A Guide for working with neurodivergence in the therapy room

When I first began working with neurodivergent clients, I realised how little guidance there was for therapists like me. The kind who want to offer affirming, respectful, and effective support but are unsure how to start adapting their approach in a meaningful way.

At the time, I couldn’t find a clear model that reflected what I was discovering in practice , that neurodivergent clients often need something different from what we were taught in training. So, combining my personal and professional experiences with my (very neurodivergent) tendency to deep dive into a special interest, I began distilling what I was doing in sessions and putting that into words.

What emerged is something I’ve now used for years. It’s not a rigid process and it’s certainly not linear, but it is a structure, one that gently supports both client and therapist. It brings clarity without oversimplifying, and it offers a way in for those who might otherwise feel unsure where to start.

This is how the SCENE approach was born.

Developed as a practical companion to the DIVERSE model of neurodivergent affirming practice, the SCENE approach bridges the gap between affirming theory and the real-time dynamics of therapy. It offers five flexible but foundational themes to guide you in sessions with neurodivergent clients, whether they come to explore their neurodivergence directly or bring other issues like anxiety, relationship struggles, trauma or grief.

What is SCENE?

SCENE stands for:

 

• • Safety

• • Compassion

• • Emotional Regulation

• • Needs Identification

• • Empowerment

These themes reflect what I’ve found most important in supporting neurodivergent clients to heal, reconnect with themselves, and move at their own pace. You don’t have to follow them in a set order. Instead, you can use them as anchor points, reminders of what matters most when working in affirming, attuned, and responsive ways.

 

Safety

As experienced professionals, we might assume we know how to create safety in the therapy room. But for neurodivergent clients, what feels safe can be very different. Silence, eye contact, or vague boundaries may be misread or experienced as dysregulating. The SCENE approach invites us to rethink safety, not just through our own lens, but through the lived experiences of our clients.

For safety to be truly felt, we need more than surface-level adjustments. It requires a deeper understanding of how trauma, ableism, intersectionality, and co-occurring physical health conditions might shape neurodivergent experience.

Many clients also arrive with a history of being misunderstood or harmed in previous therapeutic settings. Our role is not just to avoid doing harm, it’s to actively unlearn bias, take responsibility for ruptures, and practise through a more socially just and decolonised lens.

Creating safety in this context isn’t about having all the answers. It’s about being willing to ask better questions, of ourselves, and of the work.

How do we actually create a sense of safety when neurodivergent clients have been harmed in the very systems meant to support them?

“This is why a nuanced appreciation of Autism and ADHD from an affirming perspective is so crucial. It allows us to see beyond neurotypical assumptions and co-create safety in ways that are truly responsive.” (Peters, in press)

 

Compassion

For many neurodivergent clients, self-compassion doesn’t come easily. Years of ableism, misattuned support, and internalised shame often give rise to a harsh inner critic. Struggles are seen as personal failings, rather than natural responses to unmet needs or a world that wasn’t designed with them in mind.

Whatever your therapeutic modality, helping clients build self-compassion is vital. Approaches like ACT (acceptance commitment therapy) or IFS (Internal Family Systems) can support this process, whether through values-based work, parts work, or gently challenging internalised narratives.

Bringing in the wider context is essential here too. For many, especially those identifying later in life, there’s an ongoing process of comparing themselves to a neurotypical benchmark. Recognising the societal narratives that devalue difference helps to reframe self-criticism not as a personal flaw, but as something shaped by systems. That shift is where compassion begins to take root.

How do we support that shift when compassion feels unfamiliar, or even unsafe?

“As clients begin to see themselves through a kinder lens, their internal world softens, and they begin to relate to themselves not as a problem to fix, but as someone worthy of love and respect.” (Peters, in press)

Emotional Regulation

Emotional regulation is a core part of therapeutic work, but for neurodivergent clients, the challenges can be complex and often misunderstood. What looks like overreaction, shutdown or disengagement is often a body reacting to overwhelm, sensory input, or slow emotional processing.

Supporting regulation means understanding how stress and trauma show up uniquely for Autistic and ADHD clients. It also means believing their experience, even when it doesn’t match what we expect.

In practice, this might involve psychoeducation, co-regulation, or helping clients notice how emotions live in the body. It may also mean sitting with discomfort (our own and theirs) as they learn to make sense of what they feel and why.

But how do we do this without pathologising difference? And how can we offer support that honours the nervous system rather than overriding it?

 

Needs Identification

For many neurodivergent clients, identifying and expressing their needs can feel unfamiliar, even unsafe. Years of masking, adapting, and putting others first often creates a deep disconnection from the body and from inner cues. Some clients may not even recognise when they are hungry, overwhelmed, or uncomfortable until long after the moment has passed.

In therapy, part of our role is to help clients reconnect with these signals and begin to centre their own needs. This might involve supporting interoceptive awareness, noticing sensory triggers, or gently reflecting on relational patterns. It also means naming and validating the difficulty of the process , especially when self-blame has become the default response to dysregulation.

How do we help clients prioritise their needs in a world that often tells them they’re too much?

 

Empowerment

Empowerment sits at the heart of neurodivergent affirming practice. It’s not about independence in the traditional sense, it’s about autonomy, choice, and being able to exist authentically in spaces that may not always understand or accommodate difference.

“For neurodivergent clients, cultivating autonomy often begins with identifying those very values and desires which may have been obscured by years of masking.” (Peters, in press)

For many clients, especially those carrying internalised ableism or trauma, this kind of empowerment takes time. It begins with unlearning shame and rebuilding self-worth. It deepens through setting boundaries, recognising capacity, and beginning to trust that their needs matter.

Advocacy becomes part of this process too. Whether clients are asking for adjustments at work, communicating differently in relationships, or challenging systemic barriers, therapy can offer a space to practise, and to be reminded that asking for support is not a weakness.

How do we support empowerment without pushing clients toward an external ideal?

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Want to dive deeper?

If you find yourself sitting with the questions raised above, you’re not alone. challenges I explore in much more depth in my upcoming book, Neurodivergent Affirming Therapy: Rethinking Approaches for Autistic and ADHD Clients (Jessica Kingsley Publishers, 2026).

The SCENE approach is unpacked in full, with a case study from my own practice to show what this looks like in real sessions. The book is a culmination of all my personal and professional experience, offering a comprehensive guide for therapists, coaches and counsellors.

With original theoretical models combined with practical suggestions, client reflections, and case study, the book is designed to support therapists across modalities who are ready to reimagine what therapy can look like for neurodivergent people.

If you’d like to be the first to hear when it’s out — and get early access to tools and resources — you can sign up to the mailing list here.

 

Peters, A. (in press). Neurodivergent Affirming Therapy: Rethinking Approaches for Autistic and ADHD Clients. London: JKP Books.