Therapy for Autistic Adults

Therapy for Autistic Adults

What it is and what it isn’t

What types of therapy work best for autistic adults?

Many adults come in looking for therapy, but not exactly sure what to look for, or why. And going to Google can be even more confusing. Most of the suggestions that come up are for kids, and almost none of the suggestions are affirming. So, what exactly should you be looking for when searching for a therapist?

What therapy for autistic adults is NOT

I don’t like to start with the “don’ts,” but this one is so important it has to be first. Doing my own search for adult autism therapy came back with a ton of suggestions that not only aren’t helpful, they’re downright harmful. Here are things to absolutely avoid when looking for a therapist. 

Talk about “cures” for autism. 

Here’s the thing- autism isn’t something that needs to be cured. It is a part of who we are, our identity. You can’t “cure” autism any more than you can “cure” my shortness. Yes, being autistic in a world built for neurotypicals is hard. But we don’t need a cure- we need understanding and acceptance. 

Same goes for any talk of “healing” autism. Just, no. 

Mention of ABA

This one should also go without saying, but I find that while many folks don’t say they do ABA on their websites, they use similar language. ABA is abuse, and should not be used on anyone. I see this one mentioned more with therapists who work with autistic children, but even some adult therapists will put this up. 

This also goes for talk of changing your behaviors or actions. Sure, it doesn’t say ABA, but that’s generally the same thing. Many autistic people have been hurt by therapists using what’s called cognitive-behavioral therapy, which is a way of looking at your thoughts and trying to change them. Many people, and I would argue, especially autistic people, feel like CBT is like “gaslighting” yourself. It can feel like you are trying to convince yourself that your perceptions aren’t real, when they so often are. CBT can overlook the very real struggles we face. There can be some times when these skills can be helpful, but it has to be with full understanding and consent. 

What counseling for autistic adults is

Counseling for autistic adults (and children, for the record) should be affirming! Yes, being autistic can be hard, but that doesn’t mean it’s wrong. Therapy should help you find ways to unmask and to be the real you. You can work with your therapist to learn ways to stim or engage with your special interests. How to identify when you are close to burnout, meltdown, or shutdown. And then what to do with that. Because, traditional therapy for anxiety or depression does not help with autistic meltdown, and you deserve a therapist who can help with that. 

Therapy should be affirming

Yes, many of us seek out therapy because of anxiety or depression, but a truly affirming therapist will help you figure out if it’s anxiety or sensory overwhelm. Depression or autistic burnout? Your counselor should be helping you find ways to meet your needs, rather than ignore them. You can find ways to meet your sensory needs, like using weighted blankets, having fidgets, or using noise-canceling headphones. Our sensory needs have to be part of our plan for feeling better.

Therapy should be trauma-informed

Therapy should also include some focus on trauma. Many people don’t think of growing up in a neurotypical world as traumatic, but it absolutely can be! The years of masking that most autists go through is highly traumatic mentally and to our nervous systems. There’s also the trauma of childhood “interventions” if you faced them, such as being placed in ABA, subject to behavioral interventions at school, or other types of childhood trauma related to your neurotype. Not only that, but autistic children are more likely to be abused or taken advantage of by others, so there can be those traumas as well. Trauma therapy can be essential in addressing all of these. 

You can read more about affirming therapy here. 

Other therapies for autism

There are some additional services that can be helpful for autistic adults as well. Occupational therapy can help with meeting sensory needs (yes, even for adults!). Medication management can sometimes be beneficial as well. While autism isn’t something that needs to be (or even can be) medicated, there are some medications that can help with some secondary concerns, such as anxiety and depression. If you are AuDHD, medication for ADHD can help with concentration and focus. And some people use coaching as a way to help with breaking down daily tasks into smaller steps. Just like with psychotherapy, it’s important to find affirming providers for any type of therapy or service. 

Do I need therapy for autism?

No! However, many autistic adults find therapy helpful, especially when they didn’t know they were autistic until adulthood. Good, affirming therapy can help you unmask, figure out your sensory needs, make your life work for you, and unlearn internalized ableism and shame. You can also address the trauma of being forced to meet neurotypical expectations through therapy. And many autistic adults find therapy helpful in exploring more of who they are, or even to have a “sounding board” to talk about their experience. 

If you are in North Carolina or South Carolina, and looking for an affirming therapist, click here to set up a free 15 minute consultation so we can talk about ways you can start to unmask and be more authentically you. And if you’re interested in an autism evaluation, you can find more information here.