Accessibility and affirmation in counselling: An exploration into neurodivergent clients' experiences

Abstract

Neurodivergence is having ‘a mind that functions in ways which diverge significantly from the dominant societal standards of “normal”’ (Walker, 2021, p. 33; Neuroqueer Heresies: Notes on the Neurodiversity Paradigm, Autistic Empowerment, and Postnormal Possibilities). The neurodiversity paradigm reframes the medical model of neurodivergence within the social context of disability (den Houting, 2018 [Autism, 23, 171]; Dwyer, 2022 [Human Development, 66, 73]). Research converges counselling and neurodiversity in a disorder‐specific context, for example, the wide range of barriers of access to counselling that autistic individuals face (Hallett & Kerr, 2020 [You need support, validation, good coping skills. You need and deserve acceptance]). More recent literature points towards the need for a flexible, clear approach to neurodivergence‐informed counselling (Bolton, 2023b [Three ideas in person‐centered, neurodivergent‐affirming therapy]; Chapman & Botha, 2022 [Developmental Medicine & Child Neurology, 65, 310]; Pantazakos, 2023 [Counselling and Psychotherapy Research]). This research aimed to explore whether lived experiences of neurodivergent individuals within counselling were accessible, validating and affirming, in particular, regarding reasonable adjustments, communication and environment. An inductive, qualitative approach was adopted. Five individuals participated in semi‐structured interviews, which were analysed following a six‐phase approach to thematic analysis. Six main themes were found: (1) Feelings of frustration and confusion at language used in counselling; (2) Feelings of clarity and validation in language; (3) Feelings of overwhelm due to uncertainty and masking; (4) Feeling understood, heard and able to self‐advocate; (5) The need for a safe, secure sensory environment and accommodations made; and (6) General accessibility and practicalities. Recommendations for practice include amending the counselling contracting process and sensitivity to the communication and sensory needs of each individual client. Further research may wish to explore specific details of the present, and other emergent, neurodiversity research in more detail.

The positive impact of identity-affirming mental health treatment for neurodivergent individuals

“…The act of validating symptoms and experiences, allowing accommodations when requested, and exploring identity formation regardless of diagnosis, allowed all clients who identified as neurodivergent to benefit from treatment. As mentioned previously in this paper, these adaptations to treatment are just the start of what experts propose for neurodivergent affirming care ( Jones et al, 2024 ).…”

“…), and asking clients what aspects of their neurodivergence they would like support in addressing (e.g., time-management, emotion regulation, etc.) as opposed to assuming all neurodivergent conditions need to be addressed ( Jones et al, 2024 ). Compassion-focused therapy has been suggested as a way to balance dysregulated emotion regulation systems in neurodivergent individuals, and reduce feelings of shame and low-self compassion brought on by social stigma ( Mason et al, 2023 ).…”