Embracing Neurodiversity: The Role of Therapy in Empowering Autistic Adults

When I created my website, I firmly decided I would not be writing a blog. Why bother when countless others have covered every topic imaginable and way better than I ever could. Well as it turns out, in order to market my group and reach potential clients hoping to find therapy for Autistic adults, I would have to not so firmly recant that conviction.
A p p a r e n t l y, search engine optimization (SEO) is all the rage these days. Sidebar: for total transparency, I did in fact have to google if I used that idiom correctly, and I did indeed confidently get it wrong with the use of “rave” initially.

Anywho! For those who are unfamiliar, SEO is essentially the Regina George of guiding Cady Heron’s to their digital destinations. This tool, like an unapologetic it girl, read me for filth, rating my page titles too short, too basic, and too boring to make it into the Burn Book. My only hope: a makeover (making content). Once I gathered my ego off the floor, I made peace with writing some blog posts in hopes of spreading the word about my therapy group to more Autistic adults in Louisiana. Naturally, after finishing my first draft of this post, the SEO tool rolled up out of nowhere, honked loudly at me, and said “get in loser, we’re going shopping!”

Creation of ‘embracing autistic Identity’

The ‘Embracing Autistic Identity’ group I am facilitating is a spin on a couple of groups I ran at my full time job. I created the group because I noticed a theme in my clientele; my Autistic clients didn’t know many, if any, other Autistic people. I would find myself thinking “oh, if they just knew some other Autistic people, they would have others to relate to and a sense of community.”

Now, this totally could have been me projecting, fueled by my gratitude for Autistic friends who understand my struggles on a personal level. But so you know, the groups did go really well. Following the group’s success, it became clear that I would offer it again, given the scarcity of neurodiversity-affirming therapy and mental health services in general for Autistic adults. I am a firm believer in the power of community healing. We aren’t meant to do life alone, and that sentiment is much more believable when we find our people. Besides finding other Autistic individuals, here are some benefits of group therapy:

Infographic: what autistic adults can gain from therapy for autism section 1: connect with understanding Autistic peers section 2: experience a sense of belonging contribute to the collective wisdom of the group section 3: have feelings validated reduce shame associated with Autistic traits gain understanding of sensory and support needs section 4: improve interpersonal relationships enhance self-esteem decrease feelings of isolation section 5: strengthen emotional regulation skills become equipped with strategies to prevent burnout

Affirming Autistic Identity

A Neurodiversity-affirming model approaches Autism, and other neurological differences, as natural and not something that needs to be fixed. Yet, societal barriers that disable Autistic people set us up to believe that Autism is the problem instead of the set of conditions that make the world not inclusive of Autistic people. Therapies like ABA were born to train Autistic individuals to conform to neurotypical standards. This emphasis often sacrifices the development of crucial coping strategies and overall well-being. A Neurodiversity-affirming approach aims to support people in ways that are congruent with how their brain works. For example, in teaching emotional regulation to an Autistic person, it is inappropriate to hinder safe stimming, an instinctive coping method.

Given the tendency of the medical model to label Autistic traits as deficits, it’s vital to communicate with Autistic clients about the differences in their needs and communication styles, rather than framing them as deficiencies. The persistent pattern, or dare I say, disease, where those in the minority are pressured to conform fully to the ways of the majority rather than finding a middle ground is widespread. This doesn’t just apply to disabled folks, this is also experienced by people of racial, ethnic, gender, sexuality, and socioeconomic minorities.

the importance of advocacy

Girls and women, people of color, trans and gender diverse individuals, uninsured individuals, and those who experience poor access to mental health resources, are all more likely to go undiagnosed and unrecognized as Autistic. People who have intersecting marginalized identities face increased vulnerability. Being overlooked as Autistic often makes the burden to conform a silent struggle. Being able to articulate this perspective with our Autistic clients is essential; our neurodiversity-affirming care needs to be culturally inclusive. A simple way to practice advocacy for inclusion is to assist our clients in obtaining accommodations.

Accommodations will remain necessary as long as society is not inclusive of Autistic people. In an inclusive learning environment, for example, an Autistic student wouldn’t require a letter from their therapist, psychologist, or doctor for their teacher to acknowledge and allow the use of a fidget item during tests. I’ve heard people jump to the defense of this kind of gatekeeping and exclusion with arguments such as “what if all students and employees asked for these accommodations? some people just want to abuse the system!” In return, I want to pose another question: if everyone is seeking an accommodation within a given system, then is that not a sign something is wrong with the system?”

Equipping Therapists

What is therapy for Autism? Therapy is a journey of self-discovery and empowerment, where individuals can enhance their well-being and thrive. Therapy isn’t for Autism, despite what well-meaning individuals search on google, but it does need to be tailored to and affirming of Autistic people. There are plenty of ways that this can be accomplished. Here are some essential basics that can be implemented to support the needs of Autistic clients.

