Why Neurodivergent-Affirming Therapy Is a Foundational Shift
Therapy is a journey of change and it can be neuro-affirmative too!
I believe that therapy is a powerful tool for change, and I created Ouroboros Therapy with this in mind. The serpent that devours its own tail is the very core of my practice. My therapy room is open to both neurotypical and neurodivergent clients, but while traditional therapy often fits the neurotypical brain, it can be a challenge for neurodiverse clients. For many Autistic, ADHD, and other neurodivergent individuals, the traditional clinical setting can feel difficult to navigate. This is why a neuroaffirmative approach isn't just a niche skill, but a vital re-imagining of what it means to offer care. It moves from a deficit-based framework to one that celebrates difference.
Traditional therapy, for all its good intentions, often requires neurodivergent clients to fit a neurotypical standard and its expectations. This process of constant adjustment—the need to hide stims, make eye contact, or force a rigid conversation structure—gets in the way of the very safety and connection I aim to build.
This is where the SPACE model (Doherty, McCowan, Shaw) comes in. Grounded in clinical practice, lived experience, and emerging research, it's a framework that asks clinicians to do more than just understand; it asks us to adapt our approach and be proactive in building a truly safe and supportive environment.
This means:
Sensory Needs: It asks us to consider what our clients' nervous systems are telling us, creating an environment where they can drop their guard.
Predictability: It invites us to build a container of safety through clear structure and consistency, honoring a need for certainty in an often overwhelming world.
Acceptance: It challenges us to embrace neurodivergent ways of being as valid, not as something to be corrected in a neurotypical way.
Communication: It encourages us to step outside our own communication styles to meet our clients where they are, from literal language to nonverbal cues, to multiple reminders for the session.
Empathy: It asks us to look beyond our own lived experience to truly understand and validate the world from a neurodivergent perspective.
The Practice of Neuroaffirmative Care
So, what does this look like in the therapy room? This is where intentional flexibility truly shines.
It’s about affirming a client’s core identity, helping them explore what their neurodivergence truly means for them—not just in terms of challenges, but in terms of strengths and unique ways of being. We actively challenge internalized ableism—the negative beliefs a client may hold about themselves because of a lifetime of societal expectations. Ultimately, this practice is about respecting a client's chosen language and identity, and helping them build a positive self. We also keep in mind the role of masking and people-pleasing.
This work also requires a re-think of our therapeutic frame. We learn to incorporate interests and passions as a genuine doorway into their inner world. We also make space for alternative communication methods. Many neurodivergent individuals express themselves best through non-verbal modes using visual tools, writing, music, or art. This is why creative tools are so useful for encouraging a deeper, more authentic expression.
Finally, this flexibility requires us to adapt our techniques themselves. We recognize that no single modality works for everyone, and for this reason, while my approach is still very psychodynamic, I integrate creative tools like cards and music, psychoeducation, and ACT (Acceptance and Commitment Therapy) when appropriate.
The Question of Space: In-Person vs. Online Therapy
This conversation about safety extends beyond our therapeutic techniques to the very location of our sessions. For some neurodivergent individuals and people with chronic fatigue, the idea of an in-person session, with the unspoken costs of commuting and navigating public spaces, can feel like an overwhelming mountain to climb. The stress of the journey can drain them before they even enter the room, leaving little energy for the deep work we need to do. For these clients, the online space isn’t a lesser option; it's a more spacious and accessible one, allowing them to engage in therapy from their own regulated environment.
That being said, a well-designed in-person space can be an incredible tool. When we are thoughtful about integrating sensory safety measures—from lighting to sound—the in-person therapy room can become a unique and powerful container. It's about helping clients understand their unique sensory profile and collaborating to create an environment that feels calm and regulated.
What is very important in the end is finding a therapy space that can be truly tailored to your unique needs.
