Neurodiversity Affirming Counselling: How to Make Therapy Work for You
For many neurodivergent people, counselling can feel more challenging than expected. This is not because therapy is ineffective, but because many therapeutic settings have not traditionally been designed with different neurotypes in mind.
If you are neurodivergent, you may have noticed that therapy can sometimes feel draining, uncomfortable, or difficult to commit to - even when working with a well-meaning therapist. The good news is that counselling does not have to be approached in any one way. With a few adjustments, it can become a more accessible and supportive experience.
Why counselling can feel challenging for neurodivergent clients
Many counselling models assume that certain processes come naturally to everyone, such as consistently speaking freely, understanding the intention/meaning behind questions, maintaining eye contact, or identifying emotions in the moment. For neurodivergent clients, this can understandably create barriers, including:
Needing additional time to process questions or thoughts
Finding it difficult to label or describe emotions verbally
Sensory discomfort related to lighting, sound, or eye contact
Feeling pressure to mask or perform during sessions
Worrying about saying the “right” thing or engaging in therapy correctly
These experiences do not mean that therapy is unsuitable. Rather, they highlight the importance of adapting the therapeutic environment to better support neurodivergent ways of being.
Small adjustments that can make a big difference
Often, it is relatively small changes that allow neurodivergent clients to engage more fully in counselling.
1. A pace that supports processing
Some clients benefit from a slower pace, allowing time for reflection and pauses. It can be helpful to name this need openly — for example, by asking for a moment to think before responding or returning to a topic later in the session.
2. Communication styles that feel accessible
Counselling does not need to rely solely on spontaneous conversation. Many clients find it useful to bring notes, work through bullet points, or write during sessions. In online therapy, combining spoken communication with chat or written prompts can offer greater flexibility of communication and note taking.
3. Sensory-considerate therapy environments
Online counselling can be especially supportive for neurodivergent clients, as it allows greater control over sensory input. This can include turning off your camera, adjusting lighting, using headphones, or using fidget tools to help reduce overwhelm. Eye contact is never a requirement.
4. Flexible structure
Some neurodivergent clients prefer sessions with a set structure or a clear focus, while others value open-ended exploration. Both approaches are valid, and therapy can be shaped collaboratively to suit individual preferences.
How to talk to your therapist about your needs
It is understandable to feel hesitant about explaining your needs, particularly if you are used to adapting yourself to others. However, counselling is intended to be a collaborative process, and sharing what supports you can make sessions far more effective.
You might find it helpful to say:
“I need a little more time to process questions.”
“I find sessions easier if I don’t use my camera.”
“Having a brief structure at the beginning of sessions helps me feel more settled.”
A therapist who is neurodiversity-affirming will welcome these conversations and view them as an important part of the work. Equally you may enter therapy without a clear idea of what you need, it’s okay to need some time to figure out what changes will help you the most.
You are allowed to shape therapy
Counselling is not an assessment, nor is there a correct way to participate. You are not expected to push beyond your limits or present yourself in a particular way. Many neurodivergent clients find that therapy becomes more meaningful when they are comfortable enough to unmask and be authentically themselves.
If counselling has been challenging in the past, this does not reflect a personal failing. It may indicate that the approach or environment was not the right fit.
A gentle next step
If you are in therapy already, you might consider introducing one small adjustment that could make sessions more manageable or supportive. If you are seeking a therapist, it is best to look for someone who understands neurodivergence and is open to adapting how they work to what you need.
Counselling can offer a space where you feel understood, respected, and at ease — not in spite of your neurodivergence, but because it is recognised and accommodated.