‘Neuroaffirming therapy/assessments'- how to spot the bullsh*t

Many practitioners claim to be ‘neuroaffirming’ or 'neurodivergent affirming' but sadly miss the mark...

I'm not always going to 'get it right' myself- we're all learning together. The main thing is that we all have an open mind, aim to be respectful towards others, and that we listen to autistic voices- that we are autistic led.

What is 'Neuroaffirming'?

Neuroaffirming practice recognises and respects the diverse ways in which brains can function. It's about affirming our unique neurological makeup without trying to fit us into a neurotypical mould.

‘Neuroaffirming’ is a popular buzzword!

Many therapists are ‘getting on the bandwagon’, but not quite sure where it’s taking them. The neuroaffirming paradigm, whilst being a wonderful but slow cultural shift, is not deeply understood.

I’ve come across websites of other therapists who say that they’re ‘neuroaffirming’...they might have one or two blog posts on the topic and used the word ‘neuroaffirming’ here and there, and sometimes use our symbol (rainbow infinity), but on another page on their website, they'll refer to ‘spectrum’, or 'ASD'. In more subtle cases, their language will look affirming, but then they state that they offer CBT, or something similar…(most autistic folk really dislike CBT by the way). In other cases, you might see ‘a person living with autism’ or ‘a person on the spectrum’... (again, autism is not a monster I'm living with, plus I’m not standing on a rainbow).

Some Examples

Some really clear-cut examples are like the time when I took one of my children to a speech therapist who tried to get my son to look at her when saying hello and goodbye, and would talk about ‘not dropping the conversational ball’ and so on. Another therapist tried to convince me that I was not autistic, and how fortunate that is.

I’ve heard of other therapists refer to the word ‘residual autism’, and that you can 'fall off the spectrum'. But as we know, once you’re born autistic, you are always autistic — you can’t just 'fall off the spectrum'.

How to find a neuroaffirming therapist – Tips

1. Check Out Their Website

You can tell by the way that the website is written—if it sounds smooth and professional, whilst also using the odd buzz word, I doubt they are neuroaffirming. Maybe they would like to be neuroaffirming, which is a great start.

Does their website seem 'autistic friendly'? If there are loads of moving panels, hard to read font, and busy graphics, they might not have thought about what their website (their digital office) should consider...

Is there an 'all abilities button'? Does it feel genuine? Does it feel like it's all written by an AI tool? (watch for words like 'delve!')

2. Assess Their Therapy Space (if relevant)

A therapist's environment speaks volumes. I've heard of a therapist who claimed to specialise in supporting autistic people but had fluro lights in her office…arghhh!!! Another one who has incense burning at the reception and no fidget toys. Note that most autistic therapists work from home, so you'll find most of us via telehealth only by the way ;) So, if you're seeing someone in person- ask yourself- what is the waiting room like? What is the lighting like? and so on.

3. What Is Their Approach Like?

Are you reminded to let your eyes look where they need to look? To move your body how you need to move? To take shoes off? (etc). Do you feel respected and safe? Are you given options about therapy? Do you feel you can set the pace, ask them to slow down, change topics, state that you don't get something? (etc). Is the support you're given about better understanding your brain, advocating for your needs, and making accomodations instead of doing exposure therapy, trying to change your thoughts, being told about 'sleep hygiene', or given info on eating issues (for example) not done by an autistic person?

4. Do They Embrace Their Own Neurodiversity?

If you’re after someone who is truly neuroaffirming, it's helpful to see a therapist who is neurodivergent themselves. We live and breathe it- we GET it. I'd rather see someone who is open about being autistic themselves....some of us state that we have 'lived experience of neurodivergence', but this could mean our child, partner, or parent is autistic, or has OCD, or dyslexia. It's very vague. If you're autistic, say that you're autistic. Yes, it's a slight risk stating up front on my social media and website that I am autistic, but it's also role-modelling to my neurokin about being open. It's harmful for our mental health to mask and hide our true autistic selves- most of us have had to do that for years. Let's be brave as therapists, and state that we are actually autistic.

What to Do When You Can’t Find the Help You Need?

There is such a high demand for our services, that it makes it hard to A)- find a therapist, and 2)- find a truly neuroaffirming therapist. We often have closed books too. I am working on growing my own team by the way ;)

I would look to find the many wonderful autism advocates, counsellors, mental health occupational therapists, mental health social workers, and other mums and dads who have ‘been there’. Psychologists are not the 'holy grail', and if they offer CBT, walk away. Trust your gut. What does it tell you? 'Therapy' should never be about changing you- your thoughts, etc, but about giving you support. It's about understanding your disability so that you can advocate for yourself, set healthy boundaries, and move towards accepting who you are.

I have had help from many wonderful autistic counsellors who are very practical and helpful. Mental health social workers and OTs are great too. Lots of other choices.

Checklist: Neuroaffirmative Therapy in Action

• Respectful and inclusive language

• Sensory-friendly environment

• Focus on strengths, not just challenges

• Avoids pushing neurotypical social norms

• Uses practices tailored to neurodivergent needs

• Autistic led and informed

How do I try to be ‘neuroaffirming’?

• I am autistic myself

• I use neuroaffirming language

• I use a strength-based approach

• I use a trauma-informed approach, given that many of us have post-traumatic stress symptoms, like myself.

• I listen to other autistic voices via various means, and have ongoing supervision

• I role model openly stimming, moving my body how it wants to move, removing my shoes and crossing my legs, letting my eyes go where they need to go, changing topics, talking over the top of each other… this is all normal and natural

• I see people from their lens, not my own- autistic people are all so different to each other as well- I do not assume that someone is like me simply because they too are autistic, or have ADHD, for example

• I see autism and ADHD as a disability, and not as a disorder. It comes at a cost too- you won't hear me saying that you have a 'superpower', as most of us hate that type of description by the way

• I view meltdowns as a personal crisis, and not as a behaviour- we are not being manipulative

• I would never recommend ABA therapy to anyone

• I firmly believe that we are different, and not less, and that all brains are unique.. I’ve noticed that some autistic folk can feel superior to non-autistic people, but that’s just maintaining the issue- we are all human, and have a place in society as equals.

• I aim to be humble and open-minded- the language is changing all the time, and we need to stay up-to-date, humble and open to being challenged

I'm not always going to 'get it right' myself, and I want you to let me know if I haven't been respectful and inclusive to you. There is always room to grow and learn, and as long as we all remain open-minded, we can change this culture.