How I Create a Neurodiversity Affirming Psychotherapy Practice

To begin, let’s look at what neurodiversity actually means. Neurodiversity refers to the fact that all human brains’ are wired to interact with the world differently (as it relates to processing, input, sensory needs, learning etc.) and that there is nothing wrong with this. Though neurodiversity refers to the diversity of brain functioning across all people, within my practice and for many others, we are referring more specifically to neurodivergence as it relates to Autism, ADHD, learning disabilities and intellectual disabilities.

Due to a rise in understanding of neurodiversity, the term “neurodiversity affirming services” has also seen an uptick in popularity. But what does this term actually mean? How can you make sure that a service provider claiming to be neurodiversity affirming, actually is. There does not appear to be one universally accepted definition of this term. It feels important for me to address what being neurodiversity affirming within my psychotherapy practice means. 

Here are the core tenets that I integrate into my practice in order to ensure that I am providing a neurodiversity affirming service:

Working from the social model of disability

In a nutshell, the social model of disability proposes that a disability is caused by the society in which it exists. The problem does not lie in the disability itself, it lies in the barriers which are created by society. This means that I will support  people to remove barriers to their goals, to access safe spaces and to access supports and accommodations which address the social part of their disability.

Person centered approaches

Working from a person centered approach means that I do not believe that there is a “one size fits all” way of supporting people. I want to get to know you as a person, your values, your desires, your goals, and I want to ensure that you have all the necessary information when making decisions.  I also want to get to know how your neurodivergence impacts you specifically so that I can tailor support to you. 

No use of or adherence to normalization 

There is a longstanding history of normalization when it comes to the ways in which neurodivergent people have been treated. Normalization is the process of ridding people of the behaviors that make them stand out as “abnormal”. This process continues to exist through government sanctioned treatments. I ensure that I am not engaging in behaviors or treatments which look to pathologize behaviors which are not considered accepted or “normal” in our society. Rather I look to understand these behaviors as a reflection of the wide range of differences and gifts within the neurodiversity spectrum.

This means that I support a focus on special interests to guide exploration, stims, body movement during sessions and lack of eye contact.

This means that I am anti-ABA or any form of therapy which is coercive in nature or which has caused harm to the neurodiverse population.

Continued learning into the intersectionality of race, culture, gender and neurodiversity/disability.

I am committed to continuing to learn how race, culture and gender intersect with neurodiversity/disability to create unique experiences and impacts for individuals. The research into these areas is growing and changing and there are many important factors to pay attention to when offering psychotherapeutic services. For example, we know that girls and women are less likely to be diagnosed with autism even when autism is present due to stereotypes, masking and discrimination. We know that autism impacts all races and genders. It also appears that the gap in diagnosing black youth with autism is closing in some countries with growing outreach efforts.

Access to evidence based therapy

The neurodiverse population should also have access to the most evidence based therapy for whatever it is they are struggling with. I ensure this while also ensuring that these therapeutic interventions are flexible, adapted to the person’s needs, capacities, and desires, while respecting their identity and seeking consent for interventions throughout therapy.

A thorough understanding of all needs

I ensure this with all my clients but even more important with those who are neurodiverse is to ensure that a thorough intake is completed which focuses on understanding and differentiating social, mental health, disability, environmental and relational needs in order to structure the way I intervene and support appropriately. 

Here are the core values that I abide by my practice in order to ensure that I am providing a neurodiversity affirming service:

Believing in potential 

There is a longstanding history of low expectations for the neurodiverse, and in turn opportunities are limited. I am committed to ensuring that each person’s potential is optimized. 

Respecting agency 

As it relates to decision making, perspectives, opinions, boundaries, consent. 

Learning from the community 

Remaining committed to hearing the voices of the neurodiverse community. 

To conclude, neurodiversity affirming care should look to ensure a safe space for neurodivergent individuals to show up as their authentic selves, to be seen as whole, and to be understood within their larger societal context.

Written by Tara McRae MSW RSW

Registered Social Worker, Psychotherapist

Sources

https://www.health.harvard.edu/blog/what-is-neurodiversity-202111232645

Volume 10 Issue 2 Spring 2022 Article 13 April 2022 Neurodiversity-Affirming Pr ersity-Affirming Practices ar actices are a Mor e a Moral Imper al Imperative for Occupational Therapy Aaron R. Dallman Towson University – USA, aaronrdallman@gmail.com Kathryn L. Williams Therapy Playground - USA, katie.williams@therapyplayground.com Lauren Villa Towson University – USA, lvilla7@students.towson.edu 

https://www.liebertpub.com/action/showCitFormats?doi=10.1089%2Faut.2021.0091