How can I become a more neuro-affirming practitioner?

Happily, the concept of neurodivergent-affirming practice has become increasingly important in various fields, particularly within therapeutic contexts, emphasizing the value of understanding and accommodating individuals who think and process information differently. Neurodiversity acknowledges the natural variations in the way humans learn, think, relate, perceive and sense the world. Initially, autistic advocates championed the idea of affirming neurodiversity, and many other groups of people also recognise they are neurodivergent, for example, those with attention deficit hyperactivity disorder (ADHD), Tourette’s Disorder, dyslexia, dyscalculia, and dyspraxia. It is difficult to estimate the exact prevalence of neurodivergence (ND) in our community because the ND definition varies and there is a lot of overlap between neurotypes. An estimate is between 20 and 30%, which places neurodivergent people in the minority, generally, and also specific to their neurotype/s.  In this article, we first review research on neurodivergent-affirming practices, and then, we outline the implications for clinical practice that can enhance support for neurodiverse individuals and couples.

Understanding Neurodiversity and Its Implications for Therapy

Neurodiversity promotes a paradigm shift from viewing neurodivergent conditions primarily as deficits to understanding them as being valuable forms of cognitive variation. Kapp et al. (2013) argue that acceptance of neurodiverse perspectives allows clinicians to adopt practices that support autonomy and enhance functioning within the context of neurodivergent individuals' social and emotional experiences. This perspective frames neurodivergent individuals as possessing unique strengths and capabilities, which has significant implications for therapy design and delivery.

Pantazakos and Vanaken highlight the often-ignored biases in traditional therapeutic approaches that may unintentionally pathologize neurodivergent behaviours (Pantazakos & Vanaken, 2023). They suggest that practitioners reconceptualize dysfunction from a sole focus on individual symptoms to a nuanced understanding of the relational dynamics and systemic barriers impeding neurodivergent individuals’ abilities to thrive. This reframing encourages practitioners to actively create an environment of understanding and compassion, both for the neurodivergent individuals themselves and their patterns of interaction in relationships, particularly in couples and family therapy.

Compassion-Focused Approaches

Compassion-focused therapy (CFT) is one approach that has been shown to be effective in therapy for neurodivergent clients, enhancing emotional regulation and interpersonal functioning. In an early study, Gilbert and Procter (2006) indicate that CFT allows individuals to develop self-compassion and compassion for others, which is crucial in supporting individuals who experience high levels of shame and self-criticism due to living in a society that largely does not understand neurodivergence. In couples and family therapy, compassion can play a vital role in fostering greater empathy and understanding between partners and family members, specifically targeting relationship dynamics affected by neurodivergent traits.

Twinley emphasizes that a compassionate approach can reduce stigma and promote acceptance among partners, ultimately cultivating a more supportive narrative surrounding neurodiversity within relationships (Twinley, 2024). The adoption of compassion-focused techniques can enhance emotional intimacy and facilitate effective communication in couples, leading to improved relational outcomes.

Best Practices for Neurodivergent-Affirming Therapy

Practitioners can implement several strategies to create neurodivergent-affirming practices in their therapeutic settings. First, training that emphasizes awareness of neurodiversity, including workshops and education about specific neurotypes, will equip therapists with the necessary knowledge to provide tailored support. Furthermore, implementing a flexible therapeutic approach that allows for modifications during sessions can meet unique sensory or communication needs associated with neurodivergence.

Incorporating the perspectives of neurodivergent individuals themselves in treatment planning is essential. Almakrob et al. support the idea of developing inclusive practices rooted in the lived experiences of neurodivergent individuals, ensuring that therapy resonates with their realities. This involves using techniques such as person-centred therapy, which attentively listens to the client’s needs and actively incorporates their values, preferences, and feedback (Almakrob et al., 2024).

Lastly, empowerment and advocacy play significant roles in neurodivergent-affirming practices. In addition to addressing immediate therapeutic goals but practitioners can also advocate for systemic changes that promote acceptance and understanding of neurodiversity within larger societal frameworks, such as school and workplaces.

Historically, fields of knowledge were effectively ‘silo-ed’ into fields of specialisation, for example, autism, ADHD, mood or eating disorders, and there was little communication between practitioners. When one of us (MG) opened Minds and Hearts, a clinic in Brisbane that specialised in autism in 2005, the intention was to provide a service of the highest quality to autistic people and their family members. Clients would regularly thank practitioners for the specialisation, saying, ‘it is different here, you guys really get it.”  Whilst our view is that we still need specialisation, the onus is on all of us, as practitioners, to ‘really get it’ for all our neurodivergent clients. We include below eight suggestions that you can put into practice from tomorrow to be more neuro-affirming.

