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I recently responded to a referral request for an autistic client in a closed online counselling group, suggesting the client take a look at a directory of autistic therapists. This directory is a brand-new, not-for-profit resource developed by and for autistic people. One reply stuck with me: ‘Do you believe that only autistic therapists can work with autistic clients?’Ìý

I was taken aback at the pointedness, but it got me thinking about what I see in my own practice. When I ask new clients if they’ve had therapy before, I’m often met with a reluctant ‘Err… yes. Lots, actually’.Ìý

They often go on to tell me they’ve chosen me (after a lengthy search) specifically because I’m one of the few who discloses a personal lived experience of being neurodivergent (AuDHD to be precise). Now it feels like someone is finally speaking their language.Ìý

They share how past experiences with neurotypical therapists left them feeling entirely misunderstood. These range from the well-meaning and empathic, but simply lacking knowledge, to the woefully inadequate and recklessly harmful.Ìý

I spend many hours helping clients process the ‘ghosts’ of past therapists, many of whom imposed ableist beliefs. (Ableism here refers to the conscious or unconscious discrimination against autistic individuals, rooted in the belief that typical abilities are inherently superior.)Ìý

Behaviours like meltdowns, shutdowns, and masking are often misinterpreted and reframed by therapists as ‘dissociation’,Ìý‘resistance’, or ‘avoidance’.Ìý

It’s not unusual to hear how clients were encouraged to suppress traits that are actually essential to their autistic wellbeing and identity. When they couldn’t comply, some therapists responded with frustration, resentment, or even complete disengagement from the work.Ìý

In light of this – and my own experiences both as a client and in my counsellor training –I tentatively admit that I’m leaning towards the belief that autistic clients are currently better served by autistic therapists.Ìý

Not because being autistic automatically makes someone a better therapist (it doesn’t), but because of the chronic absence of neuro-affirming, anti-oppressive practice at the level of core counsellor training. Neurodivergent therapists rely almost entirely on their lived experience to meet this client group where they are at.Ìý

So how do we move forward so that autistic clients feel seen, heard, and validated by our profession? How can we reduce the distress that autistic people experience in therapy? How can we change the current lottery system of finding a therapist with adequate knowledge and understanding? At present, the onus rests entirely on autistic clients searching long and hard to find someone who doesn’t cause them harm; this is simply not good enough. The need for a separate directory speaks volumes.Ìý

There is a clear ethical knowledge gap in our profession: neuro-affirming and anti-oppressive education must urgently become a priority across all training centres and placement providers, and in consultation with autistic therapists. This is the only way we can begin to serve this community safely and ethically, beyond just a brief CPD and some fidget toys.Ìý