What autistic and ADHD clients look for from psychotherapy

What do neurodivergent clients need from therapy? And how can person-centred psychotherapy meet those needs? I’ve been pondering these questions a lot recently. More and more people are coming to psychotherapy to explore neurodivergence, whether they have had a diagnosis since childhood, or are late identified, or just starting to consider whether they might be ND.  With all of the autistic, ADHD, and questioning clients I work with there is often a quiet, steady theme: “I just want to be accepted for who I am.”

Not ‘cured’. Not ‘fixed’. Not changed from the outside towards some idea of “normal.” But to be seen, heard, and fully met.

It sounds simple. And in some ways, it is. But for many autistic and ADHD people, that kind of acceptance has been hard to come by throughout their lives.  And that includes in supportive or therapeutic spaces. Many of us who are neurodivergent frequently experience being misread and misinterpreted. We often arrive at counselling carrying years of being misunderstood. Whether that’s having been labelled “too much”; too intense, too loud, too scattered, too sensitive. Or “not enough”; not social enough, not focussed enough, not consistent enough.

Most neurodivergent people, whether diagnosed, identified, or not, have spent a lifetime masking. This means they have been consciously and unconsciously hiding parts of themselves just to get through the day in different contexts. That kind of effort takes its toll. It takes a huge amount of energy to mask, and it can lead to burnout, anxiety, and disconnection. And it makes sense that neurodivergent people might approach therapy cautiously, wondering if this too will be another space where they’re asked to bend.

So when someone walks into my therapy room with all that history, and perhaps with their guard up, the most important thing I can offer is a person-centred way of being which says “you don’t have to mask here”. I try to create a space where people can, slowly and cautiously, feel safe enough to unmask. I try to be trustworthy enough that people feel safe to open up. And I try to be welcoming and accepting enough that clints can take the risk of showing up as their true, full selves.

For me, person-centred psychotherapy offers the perfect environment for this to happen. At its heart, person-centred therapy is about meeting people exactly where they are, with warmth, empathy, and authenticity. There’s no agenda to change someone into something they’re not. No checklist of behaviours to change. No standard version of success. There’s just the relationship between us, based on trust, respect, and belief in the client’s capacity to grow, in their own way, in their own time.

For neurodivergent clients, this can feel different. Done right, the therapeutic relationship itself becomes a space to unmask. To speak freely. To stim, bring all of your scattered thoughts, to be blunt or quiet or passionate. And still receive care and empathic understanding.

Person-centred psychotherapy naturally fits with a neuroaffirming, non-pathologising approach as its focus is entirely on the client’s subjective, phenomenological experience. So I believe a person-centred approach to counselling is the perfect space for neurodivergent clients to explore themselves and their issues and concerns.

While every person is different, there are some things I’ve noticed neurodivergent clients often appreciate in therapy:

• Clarity: Being direct about what to expect. What will the sessions be like? What’s the structure? What are my options?
• Permission: To move, fidget, waffle, be silent. To communicate in whatever way feels natural.
• Pace: Letting things unfold without pressure to go faster, deeper, or ‘tidier’ than feels right.
• Attunement: Listening, not assuming. Checking gently. Being willing to work it out together.

And these are all what I endeavour to offer in my psychotherapy sessions. None of these points are about changing the foundation of therapy, they’re just about being flexible within a relationship built on trust.

When someone has spent much of their life being told they’re wrong, being fully seen can be disconcerting and strange. But if you are able to receive the invitation, and give yourself permission to dive in and give it a go, it can be deeply healing. It can reconnect you with your sense, buried deep inside that "Oh. This is me. And I’m allowed to be this way." To build self-acceptance and self-compassion, and find different ways to live in the world more authentically.

If you’re autistic or ADHD, or otherwise neurodivergent (or think you might be!) and you’re wondering whether counselling can help, I want you to know that it doesn’t have to be about fitting in. It can be about finding and accepting yourself.