What to Look for in a Neurodivergence-Affirming Therapist
Published: 23 August 2026
Last updated: 23 August 2026
By Ana Planas Domínguez
Shoreline Counselling & Psychotherapy
Finding a therapist can be difficult. Finding one who understands neurodivergence without automatically treating it as a problem to be corrected can be harder.
The term neurodivergence-affirming is increasingly common, but it does not always mean the same thing in practice. A therapist may describe themselves as neurodivergence-affirming, neuroaffirmative or neurodiversity-informed, but the important question is not really which term appears on their website.
It is how they understand you once you are in the room with them.
A neurodivergence-affirming therapist should recognise that differences associated with autism, ADHD, dyslexia, dyspraxia and other forms of neurodivergence are not simply a collection of deficits. They may create genuine difficulties, sometimes substantial ones, but they are also part of how a person processes information, communicates, relates to others and experiences the world.
The HSE describes neurodiversity as the fact that people's brains work in different ways, affecting how we think, learn and communicate. It also recommends a strengths-based approach when supporting autistic people. A good therapeutic approach should be able to hold both things at once: the difficulties are real, and the person is not the difficulty.
1. They are curious about how your mind works
A neurodivergence-affirming therapist should not assume that there is one correct way to communicate, process emotions or participate in therapy.
They might ask whether you need more time to answer questions, whether direct language is easier, whether silence is useful or uncomfortable, or whether talking while looking away helps you think.
They may also ask what happens when you become overwhelmed rather than simply interpreting withdrawal, reduced eye contact or difficulty finding words as resistance.
These can sound like small details, but they matter.
For some neurodivergent people, the traditional rhythm of therapy itself can require considerable effort. Rapid back-and-forth conversation, vague questions such as “How does that make you feel?”, maintaining eye contact or having to respond immediately may make it harder, rather than easier, to think.
The HSE's guidance on neurodivergent communication recognises that differences in processing, eye contact and conversational style can affect communication. Good therapy works with those differences rather than demanding that someone communicate in the most socially conventional way.
2. They do not make masking the goal of therapy
Many neurodivergent people become very skilled at adapting themselves to other people's expectations.
That can include monitoring facial expressions, rehearsing conversations, forcing eye contact, suppressing movement, hiding sensory discomfort or carefully studying what is expected in social situations.
This is often described as masking or camouflaging.
Masking can sometimes be useful. Most of us adapt ourselves to different contexts to some extent, and there are situations where a neurodivergent person may consciously decide that masking serves a purpose.
The problem is when being acceptable to other people becomes more important than understanding what the person actually needs.
Neurodivergence-affirming therapy should therefore not simply teach somebody how to appear less autistic, less ADHD, less intense, less emotional or more socially conventional.
The question becomes something more interesting:
What are you doing because it works for you, and what are you doing because you have learned that being yourself carries a cost?
Those are not always easy things to separate.
3. They can distinguish neurodivergence from distress
Being neurodivergent does not protect someone from anxiety, depression, trauma, grief, relationship difficulties or burnout.
But neither should every difficulty automatically be explained by autism or ADHD.
A good therapist should be able to ask what is actually happening.
Someone experiencing severe exhaustion, for example, might be dealing with depression. They might be experiencing autistic burnout. They might be overwhelmed by work, caring responsibilities, sensory demands, chronic masking or a relationship that has become unsustainable.
Several things may also be true at once.
Neurodivergence-affirming therapy should make the formulation more precise, not less.
The purpose is not to explain every experience through neurodivergence. It is to make sure neurodivergence is not ignored when it is relevant.
4. They are willing to adapt therapy
Therapy should not require you to become good at therapy before therapy can help you.
Some people think best when they have time between sessions. Some find written communication helpful. Some need very clear questions. Others think aloud and need room to wander before reaching the point.
A person might prefer the camera on during online therapy, or find constant eye contact through a screen unexpectedly intense. Someone else may need to move, use a fidget, sit differently or briefly step away.
None of these things automatically make therapy less meaningful.
NICE guidance on working with autistic adults emphasises taking individual communication needs into account and explaining information clearly rather than assuming that one communication style suits everyone.
Adaptation does not mean abandoning therapeutic boundaries or structure. It means asking whether the structure is actually helping the person it is supposed to help.
5. They understand that insight can arrive with mixed feelings
Realising that you may be neurodivergent, whether through formal diagnosis, self-identification or simply beginning to recognise yourself in descriptions you had never encountered before, can be relieving.
It can also be complicated.
People sometimes revisit large parts of their lives.
Experiences previously understood as personal failures may begin to look different. Relationships can be reconsidered. There may be relief in finally understanding certain patterns, alongside anger that nobody recognised them earlier.
There can also be grief.
