Month: February 2024

Counselling AuDHD

A change is needed! Time and time again I have parents and individuals who are autistic, or AuDHD lamenting how hard it is to find counsellors who understand neurodivergence well enough to offer non-harmful support.

I get that, as I too struggle to find supports that are neurodivergent friendly.

It can be challenging to find resources that are up to date and include neurodivergent lived experiences, what with the many, many self-proclaimed experts on neurodiversity. Some with lived experience, some with academic training, some with neither.

Academic research is evolving rapidly in this area, which can also create barriers to having up to date knowledge on what is evidence-based. The online Autism, ADHD, and AuDHD communities are growing as well, and there is so much misinformation out there. ABA used to be the gold standard, and now many of us know better (and the neurodivergent and disability community have fought against it for a very long time.)

So what do we do?

Shown on the left is a neat infographic from I enjoyed that there were more explicit examples of how to accommodate and thus I am sharing it here.

We need to do better

What I hear from friends and clients is that many therapists get so invested in doing things a certain way, that they lack the flexibility to accommodate sensory issues, literal thinking, anxiety over choices, communication shutdowns (autism/ADHD shutdowns in particular), and as a result they end up doing very harmful things.

I also know that many, many folks who do work supporting individuals with Autism Spectrum Disorder are still following the protocols used to teach ”social skills”. Those skills are very often mired in ableism and in neuro-supremacy ideas. Social skills should teach how to take perspective, advocate for one’s self, and strengthen one’s understanding of boundaries and emotional regulation-yet the mainstream view is to teach neurodivergent folk to act neurotypical which is linked to negative health impacts including anxiety, depression, self-harm and long term isolation from society.

I get it-as research does evolve quickly and most professionals in helper fields (teachers, counsellors, life-skills workers, social workers, nurses, etc) find that there is a never-ending need from clients/patients/students and very little time to do anything but put out fires as best they can. Spending time reading medical journals is a luxury that many of us simply don’t have time to do, and that is so incredibly sad (and wrong, so very wrong). Even with professional development days and requirements, many folk may be unable to access the time and energy they need to stay up to date and many may feel resistant to changing their modality for a wide variety of reasons.

So let’s look at some very basic changes we can make to better accommodate neurodivergent minds.


We can approach our clients/patients/students with a modicum of the flexibility that we tell them they need to have. This means that if using a sliding scale causes them anxiety, instead we can use words, narrow the choices, and use pictograms. It means that if they do not have the attention span for an hour-long appointment, we can have shorter appointments. If the program we are running is all about metaphors, and that isn’t working, we can change it to something more explicit.

Active Listening

We can listen for the point of understanding rather than merely waiting to have our say. Many, many neurodivergent people have shared with me stories of their teacher/counselor, etc not HEARING them when they try to communicate what they need. LISTEN, ask open-ended questions, and make sure you understand. Not just for adults either, but for all ages.

They are the expert

We can remember that no matter how many other neurodivergent folks we work with, we are NOT the expert on their life. We can be curious instead of making assumptions, we can support them in making decisions that are meaningful to them rather than imposing our ideas, and we can learn to TRUST our clients when they tell us what works for them and what doesn’t work.

Scaffolding and Learning Styles

Everyone has their learning style, and when we are counselling, teaching, or supporting someone who is neurodivergent, their learning style may not fit with our teaching/communication modality. We need to be savvy about how to modify our teaching style for the folks in front of us! This might mean using visuals or having discussions to relate it to life experiences. It might mean providing the person with written notes or fill-in-the-blank notes of what we are talking about.

We also want to scaffold and chunk. Scaffolding is about building information that starts with a foundational idea and then adds to it.

We want to use language that carries from one concept to the other, we want visual cues! We want key phrases that can prompt remembering.

This example is from a teaching website, but can also apply to counselling very easily. It allows the client to not struggle with retaining information, and instead get to practice USING the skills. This isn’t about memorization, but about connecting to the material in explicit ways.

For example.

When we talk to a client about creating a safe space, a mind palace, or whatever lingo you use, you will want to consider using a term that means something to the client. If they are into Minecraft, use that lingo. “We are in survival mode, let’s shift to creative. Now let’s picture our favorite building, free of danger, a place where we can just enjoy the view and only do things we enjoy, that bring us peace and a sense of control. If you want, you can put golems around the perimeter, and grow your favorite trees here. This can be your ”creative hideout” or ”Creative Mode Space”.

Then we need to make note of that and use that same language with that person throughout. We can prompt them when diving somewhere deep and they get dysregulated. “Go to Creative mode.. go to the space you built”.

I love that this graphic has Develop Rapport! Check your Knowledge level! This is a huge part of building a relationship and fits regardless of the type of support you provide.


Many folks with PDA (pathological demand avoidance) can experience shutdowns when complimented, directed, etc. Working with PDA requires mindfulness, but it is doable!

Be aware of Literal Thinking

Many neurodivergent folk will have some degree of literal-mindedness, meaning that subtleties of figurative language may not land the way you hoped or expected. Don’t assume they are ”reading between the lines” or picking up on hints. Be direct in your communication and be prepared to be told you were not concise when you forget to do so.

Advocacy VS Masking

Our goal as supporters should not be to teach our client/patient to be neurotypical appearing. It should be to support them in their development, connect with their values, and foster their self-advocacy skills. Be wary of judgmental statements that are based on viewing neurotypicals as the ‘right’ or ‘normal’ way, and consider those biases before directing a client to change behaviors.

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