How to find a neurodivergence-affirming counsellor

One of the most common supports that late-identified neurodivergent adults seek is counselling. However, not all counsellors will be a good fit for someone looking to process a lifetime of not knowing they were neurodivergent. This post will give some tips on how to find a neurodivergence-affirming counsellor.

Neurodiversity-affirming vs neurodivergence-affirming

Generally, neurodiversity-affirming is used to mean that an approach affirms that there are many ways that brains can work, and that all ways of experiencing the world are valid. However, if we break it down, neurodiversity-affirming can simply mean that you agree (affirm) that there is human neurodiversity which doesn’t necessarily follow that you believe in human neurodiversity being valid. So, instead of taking a claim of “neurodiversity-affirming” at its face value, we need to dig deeper.

As neurodiversity has growing in popularity as a concept, there has been a huge rise in neurodiversity-lite – service providers who have some of the language of the Neurodiversity Movement, but who have not done the truly deep internal work that is needed to live and breathe that all brains and ways of being are valid and have worth.

The danger of seeing a counsellor who is in the neurodiversity-lite stage of their personal growth is that they may reinforce negative stigmas and approaches that may strengthen internalized ableist beliefs, which can keep you, as a late-identified ND client, stuck in your past rather than helping you move towards a future where your neurotype and your life better align.

Instead, you want to look for a counsellor who is neurodivergence-affirming, meaning that they truly support all ways of being as equally valid. Neurodivergence-affirming counsellors typically have lived experience of neurodivergence (although there are some excellent allies out there as well), have done their own work on internalized ableism, and they are immersed in neurodivergent community and culture.

In a recent conversation with a few fellow neurodivergence-affirming counsellors, we recognized that neurodivergence-affirming is more than knowing the language or taking a course. It’s a paradigm shift that once you are there, there is no going back.

Red flags for neurodiversity-lite

• Language used on their website or marketing materials includes ASD, on the spectrum, person with autism, neurodiverse individuals (see here for the correct usage of neurodiverse), autism as a superpower, different ability instead of disability
• They are a practicing BCBA (Board Certified Behaviour Analyst – basically a practitioner of ABA; it is impossible to be neurodivergence-affirming and be a supporter of ABA)
• They talk about improving social skills or they recommend/use social skills programs based on neurotypical social skills as the default “right” social skills (e.g., the PEERS program or ABA)
• They specialize in CBT or DBT (both of which can heavily reinforce neuronormative thinking styles if used incorrectly for neurodivergent people)
• They highlight all of the certifications they have gained for working with neurodivergent people (keeping in mind that the vast majority of these certifications are taught from a neuronormative perspective by neurotypical people)
• They claim expertise in working with neurodivergent clients because they have family members who are neurodivergent (without also being a part of neurodivergent community themselves) or because they have worked for X number of years with neurodivergent clients in schools, etc.

Green flags for neurodivergence-affirmation

• They use “neurodiverse” correctly, as well as identity-first language (e.g., autistic, ADHDer)
• They have lived experience of neurodivergence (or are very closely allied without claiming to understand what it is like to be neurodivergent because they have family members who are neurodivergent) [If you’re in BC, check out our Find a Neurodivergent Counsellor directory!]
• They are active members of the neurodivergent community and culture
• They may use some aspects of CBT or DBT, but not as their main specialization OR they can clearly articulate how they modify these modalities for neurodivergent brains
• If they have a background in ABA, they clearly articulate how their paradigm has shifted away from ABA and they are no longer practicing it
• They believe lived experience is just as important as research-validated data due to systemic issues around research
• They believe you about your lived experience, even if it differs from their own
• They know about the Double Empathy Problem, and employ it when examining social interactions
• They actively work on challenging their own internalized ableism so that it doesn’t impact their ability to support you in your therapeutic work
• They know the difference between being neurodiversity-affirmative and neurodivergence-affirming

Ten questions to ask when interviewing a possible counsellor

Most counsellors offer a short free meet-and-greet session to help you decide whether you want to try working with them. This is an excellent opportunity to ask questions to be sure that you feel comfortable moving forward. Here are some questions that may help you decide if they are a good fit for you:

1. Can you describe your experience in working with neurodivergent clients? (or specify your own neurodivergence to make it more specific – e.g., autistic clients)
2. Do you have lived experience of neurodivergence?
3. Are you an active participant in neurodivergent communities?
4. Do you consider yourself neurodiversity-affirmative? If yes, why? (use the list of red/green flags to analyze this answer)
5. How do you incorporate neurodivergence-affirming principles into your counselling approach?
6. Can you provide examples of strategies or accommodations you use to support neurodivergent clients during sessions? (e.g., sensory accommodations, communication accommodations, different ways of processing information, stimming/fidgets, cancellation policies, etc.)
7. Are you familiar with any specific therapeutic modalities or approaches that are particularly effective for neurodivergent individuals, and do you incorporate these into your practice?
8. How do you work on your own internalized ableism?
9. How do you continue to educate yourself about emerging research and best practices related to neurodivergence, and how does this inform your clinical work?
10. Lastly, add any questions specific to your own therapeutic goals/support needs (e.g., Can you provide asynchronous texting? How do you alter your therapeutic approach for PDA clients? If I want to improve my social skills, how would you help me to do that?, etc.)

Ultimately, it is the therapeutic alliance (whether you feel a connection and feel safe) that is the biggest predictor of whether working with a counsellor is going to be a positive or negative experience. Listen to your nervous system when talking with potential counsellors and notice if you feel safe and connected, or not.

If you do find a counsellor who you feel truly comfortable with and they are not quite there in their neurodivergence-affirming paradigm shift, it may not be that you shouldn’t work with them. Rather, see if they are open to learning more (feel free to give them my website address to start!), and you just might find that not only will your life change for the better through your therapeutic work, but theirs’ will as well since ultimately being neurodivergence-affirming benefits everyone!