Neurodiversity Affirming Care: What Does it Mean for Therapy?

Neurodiversity-affirming care is a practice founded on accepting each person’s differences and celebrating our individual strengths.¹ For those who are neurodivergent, the shift towards neurodiversity-affirming practices can come with a significant mental health boost by celebrating diverse ways of thinking and fostering a sense of belonging, rather than framing differences as challenges to be fixed.²

Given the significant variability in how our minds think and process, therapy requires inclusive, supportive practices so each person’s unique strengths are valued.^{2, 3} Neurodiversity-affirming practices shift therapy away from a model focused on correcting perceived differences and instead embrace and support the unique strengths and needs of neurodivergent people.^{1, 2}

What Does Neurodiversity Affirming Mean?

Neurodiversity-affirming refers to the acknowledgment that individuals have differences in their abilities and the way in which they interact with the world. It’s a step forward from the belief that those who are neurodiverse have a challenge to overcome. Instead, neurodiversity affirming celebrates our diverse minds and how we uniquely perceive information, process and learn.²

Neurodiversity-affirming practices are crucial for promoting inclusivity because they embrace, rather than challenge, individual differences, allowing those who are neurodiverse to feel supported.¹ This shift is vital for mental health: those who are neurodivergent but do not receive an affirming medical diagnosis report significantly worse mental health symptoms. ²

A common concern voiced by those with autism regarding applied behavior analysis (ABA), the first intervention widely applied to those with autism, is that they experience iatrogenic effects.¹ Unfortunately, in the past, these concerns were met with minimization. However, the purpose of neurodivergent-affirming therapy is to consider these concerns, acknowledge their validity and work collaboratively to identify an alternative.¹

Neurodiversity-affirming therapy may include the validation of symptoms and experiences, exploration of identity formation regardless of diagnosis and permission to accommodate specific needs when requested.²

What Does Neurodiversity Affirming Therapy Look Like?

Neurodiversity-affirming therapy celebrates the differences that make each person unique rather than focusing on how one person differs from what is considered normal.^{1, 2} It focuses on each person’s strengths rather than the belief that those who are neurodivergent need to be changed.¹

• Respecting individual differences. The keystone trait of neurodiverse-affirmative therapy is acknowledging and accepting that everyone’s brain works differently and that there is no right way to think, perceive and process.⁴
• Self-advocacy. Neurodiversity-affirming therapy encourages individuals to advocate for their needs, feeding into the acceptance that since everyone is different, therapy needs also differ from person to person.^{1, 5}
• Strengths-based approach. Neurodiversity-affirming centers on a strengths-based approach that focuses on the unique strengths of neurodivergent individuals rather than viewing their challenges and traits as something to be corrected ⁶
• Increasing inclusivity. Neurodiversity-affirming practices acknowledge that those who are neurodivergent may face societal barriers, such as discrimination and prejudices. Therapists work to create a more inclusive and accepting ⁶

The Benefits of Neurodiversity Affirming Practices

Neurodiverse-affirming therapy offers many benefits for neurodivergent individuals.

Boost Self-Esteem

Neurodiversity-affirming focuses on accepting and celebrating differences, which helps enhance self-esteem by allowing neurodiverse individuals to feel as though they belong.⁷ This shift in therapy improves mental health by fostering self-acceptance in neurodivergent individuals.²

Reduce Stigma

Neurodiversity-affirming practices also help to reduce the stigma surrounding neurodiversity by challenging the negative stereotypes and reframing these differences as something to be celebrated and embraced rather than corrected.⁶ In this way, neurodiversity-affirming therapy creates a more accepting society, which then increases inclusivity. Society is more knowledgeable about how to support everyone, no matter their differences.⁶

Neurodivergent-affirming therapy encourages neurodiverse individuals to be proud of their differences.⁶ Studies have found that the well-being of neurodivergent individuals is more dependent on support and acceptance from their peers and family than it is on reducing neurodivergent symptoms.²

Improve Social Skills

Along with the ability to create a more inclusive society, neurodiversity-affirming speech therapy can help improve social and communication skills. It can allow those who are neurodiverse to express their thoughts and feelings more clearly in social interactions.⁸

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How to Implement Neurodiversity Affirming Practices in Therapy?

