Neurodiversity-affirming practices represent a significant change in the conceptualisation of therapy and support for autistic individuals. There is a recognition that autistic and other neurodiverse individuals have a different, not defective, way of perceiving, thinking, learning, and relating.
We are increasingly recognising the need for neurodiversity-affirming clinical treatment because many autistic individuals face a mental health crisis, with high rates of anxiety, depressive, eating and addictive disorders (Lai et al 2019) and early death via suicide compared to nonautistic people (Hirvikoski et al 2016). In addition, many autistic people find the mental health support services alienating and counterproductive. There is limited evidence that targeting core autistic features for change is helpful, but strong evidence that adequate support structures are helpful (Pantazakos & Vaneken, 2023).
Neurodiversity-affirming psychological practice is an approach to mental health care that respects and embraces neurological differences as natural variations of the human brain, rather than viewing them solely as disorders or deficits to be "fixed." Neurodiversity-affirming practices use affirming language and methods in therapy, a departure from traditional pathologising views (Jones et al., 2024). Neurodiversity-affirming practices incorporate a strength-based approach, focusing on what individuals can do and the strengths they bring, such as creativity, attention to detail, and hyperfocus, rather than only on their challenges. Neuroaffirming practices encourage autistic individuals to be their authentic selves, promoting autonomy rather than compliance. which improves self-esteem (Cooper et al, 2017).
When treatments for mental health concerns are modified to be neuroaffirming, symptoms of anxiety, depression and self-harm decrease (e.g. Kroll et al, 2024). Recently the PEERS® for Young Adults programme was modified to include input from neurodivergent individuals, which enhanced the programme’s effectiveness and relevance (Harker et al., 2024). This aligns with perspectives that assert that inclusive and participatory approaches improve service delivery contributing to better mental health and well-being outcomes (Maciver et al., 2023; Pritchard-Rowe & Gibson, 2024).
A recognised strength of autistic individuals is their ability to use metaphors and develop passionate interests. Incorporating interests can enhance the effectiveness of psychological treatment for anxiety and depression. For example, an interest in the Harry Potter books could enhance conventional psychological therapies for a mood disorder. In the books, a Boggart is a shape-shifter that takes the form of a person's worst fear. The Riddikulus charm forces the Boggart to change into something humorous, thus taking away its power. Laughter is essential in defeating a Boggart. Dementors feed on fear and despair and induce feelings of depression. The Patronus Charm conjures a silvery, protective animal (a Patronus) that repels Dementors. Happy and powerful memories are needed to cast it successfully. Thus, the autistic person’s enjoyment of the Harry Potter books can be integrated into psychotherapy. Noctor (2007) describes more ideas about how to incorporate Harry Potter themes into psychotherapy for mental health issues for Harry Potter fans.
A central theme of neurodiversity affirming practice is self-acceptance, especially for those autistic individuals who develop masking strategies that can lead to autistic burnout and depression. We are in the process of writing a self-help book, Being Me, based on our extensive neurodiversity affirming clinical experience. The book explores and encourages self-awareness, self-acceptance and resilience of autistic teenagers and young adults. The programme explores:
Conventional psychotherapy has been based on non-neurodivergent thinking and experiences. Neurodivergent psychologists and counsellors are developing new psychotherapies designed for those who are neurodivergent. For example, our autistic colleague Rachael Harris has written Contemplative Therapy for Clients on the Autism Spectrum (Harris, 2017). Her Reflective Integration Therapy™ programme uses the cognitive abilities associated with autism, such as intense focus and repetition and capacity for silence and withdrawal as sources of therapeutic healing.
In conclusion, a neurodiversity-affirming approach takes significant steps toward reducing feelings of isolation and fostering a culture of acceptance and inclusion. Clinical evidence supports that such strategies yield beneficial outcomes for neurodivergent individuals. Focusing on shared experiences, community engagement, and positive affirmations of identity is vital for developing effective, inclusive, and supportive practices.
