Practical Steps for Neuro-Affirming Counselling Practices

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It is becoming increasingly obvious that helping professionals such as counsellors develop a better understanding of the ways in which those who identify as neurodivergent adjust their functionality to suit expected “societal norms.”  However, for the vast majority of counsellors and psychotherapists, neurodivergence is not in the core curriculum.

The pressure to fit neurotypical expectations of the ‘correct way’ to be in the world is well recognised as being a factor in the everyday struggles that neurodivergent individuals face, putting them at greater risk of additional mental health conditions. 

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The number of neurodivergent individuals is not certain: the University of Wellington in New Zealand has estimated that, globally, eight percent of adults are neurodivergent in some way (2024). Meanwhile, Ben Branson (The Hidden 20%) estimates the figures as closer to 1 in 5. Indirect conversations, an expectation of conflict, drives for perfection and ableist perceptions of ‘good enough’ are potential causes of the everyday harms that keep the nervous system of the neurodivergent client in hyper or hypo arousal.

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This is a key focus in our Working with the Functionality of Neurodivergent Children and Young People. Feedback from the therapists who are integrating sensory-awareness practices into their therapeutic approaches is showing just how much of a difference this makes to their therapeutic participants. As an underpinning to this more specialised knowledge offered in our CPD event are the thoughtful changes that can also make positive and lasting difference.

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1. Notice your language.

Educating ourselves in neuro-affirming language can make a dramatic difference in therapeutic work. As we learned from training with Myira Khan, even telling our clients that ‘we provide a safe space’ is oppressive in nature, potentially setting clients up to repeat patterns of behaviours that no longer serve them. 

Similarly, we could change the pathologising language of ‘disorders’ which, if you read the Diagnostic Statistic Manuals, tend to adopt a deficit stance. 

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2. Review your interpretation of assessments.

Whilst assessment tools serve a purpose, they are rarely relational and are often structured around neurotypical expectations. Linsey Bailey-Rowles speaks of her experience of working therapeutically with neurodivergent therapy participants who also commonly experience chronic illness. She reflects that the measures that might activate a safeguarding alert for a neurotypical client is an everyday benchmark for others. Failing to acknowledge this can be a cause of shame for people who already feel ‘less than’ or that they should be ‘getting better’ because ‘everyone else copes.’  

 

3. Check your assumptions about behaviours.

Turning up on time, making eye contact, talking about feelings, staying on topic, not asking information about the therapist ... These are all unfair judgements that have been made about not engaging ‘properly’ in counselling. 

Zara Winstanley’s FECit© model explains that the way in which we function (behave, act, engage) is affected by the environment and the context. This is true for neurodivergent and neurotypical clients however some people may be affected more than others because of other day-to-day factors such as anxiety, stress, burnout or fatigue. 

It is vital that we, as counsellors, accept that we are part of the environment and the context in which clients are trying to find safety. Our own functionality may be at odds with our therapy participant’s concepts of safety but the power dynamic is inherently in our favour meaning that the client is more likely to mask to please us rather than hold us to account.

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Final Thoughts

A neurodivergent lens is about justice, dignity, and the right to be understood on your own terms. Our experiences are that our clients do not expect us to be experts in neurodivergence. They do, though, expect us to be able to sit in their space without causing further harm to them. Our language, conversations, environments, use of assessments, environments and so on ideally reflect the ongoing endeavour to respect our place within difference. 

 

Are you a therapist looking to build more inclusive practices? Consider continuing professional development in neurodiversity-affirming approaches or collaborating with neurodivergent peers and communities to learn directly from lived experience.

#Neurodiversity #InclusiveTherapy #CounsellingTools #Anti-OppressiveCounselling #NeurodivergentVoices #TherapistsForChange

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