For occupational or physical therapists looking to incorporate neurodiversity-affirming practices into their therapies, there are many avenues they can explore to make this shift.

First, incorporating neurodiverse-affirming therapy may require the therapist to adjust their lens and consider how their words or actions can impact those who are neurodiverse.⁹ Shifting the mindset from a deficit-based to a strengths-based approach requires a change in words, tone and actions. Therapists should evaluate their method and consider how to pivot towards a strengths-based practice, as this could influence how those who are neurodiverse perceive themselves and others.^{1, 9} Many advocates of neurodiversity-affirming practices suggest switching the focus of intervention from neurodivergent individuals to their environment.¹⁰ To support this shift, learning from neurodivergent voices is key—they best understand which language and actions are respectful versus harmful.²

Therapists who are interested in neurodiversity-affirming therapy should also avoid the reinforcement of masking, which is when neurodiverse individuals camouflage their innate social behaviors to adapt to the neurotypical people around them.⁴ Masking can be detrimental to mental health and well-being, so therapists should ensure their practice focuses on supporting neurodivergent traits by showing eagerness to understand their innate behaviors and help them feel comfortable displaying them.⁷

For therapists looking to integrate a neurodiversity-affirming approach, having the right training and resources makes all the difference. The University of St. Augustine for Health Sciences (USAHS) offers graduate occupational therapy, speech-language pathology and physical therapy programs that integrate these principles to prepare compassionate, competent practitioners.

A Neurodiverse Affirming Approach

Neurodivergent-affirming care focuses on celebrating the differences that make everyone unique rather than perpetuating the stereotype that neurodivergent individuals have challenges that need to be corrected.¹ This therapeutic approach is critical for fostering inclusivity and success, ensuring that those who are neurodivergent see a mental health boost.²

Sources

1. Lerner, M. D., Gurba, A. N., & Gassner, D. L. “A framework for neurodiversity-affirming interventions for autistic individuals,” Journal of Consulting and Clinical Psychology, 2023: 91(9), 503–504, https://doi.org/10.1037/ccp0000839
2. Kroll, E., et al. “The positive impact of identity-affirming mental health treatment for neurodivergent individuals,” Frontiers in Psychology, 2024: 15, https://doi.org/10.3389/fpsyg.2024.1403129.
3. Graf‐Kurtulus, S., & Gelo, O. C. G. “Rethinking psychological interventions in autism: Toward a neurodiversity‐affirming approach,” Counselling and Psychotherapy Research, 2024: 25(1), https://doi.org/10.1002/capr.12874
4. Dwyer, P. “The Neurodiversity Approach(es): What Are They and What Do They Mean for Researchers?” Human Development, 2022: 66(2), 73–92, https://doi.org/10.1159/000523723.
5. Jones, F., Hamilton, J., & Niko Kargas. “Accessibility and affirmation in counselling: An exploration into neurodivergent clients’ experiences,” Counselling and Psychotherapy Research, 2024, https://doi.org/10.1002/capr.12742.
6. Chapman, R., & Botha, M. “Neurodivergence‐informed therapy,” Developmental Medicine & Child Neurology, 2022: 65(3), 310–317, https://doi.org/10.1111/dmcn.15384.
7. Silvester, S.-J. E., & Rankine, R. “Neurodiversity-affirming school counselling: supporting neurodivergent student wellbeing with person-centred therapy,” Journal of Psychologists and Counsellors in Schools, 2024: 34(3), 266–284, https://doi.org/10.1177/20556365241267050.
8. Gaddy, C., & Crow, H. “A Primer on Neurodiversity-Affirming Speech and Language Services for Autistic Individuals,” Perspectives of the ASHA Special Interest Groups, 2023: 8(6), 1220–1237, https://doi.org/10.1044/2023_persp-23-00106.
9. Mills, D. “Applying a neurodiversity affirmative approach to the pluralistic framework,” Counselling and Psychotherapy Research, 2023: 23(3), 627–637, https://doi.org/10.1002/capr.12637
10. Pantazakos, T. & Vanaken, G.-J. “Addressing the autism mental health crisis: the potential of phenomenology in neurodiversity-affirming clinical practices,” Frontiers in Psychology, 2023: 14, https://doi.org/10.3389/fpsyg.2023.1225152.