How to Tell If a Therapist is (Really) Neurodiversity-Affirming

Finding a therapist who “gets” your neurodivergence can be transformative. But how can you tell if they’re truly affirming?

Imagine spending years — maybe even your whole life — with a lingering sense that you’re different from the people around you.

You can sense that the way that you think, feel, and interact with others isn’t the norm, but you struggle to name exactly where these differences come from.

Even so, you’ve been called things like “weird,” “intense,” or “too much” long enough to know that, for whatever reason, you don’t exactly fit in — and worse yet, things that seem remarkably easy for everyone else are especially difficult or complicated for you.

Now imagine that you finally ask for support, just to be told that you are broken, deficient, or even sick. But fear not! They assure you that there are “treatments” that can make you more like everybody else.

You can probably imagine how this might be harmful and, in many ways, the exact opposite of what you needed to hear.

But this is the all-too-common experience of many neurodivergent people who seek out mental health care — and it’s why neurodivergent-affirming care (sometimes called neurodiversity-affirming or neuro-affirming care) is so, so important.

What is Neurodiverse or Neurodiversity? Is it Different From Neurodivergent?

Neurodiversity (or neurodiverse) does not describe an individual, though it is often misused this way.

Instead, neurodiversity describes the condition of a population, in that it is neurologically diverse.

Neurodiversity is simply a biological fact, and an expected part of human diversity and variation.

As Sonny Jane Wise, neurodivergent educator and advocate, says, “You can line up like, fifty brains in a room and you will not get one brain that is exactly like another brain. So therefore, how can there be a standard brain? . . . [Normal] is a social construct.”

From that biological fact stems the idea that there is no right or wrong experience for human beings to have.

This reframe is often referred to as the “neurodiversity paradigm,” and while it is commonly misattributed to Judy Singer, the term “neurodiversity” was actually coined collectively by autistic and neurodivergent thinkers and advocates back in the mid-90s.

The neurodiversity paradigm is a philosophical foundation which allows us to embrace neurodiversity as a valuable form of human diversity.

It suggests that there is no healthy or unhealthy, good or bad neurocognitive experience, and that social inequities stemming from this assumption — that there are better or worse brains — often function much the same way as they would with other forms of human diversity, like race, gender, or culture.

So, in short, neurodiversity describes a population, while the paradigm refers to viewing neurodiverse populations in a non-pathologizing way.

“Neurodivergent,” on the other hand, describes an individual whose way of functioning and being in the world doesn’t line up with societal norms (sometimes called “neuronormativity”).

Neurodivergent is an umbrella term that can include individuals that society might label as autistic, bipolar, schizophrenic, ADHD, and so on.

But it’s important to know that neurodivergent exists as a purposeful alternative to disorder or illness.

Instead of suggesting that something is wrong, deficient, or broken about someone, neurodivergent is used to emphasize that diverging from the norm is not inherently wrong.

In fact, some of the most distressing aspects of being neurodivergent actually come from a lack of support, accommodation, and acceptance.

Nowadays, many encounter the phrase “neurodiversity-affirming” in a variety of contexts, including organizations, workplaces, and even healthcare.

Not every person using the phrase is using it in the spirit with which it was intended, though, and there’s a noticeable trend of co-opting the phrase without fully investigating its origins.

Remember: The neurodiversity paradigm seeks to challenge harmful norms around how people are expected to communicate, behave, emote, learn, and so on.

So rather than asking individuals to adapt to or mimic the norms in their environment, and ostracizing those who are unable to conform, this approach challenges us to create environments that can support a diversity of human experiences.

Importantly, this is why "neurodivergent" is not just a polite way of saying “mentally ill.”

Rather, the neurodiversity paradigm actively calls into question a social hierarchy which suggests that some brains (and by extension, ways of experiencing the world) are inherently better, healthier, or more acceptable than others.

A neuro-affirming workplace, for example, might challenge the norm that employees should remain completely still during meetings, acknowledging that some folks may require fidgets, body repositioning, or other forms of movement to focus more effectively.

A neuro-affirming health clinic might take into account that some people experience situational nonverbalism, meaning they can’t speak, struggle to, or strongly prefer not to in certain contexts.

So they might encourage patients to share their communication preferences ahead of time, and accept alternatives like a text-to-speech device or hand signals, to ensure the patient can still consent to what is happening during their exam.

Any space or organization that claims to be “neurodiversity-affirming” should be equipped to accommodate, support, and uplift people who diverge from the norm — which means neurodivergent people should be at the center of defining what is and isn’t supportive for them.