What Can I do in my Clinic Tomorrow to Promote Neuro-Affirmation?

1. Engage in Continuous Education: Attend workshops and training on neurodiversity to better understand the strengths and challenges faced by neurodivergent individuals, including autism and ADHD.
   
   
2. Adopt a Flexible Approach: Modify therapy sessions to accommodate sensory sensitivities, communication preferences, and varying attention spans and processing time of typical neurodivergent clients.
   
   
3. Integrate Compassion Techniques: Employ compassion-focused interventions to improve emotional regulation and foster empathy within therapeutic relationships.
   
   
4. Involve Clients Actively: Encourage clients to share their experiences and preferences in therapy, thus allowing them to take an active role in their therapeutic process.
   
   
5. Utilize Person-Centred Therapy: Focus on tailoring therapeutic interventions to fit the unique needs of neurodivergent individuals and couples, respecting their experiences and perspectives.
   
   
6. Promote Advocacy: Encourage clients to advocate for themselves and their rights within and outside of therapy sessions, fostering a sense of empowerment. If self-advocacy is unavailable, uncover the barriers. These often include trauma and shame.
   
   
7. Create Inclusive Environments: Ensure the therapeutic setting is sensory-friendly and reflective of an understanding of neurodiverse needs, including retreat spaces and the waiting room.
   
   
8. Implement Regular Check-Ins: Allow for frequent feedback from clients regarding their experiences in therapy to continually adapt and improve therapeutic practices.

By incorporating these practices, therapists can enhance their ability to support neurodivergent individuals, couples and families effectively, ensuring that therapy is not only inclusive but empowering and affirming to their unique experiences.

Where to from here?

On 23rd May 2025 we are presenting a 3 hour live online webinar to train practitioners is ways to become more neuro-affirming in their practice:

Webcast: Neuro-Affirming Practice - 23rd May 2025 – Attwood & Garnett Events

What you will gain from the course…

• Understand the foundational principles of the neurodiversity-affirming movement and its historical context, particularly its roots in autistic advocacy from the 1990s.
• Identify the key elements of autism as a positive identity within the broader framework of neurodiversity, and how this perspective contrasts with traditional deficit-based models.
• Examine the new AHPRA guidelines for neurodiversity-affirming psychology practices and their implications for healthcare professionals beginning in December 2025.
• Explore the lived experiences of neurodivergent individuals, including the perspectives of Tony (as a father and grandfather to neurodivergent children) and Michelle (AuDHD), to enhance empathic, person-centred care.
• Analyse the benefits of adopting a neuroaffirming approach in healthcare settings, including its impact on patient outcomes and practitioner satisfaction.
• Critically evaluate research on neuroaffirming practices and apply these insights to clinical or medical settings.
• Develop practical strategies for implementing neurodiversity-affirming practices in your professional role, whether as a medical doctor, psychologist, or allied health practitioner.
• Recognize and challenge ableism and unconscious bias within healthcare systems and develop approaches to ensure more inclusive and respectful service provision for neurodivergent individuals.
• Create an action plan for continuous professional development in becoming a truly neuroaffirming practitioner, incorporating lived experience, ongoing research, and new regulations.

References

Almakrob, A., Alduais, A., Be, B., & Mhone, A. (2024). Neurodiversity in saudi arabia: a conceptual model for inclusive practices. European Journal of Education, 59(4). https://doi.org/10.1111/ejed.12809

Gilbert, P. and Procter, S. (2006). Compassionate mind training for people with high shame and self‐criticism: overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13(6), 353-379. https://doi.org/10.1002/cpp.507

Kapp, S., Gillespie‐Lynch, K., Sherman, L., & Hutman, T. (2013). Deficit, difference, or both? Autism and neurodiversity. Developmental Psychology, 49(1), 59-71. https://doi.org/10.1037/a0028353

Pantazakos, T. and Vanaken, G. (2023). Addressing the autism mental health crisis: the potential of phenomenology in neurodiversity-affirming clinical practices. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1225152

Twinley, R. (2024). Neurodivergent affirming practice in occupational therapy: scoping review and qualitative content analysis of the literature. Neurodiversity, 2. https://doi.org/10.1177/27546330241301740