Not necessarily grief about being neurodivergent, but grief for the version of yourself who spent years trying harder at things that other people seemed able to do naturally.
A therapist should not dictate how you are supposed to feel about discovering or understanding your neurodivergence.
There is no compulsory journey from diagnosis to celebration, just as there is no reason it should automatically be experienced as tragedy.
6. They are interested in the rest of you
Neurodivergence matters. It is rarely the whole story.
You also have relationships, history, culture, work, family, sexuality, gender, responsibilities, losses, values and experiences that have shaped you.
Sometimes the difficulty someone brings to therapy is directly related to neurodivergence.
Sometimes it isn't.
A neurodivergence-affirming therapist should be able to hold neurodivergence in mind without reducing every experience to it.
This matters particularly when somebody has spent years being described primarily through diagnostic language.
A diagnosis can provide important information. It should not become a substitute for knowing the person.
7. They can explain what “neurodivergence-affirming” means to them
It is perfectly reasonable to ask a therapist what experience or training they have in working with neurodivergent people.
You can also ask what the term neurodivergence-affirming means in their own practice.
Their answer will probably tell you more than the label itself.
You might ask:
How do you adapt therapy for autistic or ADHD clients?
What is your understanding of masking?
Do you work with people who are self-identified as neurodivergent as well as formally diagnosed?
How do you approach sensory or communication differences?
What happens if a conventional therapeutic technique does not work for me?
How do you distinguish between supporting someone with a difficulty and trying to make them behave more neurotypically?
There does not need to be one perfect answer.
What you are looking for is thoughtfulness, flexibility and a willingness to treat you as an active participant in understanding what works.
Some warning signs
I would be cautious about a therapist who describes neurodivergence primarily as something to overcome, promises to make somebody appear more “normal”, insists on behaviours such as eye contact without considering why they may be difficult, or treats harmless self-regulation as something that should automatically stop.
I would also be cautious at the other extreme.
Affirming practice does not require pretending that neurodivergence never creates difficulties. ADHD can make daily life extraordinarily demanding. Autistic sensory differences can be disabling in unsuitable environments. Executive functioning difficulties, rejection sensitivity, overwhelm and communication differences can have very real consequences.
Acknowledging those difficulties is not incompatible with affirmation.
The difference is whether therapy starts from the assumption that you need support, or from the assumption that you need correcting.
The relationship still matters
A therapist can have extensive knowledge of neurodivergence and still not be the right therapist for you.
You should be able to disagree with them.
You should be able to say when something does not make sense.
You should not feel that you have to perform being a “good client” in order to keep the relationship comfortable.
And good therapy should not consist entirely of validation. There are times when a therapist may notice patterns, ask uncomfortable questions or challenge something you have come to believe about yourself.
Being affirming does not mean never challenging you.
It means that the challenge comes from trying to understand you more accurately, rather than trying to make you more conventional.
Neurodivergence-affirming therapy at Shoreline
At Shoreline Counselling & Psychotherapy, I work online with neurodivergent and non-neurodivergent adults, young people and families across Ireland, in English and Spanish.
My approach is integrative, relational and systemic. Neurodivergence is considered in the wider context of the person's relationships, history, environment and current circumstances rather than treated as the sole explanation for who they are.
Therapy is not about learning to pass better.
It is about understanding what is happening, what you need, and what you want to do with that understanding.
Professional sources and further reading
Health Service Executive (HSE)
Neurodiversity and communication
The HSE describes neurodiversity as variation in how people think, learn, process information and communicate.
https://www2.hse.ie/babies-children/disabilities/communication/neurodiversity-and-communication
Health Service Executive (HSE)
What is involved in an autism assessment for children or adults
Includes guidance on strengths-based approaches and individualised support following identification.
https://www2.hse.ie/conditions/autism/assessment-and-support/what-is-involved-autism-assessment/
Irish Association for Counselling & Psychotherapy (IACP), AsIAm and Thriving Autistic
Guidelines for Counsellors & Psychotherapists Working with Adult Autistic Clients
Guidance developed specifically to support neuroaffirmative therapeutic practice with autistic adults.
https://iacp.ie/Guidelines-for-Counsellors-and-Psychotherapists-working-with-Adult-Autistic-Clients
AsIAm
Adult Diagnosis
Includes guidance on recognising neurodiversity-affirmative professional practice and the importance of language that does not automatically frame autism in deficit terms.
https://asiam.ie/advice-guidance/adult-diagnosis
National Institute for Health and Care Excellence (NICE)
Autism spectrum disorder in adults: diagnosis and management (CG142)
Recommends adapting communication and support to the individual needs and preferences of autistic adults.
https://www.nice.org.uk/guidance/cg142
This article provides general information and is not a substitute for individual mental health or medical advice.