What is Neurodiversity-Affirming Therapy?

Neuro-affirming therapy doesn’t describe a specific modality (or type of “treatment,” like cognitive behavioral therapy, EMDR, psychodynamic, etc) but instead, a paradigm — a philosophy or lens through which the relationship between therapist and client is approached.

How Can I Tell If a Therapist is Neurodiversity-Affirming?

While there are many therapy directories that offer tools and filters for selecting a therapist, the truth is, a therapist can call themself neuro-affirming without truly understanding what that entails.

The neurodiversity paradigm is not something that’s often covered in a therapist’s initial training, and there's no centralized certification process that can guarantee a therapist has those competencies.

In my experience, the best way to assess if a therapist understands neurodiversity is to look at their profile or website first, and to schedule a consultation to ask questions.

Below, I’ve outlined some of the common green and “orange” flags when seeking out a neuro-affirming therapist.

Neuro-Affirming Therapist Green Flags

There is no easy, simple way to vet a therapist and guarantee that they are neuro-affirming, especially when you're looking at something they've posted online.

However, there are some shared language practices and approaches that, generally speaking, are encouraging signs.

Some green flags to look for:

✔️ They use language about “working with your brain and not against it,” tailoring their approach to your unique needs and experiences.

✔️ They identify as neurodivergent themselves and/or emphasize learning from folks with lived experience.

✔️ They link or reference other neurodivergent thinkers and educators.

✔️ They reference the social model of disability (that our norms and systems often create barriers to thriving, rather than our struggles being self-inflicted).

✔️ They don’t use phrases like “mental illness” and “symptoms” uncritically, if ever.

Non-Affirming Therapist ‘Orange Flags’

The list below are what I would consider “orange flags.”

We can’t know for certain if a therapist is using language in a particular way because they assume it’s more familiar to therapy-seekers, because it’s the expectation of their profession or group practice, or if they are genuinely unfamiliar.

But, as potential clients, we can exercise healthy skepticism when we encounter less affirming language, especially in the absence of affirming alternatives!

Some orange flags to look for:

✖️ They speak a lot about “mental health disorders,” “mental illness,” and “symptoms,” but don’t seem to acknowledge any alternatives.

✖️ They only use “neurodiverse” in their profile (never “neurodivergent”), or use the words interchangeably as synonyms, which might indicate a lack of familiarity or comfort.

✖️ They use “neurodivergent” to only mean ADHD and autism, rather than being inclusive of others types of neurodivergence.

✖️ Their profile/website only uses person-first language (“person with neurodiversity” or “person with neurodivergence”) and never identity-first language.

Why do therapists use “neurodiverse” if they aren’t really affirming?

It seems that some well-intentioned clinicians learn about the word “neurodiversity” in passing, and begin swapping out “mentally ill” for “neurodiverse” because it sounds more respectful and inclusive.

However, using "diverse" to euphemistically describe a specific marginalized group is a form of erasure.

From a therapist's point of view, it suggests there may be some discomfort still in working with that population.

This discomfort would indicate a need for the therapist to further unpack their own biases, as well as deepening their education about the neurodiversity paradigm, especially from neurodivergent educators and advocates.

What Questions Should I Ask a Potential Therapist About Neurodivergence?

Don’t be afraid to ask your therapist about their understanding of the neurodiversity paradigm and their experience with neurodivergent clients! This is the best way to get a sense of how affirming a therapist really is.

Some questions you might ask during a consultation or first session:

• Do you consider yourself to be neurodiversity-affirming? How does this show up in your work as a therapist?
• What role will diagnoses play in our work together?
• What do you know about neurodivergent experiences (like masking, burnout, and executive dysfunction)?
• Is the social model of disability something you utilize as a therapist?
• Do you yourself identify as neurodivergent? How does that impact your approach?
• Do you have any special training related to neurodiversity and affirming care? How do you stay educated about the community?
• Are there any modalities or approaches you won’t use as a therapist, or find to be harmful toward neurodivergent people?

You Deserve Affirming Support

A neuro-affirming therapist can make all the difference, helping us embrace our unique strengths, while challenging the norms and systems that leave us feeling ashamed and ostracized.

You deserve, without question, a safe space to be supported and celebrated as a neurodivergent person.

But most of all, you deserve to be seen — not as a collection of problems to be solved or an oddity to categorize, but instead, as a whole person.