Infographic: Affirming Practices section 1- use inclusive language re: culture, age, gender, sexuality section 2- use friendly lighting: soft, warm, natural, adjustable section 3- provide stim toys: sand tray, pop it toys, Speks™ toys, drawing & painting materials section 4- consider sensory needs: provide flexible seating, be mindful of fragrances, supply a weighted blanket, encourage movement breaks section 5- supplement verbal information with: written info, visual aids, audio recordings, digital resources section 6- increase accessibility: offer telehealth, promote various communication options

To better provide normalization for Autistic clients, therapists must continually broaden our understanding of Autistic experiences and recognize that no two Autistic people are the same. Normalizing can be quite simple. I’m sure Autistic clients of mine would be able to tell you, if they ever expressed something they did was “not normal”, they have likely heard me say “that is normal… for Autistic people.” To expand your understanding of normal Autistic experiences, here are some avenues to explore:

• The #ActuallyAutistic hashtag on TikTok

•Check out neuroclastic and the art of autism.

•Learn from actually Autistic helping professionals: Dr. Neff, Emily Price, and Nick Walker.

This list isn’t all inclusive, of course, but can be a good place to start. Gaining a richer understanding of the diverse and nuanced experiences within the Autistic community helps to build a more inclusive and informed approach to neurodiversity-affirming care.

supportive therapeutic techniques

When treatment planning, therapists should assess the extent to which systemic barriers and exclusion have impacted their Autistic clients. Therapists can explore ways their clients may need to be accommodated in their various environments. When assessing, therapists should keep in mind that some Autistic people need extra time to process before answering questions; this could be due to any number of factors including difficulty tuning out distractions or trying to summarize multiple streams of thought. What I have found to be helpful is offering suggestions, providing options, and/or being very specific. Here are some examples of what therapists can ask when exploring sensory issues instead of asking a broad question:

• “For some Autistic people, sounds may go from being dull to feeling overwhelming, and this might even change within the same day. Is this something you have experienced?”

Or

• “Have you ever been trying to work on something and notice that you’re getting more irritable because you can’t tune out the sound of the air condition, or people talking, or the creak of a door hinge?”

Therapists shouldn’t be discouraged if their suggestions are completely wrong; it can always help the person to communicate what it is that they do experience. And for the times we do get it right and clients give us an awe-struck look, we can respond “It’s like I have ESPN or something.”

Theoretical approaches

My personal therapeutic approach frequently utilizes Acceptance and Commitment Therapy (ACT) and Somatic Mindfulness. (Note: I have no experience with the Aura app, so I cannot vouch for its effectiveness, but I appreciate their descriptions in this post.) I find that somatic based interventions and skills are so helpful for Autistic people who have an inclination to intellectualize their feelings. This doesn’t mean that there isn’t room for intellectualization, it can help build a full understanding of feelings and what contributed to them. However, intellectualization will not usually be particularly helpful in moving through feelings, decreasing anxiety, and re-establishing a feeling of safety in the body.

When I had this realization in my personal life…

Infographic: i described it like this Section 1: my feelings are like a match and my thoughts are like gasoline Section 2: then suddenly there's a wildfire (meltdown) Section 3: and I start trying to figure out what caused the fire, the gasoline or the match (intellectualization) Section 4: but it doesn't help me put out the fire

Mindfulness can help put out the fire. When it comes to somatic exercises and techniques, it’s helpful to use literal descriptions. For example, I do my best to avoid saying things such as “imagine a ball of light in your belly.” Instead, I might say something like “notice how your belly expands when you take a deep breath in.” Know that at times, it may overwhelm people to be so aware of what is happening in their body. That is okay. Keep this mind in order to be attuned to clients’ response to techniques, so clients can take things at a pace that feels safe for them.

continuing the conversation

There are many more ways to make therapy more affirming and therefore effective for Autistic clients. I’m sure I will write more blog posts where I expand on ways to help clients identify their needs and what some of those needs may be. I’m looking forward to sharing more tips on ways to tailor therapeutic interventions that will actually help neurodivergent clients. And one day, I’ll tackle all the ramblings in my head about nervous system regulation and how understanding your body’s processes can transform your response to discomfort. All in due time, I suppose.

It’s quite ironic to me that I already have at least three more blog posts planned. In my defense (to myself? lol), this process has reminded me of how much I love to write and that I have so much to say (which I’m sure is not a shock to anyone who knows me). Additionally, I realized somewhere around writing the advocacy section that my original attitude towards creating my own blog posts did not account for the power of repetition. So, next time I’m worried about over-saturating the internet with my writing, I’ll be sure to take a deep breath and tell myself, “the limit does not exist.”

*If you have any questions please send me an email! I love to be a resource for people and I can very literally talk about this topic for hours. If I don’t have an answer for you, I will find you an answer or a place to look.