too.

It takes time to learn how to communicate, learn and help neurodivergent clients because every client’s needs are unique, so please be kind to yourself as you grow and learn.

Clinical Psychology Conclusion

At the end of this podcast episode, we’ve looked at how to create a sensory-friendly space, never assume something related to a client’s neurodivergence is a problem, how listening to understand, provide your clients with multiple ways of communicating and how being kind to yourself and asking for feedback all helps to create a Neurodiversity-Affirming therapy space.

If you want to work with neurodivergent clients then this is more important than any of us will probably ever know. It’s important that we support our clients, improve their lives and decrease their psychological distress. That is just the standard baseline of what clinical psychologists and therapists do.

However, for neurodivergence clients, the social and emotional challenges of therapy might be even more intense and distressing than for our neurotypical clients. So it is imperative that we work to create a safe, calm and affirming space where our neurodivergent clients feel safe, listened to and they can bond with us.

The therapeutic alliance might be the most important factor in therapy, and it is our duty to make sure that the alliance can be established as quickly and securely as possible. This is why learning how to create Neurodiversity-Affirming spaces are so important.

It’s probably the difference between us helping or failing a client.


I really hope you enjoyed today’s clinical psychology podcast episode.

If you want to learn more, please check out:

Working With Children and Young People: A Guide To Clinical Psychology, Mental Health and Psychotherapy. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.

Have a great day.

Clinical Psychology References and Further Reading

Anderson, L. K. (2023). Autistic experiences of applied behavior analysis. Autism, 27(3), 737-750.

Babb, C., Brede, J., Jones, C. R., Elliott, M., Zanker, C., Tchanturia, K., & Fox, J. R. (2021). ‘It’s not that they don’t want to access the support... it’s the impact of the autism’: The experience of eating disorder services from the perspective of autistic women, parents and healthcare professionals. Autism, 25(5), 1409-1421.

Bachelor, A. (2013). Clients' and therapists' views of the therapeutic alliance: Similarities, differences and relationship to therapy outcome. Clinical psychology & psychotherapy, 20(2), 118-135.

Beauvais, V. Identity-Affirming Approaches for Autistic Clients: Therapists Best Practice.

Bonanza, C. E., Index, H., McNulty, K., Center, L. K., Stark, M., & Lite, D. B. T. Neurodiversity Affirming Understanding and Care for ADHD.

Gaddy, C., & Crow, H. (2023). A Primer on Neurodiversity-Affirming Speech and Language Services for Autistic Individuals. Perspectives of the ASHA Special Interest Groups, 8(6), 1220-1237.

Hu, X., Wang, H., Han, Z. R., Zhao, Y., & Ke, L. (2021). The influence of visual supports and motivation on motor performance of the MABC-2 for Chinese school-aged children with autism spectrum disorder. Scientific reports, 11(1), 15557.

Johnston, L., Maciver, D., Rutherford, M., Gray, A., Curnow, E., & Utley, I. (2024, March). A brief neuro-affirming resource to support school absences for autistic learners: development and program description. In Frontiers in Education (Vol. 9, p. 1358354). Frontiers Media SA.

Lambert, M. J., & Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory, research, practice, training, 38(4), 357.

Mazurek, M. O., Pappagianopoulos, J., Brunt, S., Sadikova, E., Nevill, R., Menezes, M., & Harkins, C. (2023). A mixed methods study of autistic adults' mental health therapy experiences. Clinical Psychology & Psychotherapy, 30(4), 767-779.

McGreevy, E., Quinn, A., Law, R., Botha, M., Evans, M., Rose, K., ... & Pavlopoulou, G. (2024). An experience sensitive approach to care with and for autistic children and young people in clinical services. Journal of Humanistic Psychology, 00221678241232442.

Nordby, E. S., Gilje, S., Jensen, D. A., Sørensen, L., & Stige, S. H. (2021). Goal management training for adults with ADHD–clients’ experiences with a group-based intervention. BMC psychiatry, 21, 1-12.

Simpson, B. (2020). An open letter to the psychotherapy and counselling profession: It is time to recognise the politics of training and practising with Tourette's syndrome. Psychotherapy and Politics International, 18(3), e1549.

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