Psychotherapy What Does It Mean For a Therapist to Be Neurodiversity-Affirming? By Amy Marschall, PsyD Amy Marschall, PsyD Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health. Learn about our editorial process Updated on November 29, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Claire Eggleston, LMFT-Associate Medically reviewed by Claire Eggleston, LMFT-Associate Claire Eggleston, LMFT-Associate is a neurodivergent therapist and specializes in and centers on the lived experiences of autistic and ADHD young adults, many of whom are also in the queer and disability communities. She prioritizes social justice and intertwines community care into her everyday work with clients. Learn about our Medical Review Board Print Iryna Khabliuk / EyeEm / Getty Images Table of Contents View All Table of Contents What Is Neurodivergence? What Is Neurodiversity-Affirming Therapy? Risks of Therapy That Is Not Neurodiversity-Affirming Neurodiversity-Affirming Therapists Neurodiversity-Affirming When a therapist is neurodiversity-affirming, they recognize that neurodivergence by itself is not a flaw or illness that needs to be “fixed” or corrected. They recognize that neurodivergence can come with its own set of strengths that can be fostered. Neurodiversity refers to the naturally-occurring differences and variety in brain functioning and resulting behaviors. It is part of typical variation among humans, just like variances in height, eye color, and family traits. Even though neurodiversity, like other forms of human diversity, is natural and beneficial to society, certain neurotypes are framed as “different” and “othered” due to not following neurotypical standards for behavior, communication, and cognition. The field of psychology has traditionally prioritized neurotypical brains as the standard for mental health, which has caused harm to neurodivergent populations through over-pathologizing non-harmful behaviors and trying to enforce neurotypical standards of behavior. In this article, you'll learn more about what neurodiversity-affirming care looks like, why it's important, and how to find a neurodiversity-affirming therapist. What Is Neurodivergence? Neurodiversity is a term coined by the sociologist Dr. Judy Singer to refer to how each person’s brain develops differently, and how these differences impact how each of us thinks, feels, behaves, and perceives the world around us. While each brain is unique and there is no one definition of “normal,” the term neurodivergence was developed to reflect the experience of those whose neurodiversity falls outside of social expectations for “typical.” Some neurodivergent people are disabled as a result of their neurodivergence, but some neurodivergent people do not consider their neurodivergence to be a disability. Both perspectives are true and valid. In recent years, neurodivergence is often defined as those with neurodevelopmental disabilities as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: learning disorders, ADHD, autism, intellectual disability, et cetera. However, Dr. Singer has stated that the term was originally intended to include all brains that diverge from neurotypical standards, including those with any mental health diagnosis. If the way you perceive and interact with the world around you diverts from typical expectations and standards, you may be neurodivergent. Awareness and Allyship: It's a New Day for Neurodiversity What Is Neurodiversity-Affirming Therapy? Neurodiversity-affirming therapy is not a specific set of interventions or things the therapist says or does in their sessions. Rather, it is an approach to treatment and overarching philosophy that impacts how the therapist views their client and the client’s experience, much like trauma-informed therapy recognizes the unique impact of trauma on an individual’s experience. When a therapist is neurodiversity-affirming, they recognize that neurodivergence by itself is not a flaw or illness that needs to be “fixed” or corrected. At the same time, a neurodiversity-affirming therapist acknowledges and affirms that neurodivergence can also be disabling. If someone insists that neurodivergence is always a strength with no deficits, they are falling into the trap of toxic positivity and not honoring the full experience of neurodivergent people. In sum, a neurodiversity-affirming therapist is aware that each client is the expert on their own experience and holds space for the good and the bad that come with it. They let neurodivergent communities lead the way in determining the most appropriate language, treatment intervention, and resources rather than telling them what they need based on neurotypical expectations. Introducing: Neurodivergence at Work Risks of Therapy That Is Not Neurodiversity-Affirming Traditionally, therapy has not been neurodiversity-affirming. The medical model of mental health assumes that neurodivergence is a problem to be fixed. While this may be true of some symptoms, many neurodivergent communities have pushed back on this as a default approach to treatment. If a therapist is not neurodiversity-affirming, they may push for their client to correct or fix behaviors simply because those behaviors are atypical, even if the behavior is not harmful. For example, the autistic community has challenged the assumption that applied behavioral analysis (ABA) is an appropriate "treatment" for autism. Through ABA, many autistic people have been taught to hide stimming behavior because it is “annoying” or “distracting” even though they may be using the behavior to self-regulate or cope with an uncomfortable sensory experience. Essentially, the goal of the treatment is often to make them stop appearing autistic and to mask their autistic traits. Since masking is highly stressful for autistic people and leads to burnout in the long term, a treatment that requires masking is harmful. Therapists who are not neurodiversity-affirming may additionally have less knowledge about neurodivergent communities. While no therapist can be an expert on every topic, and even therapists with expertise are not the experts on individual client experiences, a therapist who lacks this background may have to rely on the client to teach them about neurodivergence. This puts added demand on the client in their treatment. Essentially, neurodiversity-affirming care is a form of cultural competence. Therapists who are neurodiversity-affirming have taken steps to be aware of possible biases and to gather appropriate knowledge about neurodivergent clients before working with them to avoid doing harm. What to Know About Stimming in ADHD How Can I Find a Neurodiversity-Affirming Therapist? If a neurodivergent individual is seeking therapy services and wants a provider who is affirming of neurodiversity, it is important to research prospective therapists. Unfortunately, a recent study showed that 46% of providers who serve neurodivergent people (including psychotherapists, speech therapists, teachers, and others) are aware of neurodiversity-affirming practices, and 58% overestimated their knowledge and competency in this area. Prior to scheduling an appointment, you can ask a potential therapist if they consider themselves to be neurodiversity-affirming and what they believe this means or looks like in their practice. Many therapists who understand the importance of neurodiversity-affirming practice will make a statement about this on their website. In addition, some therapist directories allow providers to indicate this as specialized experience: TherapyDen has a filter for neurodiversity-affirming therapists. Neurodivergent Therapists requires that all listed providers be both neurodiversity-affirming and neurodivergent. Choosing Therapy has a filter for therapists who specialize in neurodivergence as well. Inclusive Therapists allows individuals to search for ND-affirming therapists as well as therapists with ND-lived experience, along with other marginalized identities. Even if a therapist is neurodiversity-affirming, it is okay to change providers if their approach, personality, or training are not a good fit for your unique needs. As with all types of therapy, you might have to try out multiple providers before finding the right fit for you. The Reality of Getting Diagnosed With ADHD in Adulthood 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Cleveland Clinic. Neurodivergence. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed., American Psychiatric Association, 2013. DSM-V Silberman S. Neurodiversity rewires conventional thinking about brains. In: Davis LJ, Dolmage J, Erevelles N, et al., eds. Beginning with Disability. 1st ed. Routledge; 2017:51-52. Anderson LK. Autistic experiences of applied behavior analysis. Autism. Published online August 23, 2022:136236132211182. Raymaker DM, Teo AR, Steckler NA, et al. “Having all of your internal resources exhausted beyond measure and being left with no clean-up crew”: defining autistic burnout. Autism in Adulthood. 2020;2(2):132-143. Pacific Undergraduate Research and Creativity Conference. Perspectives About Neurodiversity-Affirming Practices. By Amy Marschall, PsyD Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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