Counselling & Therapy
Therapy can help - but it needs to fit
Therapy and counselling can make a real difference to the mental health and wellbeing of neurodivergent people. But not all approaches work in the same way, and not all therapists understand neurodivergence.
Many neurodivergent people have had difficult experiences in therapy - feeling misunderstood, judged, or pushed to change things that are part of who they are rather than the source of their distress.
A bad experience does not mean therapy is not for you
If you have tried therapy before and it did not help, it may not have been the right approach - or the right therapist. Finding someone who understands neurodivergence can change everything.
This section of the Advice Hub explains the main types of therapy and counselling available, how they work, and what to look for if you are neurodivergent.
What is the difference between counselling and therapy?
The terms “counselling” and “therapy” are often used interchangeably, but they have different roots and can involve different approaches.
Counselling tends to focus on a specific issue or set of feelings. It is often shorter-term and draws on person-centred or humanistic approaches, giving you space to explore what is happening in a supportive, non-directive way.
Psychotherapy tends to go deeper. It may explore patterns from childhood, unconscious processes, and long-standing difficulties with relationships, identity, or emotional regulation. It is often longer-term and draws on psychodynamic, psychoanalytic, or integrative models.
In practice, there is significant overlap. Many practitioners combine elements of both, and the most important factor is usually the quality of the relationship between you and your therapist.
Read more about counselling Read more about psychotherapy
Types of therapy
There are many different therapeutic approaches. Each has a different focus and works in a different way. Here is a brief overview of the main types covered in this section:
Cognitive Behavioural Therapy (CBT)
CBT focuses on the connection between thoughts, feelings, and behaviours. It is structured, goal-oriented, and often time-limited. CBT has a strong evidence base for anxiety and depression, but standard CBT may need significant adaptation for neurodivergent people.
Dialectical Behaviour Therapy (DBT)
DBT was originally developed for borderline personality disorder but has growing evidence for emotional dysregulation more broadly. It combines cognitive-behavioural techniques with mindfulness and distress tolerance skills. DBT can be particularly relevant for autistic people and people with ADHD who struggle with emotional regulation.
Acceptance and Commitment Therapy (ACT)
ACT focuses on psychological flexibility - learning to accept difficult thoughts and feelings rather than fighting them, while taking action aligned with your values. There is growing interest in ACT for ADHD and autism, particularly as it does not require you to change your thoughts - only your relationship with them.
Eye Movement Desensitisation and Reprocessing (EMDR)
EMDR is a trauma-processing therapy that uses bilateral stimulation (such as eye movements) to help the brain reprocess distressing memories. Given that neurodivergent people experience higher rates of trauma, bullying, and adverse life events, EMDR can be an important option.
Self-help and wellbeing
Not all support needs to come from a therapist. Mindfulness, grounding techniques, breathing exercises, and other self-help strategies can be valuable - though they often need adapting for neurodivergent people.
Read more about self-help and wellbeing
Finding a neurodiversity-affirming therapist
A neurodiversity-affirming therapist is someone who:
- Understands that neurodivergence is a natural variation, not a disorder to be cured
- Does not try to make you “less autistic” or “less ADHD”
- Adapts their approach to your communication and sensory needs
- Recognises that many difficulties arise from environment and social context, not from you being “broken”
- Is willing to learn from your lived experience, not just from textbooks
Questions to ask a potential therapist
Before starting therapy, consider asking: Do you have experience working with neurodivergent adults? How would you adapt your approach for someone with ADHD or autism? Are you familiar with the neurodiversity paradigm?
Research has found that many therapist training programmes do not cover autism or neurodiversity at all, creating what researchers have described as a “blind spot in mental healthcare.”1 This means you may need to be proactive in finding the right fit.
Accessing therapy in the UK
Through the NHS
The NHS offers talking therapies through the NHS Talking Therapies programme (formerly IAPT). This is free and available through self-referral in most areas. However, NHS therapy is typically short-term (6-12 sessions) and most commonly offers CBT. Waiting times vary significantly by area.
Through a charity or low-cost service
Many charities and community organisations offer free or low-cost counselling. Some specifically serve neurodivergent people or people with mental health difficulties. The neurobetter local services directory can help you find services in your area.
Privately
Private therapy offers more choice of therapist and approach, but costs vary widely (typically between £40 and £120 per session). Look for therapists registered with professional bodies such as the BACP, UKCP, or BPS.
Through your employer
Some employers offer counselling through Employee Assistance Programmes (EAPs) or occupational health services. These are typically short-term but can be a useful starting point.
Practical considerations for neurodivergent people
Therapy involves more than just the conversation. The environment, format, and structure all matter - and these can be particular barriers for neurodivergent people.
Things to consider:
- Sensory environment - lighting, noise, textures, and smells in the therapy room can affect your ability to engage. Ask about the space in advance, or consider online sessions if the physical environment is a barrier.
- Communication style - some people process better through talking, others through writing, drawing, or movement. A good therapist will adapt.
- Structure and predictability - knowing what to expect in each session, having a consistent format, and understanding the process can reduce anxiety.
- Processing time - many neurodivergent people need more time to process questions and formulate responses. A therapist who is comfortable with silence and does not rush is important.
- Homework and between-session tasks - CBT and DBT often involve homework. For people with ADHD, executive functioning difficulties can make this challenging. This is worth discussing openly.
Therapy should never make you feel worse about who you are
If a therapist makes you feel that your neurodivergence is the problem - rather than the distress you are experiencing - it may be time to find a different therapist. You deserve support that affirms who you are.
Further reading on neurobetter
neurobetter services
- Local services directory - find therapists and support services near you
- Online community - connect with others who have navigated therapy as neurodivergent people
- Ask a Counsellor - get a confidential response from a registered counsellor
If you are in crisis
If you are struggling right now, please visit our Get Help Now page for immediate support options, including Samaritans (116 123), Crisis Text Line (text SHOUT to 85258), and NHS 111.
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Lipinski, S. et al. (2022). A blind spot in mental healthcare? Psychotherapists lack education and expertise for the support of adults on the autism spectrum. Autism, 26(6), pp. 1509-1521. https://doi.org/10.1177/13623613211057973 ↩
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