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🎙️ Ep 27: AuDHD Experience - Therapy Adaptations for Neurodivergent Folk (AuDHD, ADHD & Autism) — What's the Point?
"Barriers aren't a 'you' problem — they're an 'us' problem to manage together."
Hi friends. If neurodivergent people are already showing up to therapy, why do affirming adaptations even matter? In this solo episode I work through that question from my own clinical experience and lived experience as an AuDHD psychologist. We map the barriers that keep neurodivergent people out of the therapy room — physical, psychological, emotional, sensory, and cognitive — and then walk back through the same five to look at small, practical, often low-cost changes that make care genuinely accessible. From externalising working memory and body doubling, to trauma-informed safety, non-fluorescent lighting, situational mutism, and a cushion instead of new chairs, this one is for neurodivergent listeners deciding what to ask for, and for clinicians wanting to do better.
A note on the evidence: I'm speaking mostly from clinical and lived experience here, not a deep RCT base. Where I mention that neurodivergent people "endorse" adapted approaches as helpful, that's about acceptability and client-rated helpfulness — how much people value these adaptations — not proven treatment efficacy or effect sizes. The main study behind that point is Paynter, Sommer & Cook (2025), who asked autistic adults to rate the helpfulness of specific therapy adaptations. The passage on perimenopause and sensory gating is an emerging, still-contested area, not settled science — hold it lightly.
Takeaways:
• There's no single "neurodivergent barrier" — physical, psychological, emotional, sensory, and cognitive access all matter, and they stack.
• Affirming therapy is trauma-informed by default; many of us carry complex stress and iatrogenic harm from past care.
• Speech is never a choice — situational mutism is overwhelm, not defiance.
• Meltdowns are overwhelm, and what looks like social anxiety or agoraphobia is often sensory-cognitive overload.
• Most adaptations are cheap: in-session alarms, chunking information, body doubling, dimmable lights, a cushion, starting on time.
• Clients: you're allowed to ask for a reasonable accommodation. Clinicians: mostly, just ask.
If this was useful, please share it with a clinician who needs to hear it — that's the single best way to get affirming care to more people.
📚 Reference: Paynter, J., Sommer, K., & Cook, A. (2025). How can we make therapy better for autistic adults? Autistic adults' ratings of helpfulness of adaptations to therapy. Autism. https://journals.sagepub.com/doi/10.1177/13623613251313569
Educational content only — this is not therapy or personalised clinical advice.
We are different, not defective.
Keywords: neurodivergent therapy, AuDHD, autism, ADHD, affirming practice, therapy adaptations, accessibility, situational mutism, sensory overwhelm, trauma-informed care, clinical psychology
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Keywords: AuDHD podcast, autism and ADHD, neurodivergent psychologist, neurodiversity affirming, Howearth Psychology, queer psychologist, autism diagnosis, ADHD awareness, lived experience, neurodivergent mental health, clinical psychology podcast