On 23rd May 2025, we are presenting a 3-hour live online webinar to train practitioners in ways to become more neuroaffirming in their practice:
Webcast: Neuroaffirming Practice - 23rd May 2025 – Attwood & Garnett Events
What you will gain from the course…
Understand the foundational principles of the neurodiversity-affirming movement and its historical context, particularly its roots in autistic advocacy from the 1990s.
Identify the key elements of autism as a positive identity within the broader framework of neurodiversity, and how this perspective contrasts with traditional deficit-based models.
Examine the new AHPRA guidelines for neurodiversity-affirming psychology practices and their implications for healthcare professionals beginning in December 2025.
Explore the lived experiences of neurodivergent individuals, including the perspectives of Tony (as a father and grandfather to neurodivergent children) and Michelle (AuDHD), to enhance empathic, person-centred care.
Analyse the benefits of adopting a neuroaffirming approach in healthcare settings, including its impact on patient outcomes and practitioner satisfaction.
Critically evaluate research on neuroaffirming practices and apply these insights to clinical or medical settings.
Develop practical strategies for implementing neurodiversity-affirming practices in your professional role, whether as a medical doctor, psychologist, or allied health practitioner.
Recognize and challenge ableism and unconscious bias within healthcare systems and develop approaches to ensure more inclusive and respectful service provision for neurodivergent individuals.
Create an action plan for continuous professional development in becoming a truly neuroaffirming practitioner, incorporating lived experience, ongoing research, and new regulations.
Cooper, Smith and Russell (2017) European Journal of Social Psychology, 47.
Harker, S. A., Baxter, L. C., Gallegos, S. M., Mitchell, M. M., Zerga, L., Matthews, N. L., … & Braden, B. B. (2024). Adapting the peers® for young adults program for autistic adults across the lifespan. Healthcare, 12(16), 1586. https://doi.org/10.3390/healthcare12161586
Harris, R.L. (2017 Contemplative Therapy for Clients on the Autism Spectrum. London. Jessica Kingsley Publishers.
Hirvikoski, T., Mittendorfer-Rutz, E., Boman, M., Larsson, H., Lichtenstein, P., & Bölte, S. (2016). Premature mortality in autism spectrum disorder. The British Journal of Psychiatry, 208(3), 232–238. https://doi.org/10.1192/bjp.bp.114.160192
Jones, F., Hamilton, J., & Kargas, N. (2024). Accessibility and affirmation in counselling: an exploration into neurodivergent clients' experiences. Counselling and Psychotherapy Research, 25(1). https://doi.org/10.1002/capr.12742
Kroll E, Lederman M, Kohlmeier J, Kumar K, Ballard J, Zant I, Fenkel C. The positive impact of identity-affirming mental health treatment for neurodivergent individuals. Front Psychol. 2024 Jul 15;15:1403129. doi: 10.3389/fpsyg.2024.1403129. PMID: 39077203; PMCID: PMC11285098.
Lai MC, Kassee C, Besney R, Bonato S, Hull L, Mandy W, Szatmari P, Ameis SH. Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. Lancet Psychiatry. 2019 Oct;6(10):819-829. doi: 10.1016/S2215-0366(19)30289-5. Epub 2019 Aug 22. PMID: 31447415.
Maciver, D., Rutherford, M., Johnston, L., Curnow, E., Boilson, M., & Murray, M. (2023). An interdisciplinary nationwide complex intervention for lifespan neurodevelopmental service development: underpinning principles and realist programme theory. Frontiers in Rehabilitation Sciences, 3. https://doi.org/10.3389/fresc.2022.1060596
Noctor C. Putting Harry Potter on the couch. Clin Child Psychol Psychiatry. 2006 Oct;11(4):579-89. doi: 10.1177/1359104506067879. Erratum in: Clin Child Psychol Psychiatry. 2007 Jul;12(3):479. PMID: 17163226.
Pantazakos, T. and Vanaken, G. (2023). Addressing the autism mental health crisis: the potential of phenomenology in neurodiversity-affirming clinical practices. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1225152
Pritchard-Rowe, E. & Gibson, J. L. (2024). Professionals’ perspectives on neurodiversity-affirmative autism diagnostic assessment. Neurodiversity, 2. https://doi.org/10.1177/27546330241274674
