What Is Neurodiversity-Affirming Therapy?

The word neurodiversity emerged from the autistic self-advocacy movement in the 1990s. The idea it names is that human brains vary — in attention, sensory processing, communication and social style — the way human beings vary in everything else, and that this variation is a normal part of our species rather than a collection of disorders.

For a long time, therapy for autistic people and ADHDers mostly worked from a deficit model: identify the ways a person differs from the typical, and work to reduce the difference. Many neurodivergent adults describe the result as learning to perform — masking their natural responses at great personal cost, while the difficulties that actually bothered them went unaddressed.

Neurodiversity-affirming therapy reverses the starting assumption. Differences are not the illness. Distress is real and worth treating — but much of it is understood as arising from the mismatch between a person and environments built for a different neurotype, from years of masking, and from co-occurring conditions like anxiety, depression and burnout. Those are the targets of the work.

Several papers help explain ideas relevant to this approach. In his 2012 paper on the double empathy problem, Damian Milton proposed that difficulties understanding one another can arise between autistic and non-autistic people, rather than residing only in the autistic person. Murray, Lesser and Lawson (2005) proposed monotropism as a model of how autistic attention may concentrate on a small number of interests.

In Hull and colleagues’ 2017 study of 92 autistic adults, participants described experiences of camouflaging, including exhaustion, anxiety and strain on their sense of identity. This was a qualitative study of people’s experiences, rather than a test of a therapy’s effectiveness. The source notes below explain what these papers can tell us.

Adults (18+) who are autistic, ADHDers, or both — formally diagnosed, self-identified, or still working it out. Late identification is common: many people first recognise themselves in their thirties, forties or later, often after their own child’s diagnosis or a period of burnout, and arrive with a lifetime of masking to unpack.

It also suits neurodivergent adults whose main concern is something else entirely — anxiety, depression, work stress, relationships — and who simply want that work done by someone who will not treat their neurotype as the problem.

If that sounds like what you are looking for, our neurodiversity support page describes the sessions we offer, and NDIS participants can read how NDIS funding works for psychology.

These papers concern autism. They offer conceptual explanations and accounts of lived experience; they do not establish that a particular therapy is effective, or that the same findings apply to ADHD.

• Milton, D. (2012). On the ontological status of autism: the ‘double empathy problem’. Disability & Society, 27(6), 883–887. A conceptual paper about reciprocal understanding between autistic and non-autistic people.
• Murray, D., Lesser, M. & Lawson, W. (2005). Attention, monotropism and the diagnostic criteria for autism. Autism, 9(2), 139–156. A proposed model drawing on existing literature and personal accounts, rather than a new treatment study. Read the full paper.
• Hull, L. and colleagues (2017). “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions. Journal of Autism and Developmental Disorders, 47, 2519–2534. An online qualitative study whose sample does not represent every autistic person’s experience.