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Finding a Therapist

Not every therapist understands autism. Some make things worse. How do you find someone who actually helps?

The hard truth

Most therapists are trained in neurotypical psychology. Their techniques often don't work for autistic people, or make things worse. A therapist who's great for someone else might be a disaster for you.

This doesn't mean therapy can't help. It means you need to be selective about who you choose. You're allowed to leave. You're allowed to find someone else. You're not a difficult client if you don't click with the first one.

What to look for: good signs

They believe you

No doubt or 'you don't seem autistic at all.' They take your experience seriously.

They understand masking

They get that you've learned to adapt and that this costs energy.

They listen more than they talk

Therapy is about you, not about imposing their interpretations.

They're flexible

Adaptable with appointments, okay with written communication, understanding about cancellations.

They explain what they're doing

No mysterious techniques. You understand the approach and why it might help.

They have experience with adults

Autism in children is different. Look for someone who specifically works with adults.

Red flags: when to leave

'You're not autistic enough for...'

Autism is a spectrum. There is no 'enough.' This therapist doesn't understand the basics.

They want to 'cure' or 'reduce' your autism

Autism isn't a disease. Good therapy helps you live with it, not hide it.

They force eye contact

If eye contact is difficult for you, a therapist should respect that.

They ignore sensory needs

Harsh lighting, smells, background noise. A good therapist asks about these.

They keep comparing you to neurotypical norms

'But others don't find that difficult' isn't a helpful observation.

You feel worse after sessions

Therapy can be confronting, but you should feel heard, not smaller.

Where to search

1

Autism organizations

National autism societies often maintain directories of specialists. Check your local autism association.

2

Online directories

Psychology Today, Good Therapy, and similar sites let you filter for autism experience. Read reviews.

3

Autism communities

Reddit (r/autism), Facebook groups, forums. Ask for recommendations in your area.

4

Your GP

Ask specifically for therapists with autism experience. Not just 'someone good.'

5

Your diagnosis clinic

After diagnosis you often get referrals. Ask explicitly for options.

Questions for the first meeting

An introductory session is also for you to check if it's a good fit. You're allowed to ask questions. Here are some:

  • How much experience do you have with autistic adults?
  • Are you familiar with the concept of masking?
  • How do you adapt your approach for autistic clients?
  • Can I contact you outside of sessions if something comes up?
  • What's your policy if I need to cancel due to overstimulation?
  • Is it okay if I take notes or record sessions?

You can quit

If it's not working, you can stop. Sometimes it just doesn't click. Sometimes the approach is wrong. Sometimes the therapist isn't skilled enough for your situation.

You don't need to give an elaborate explanation. "This isn't working for me" is enough. A good therapist respects that.

Therapy types that may help

Cognitive Behavioral Therapy (CBT)

Can help with specific issues like anxiety or sleep. Works best when adapted for autism.

EMDR

For trauma processing. Many autistic adults carry trauma from not being understood or from years of masking.

Psychoeducation

Learning about autism and how it affects you. Often the first step after diagnosis.

Coaching

Practical help with daily things: planning, energy management, work. Not therapy, but can help enormously.