How to accommodate yourself in therapy as a neurodivergent person

Going to therapy can be difficult for many neurodivergent people, and may feel unnatural and uncomfortable. Although some level of discomfort is normal in therapy, it’s important that you don’t become ‘flooded’ or totally overwhelmed by the process – that would be counterproductive!

What do I mean by ‘accommodate yourself?’ Accommodations are about adapting or adjusting an environment or situation to better meet your needs. If you’re distracted by sensory discomfort, or if your nervous system is on high alert because of the environment, it will be difficult to fully engage in the therapy process. These suggestions can help you start each session from a place of relative calmness, or to self-soothe during a difficult session.

One key element of making the therapy process better for neurodivergent people is finding a therapist who can accommodate you, and meet you where you’re at. Stay tuned for another post soon about how to find a therapist that will be a good fit for your needs.

Regardless of who your therapist is, there are several ways you can make adjustments for yourself in therapy so that you can make the most of your time. Here are some tips:

--TLDR/Cheat Sheet at bottom of page--

Space

• Make sure you are in a space where you feel comfortable. Consider how the sensory environment might be affecting your ability to regulate.

  • If you’re meeting in the therapist’s office, you can ask to change things that make you uncomfortable. For example - ask to dim the lights, or to turn off anything that’s making disruptive sounds.

  • If you’re meeting virtually, find a comfortable space in your home. Spend a few minutes before the session preparing the space so you’ll be ready when the session starts. (It’s also ok to pause a session to readjust, if needed)

• Dress however you feel comfortable. You’ll want to make sure you are fully clothed (no undies, please), but beyond that – wear what you want. Wear what makes you feel good about yourself, or wear the clothes that won’t distract you with an itchy tag.

• Turn your camera off or away from yourself. While it is preferable that your therapist is able to see you in the sessions, it’s not a requirement if it’s highly distracting for you.

• Bring any comfort objects with you. This can be part of setting up your environment before the session. Make sure to bring any blankets, stuffies, fidgets, whatever helps you to feel more calm and secure. You can bring them to the therapist’s office, too.

• Pets are very welcome! If your pet is a source of soothing and comfort for you, bring them along to your virtual appointment.

• Comforting drinks are encouraged, and snacks are welcome as long as they aren’t interfering. Taking a sip of some water or tea can be a great way to regulate during a difficult session.

Activity

• You can stim whenever and however you would like. Bring a fidget, sway or rock, or even get up and pace the room if you need.

• You can engage in another activity if it helps you to focus more, such as drawing, knitting, pacing the room.

• Take notes if it helps you to concentrate, or if you tend to forget goals and important take-aways.

Communication

• Communicate with your therapist in whatever way works best for you. I know that’s easier said than done, especially when you’re used to masking heavily in social interactions, but this is a good chance to practice unmasking. This might involve:

  • Nonverbal, incomplete, or jumbled communication

  • Very direct communication

  • Not worrying about ‘politeness’ or ‘rudeness’

  • Not worrying about eye contact or your body language

  • Disagree with your therapist, give them direct feedback, tell them whatever is on your mind unfiltered

• You can request adjustments in your therapist’s communication.

  • You can ask them to be more direct, ask for clarification, or ask for them to reword or explain differently

  • You can ask to change the subject for any reason. Maybe the conversation has gotten away from the topic you want to discuss. Or maybe the therapist brought up a difficult topic that you’re not ready to dive into yet. That’s ok – the session is your time and you get to choose what it looks like.

• You can communicate directly about what’s working or not working for you in the therapeutic process. If you need more or less of something from your therapist, let them know.

*Note – the communication aspect is a big reason why it’s important to find the right therapist. If the therapist isn’t willing to adjust to your communication style, then they aren’t the right therapist for you.

Part of how therapy works is that we’re exploring difficult topics in a safe and calm environment, to let your nervous system know that you can handle it. The key here is to provide your nervous system with as much support as you can. There’s not just one right way to do therapy, so let’s mold it and shape it to fit your needs!

Share this with your therapist to start a conversation about your needs, or reach out to get started with a neurodivergent-affirming therapist!

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TLDR/Cheat Sheet:

A few basic accommodations can make therapy easier for neurodivergent people. They can help you start the session from a place of relative calmness, or to self-soothe during a difficult session. The key here is to provide your nervous system with as much support as you can.

Space

• Make adjustments in your environment so you feel comfortable. Consider the sensory environment.

• Dress however you feel comfortable.

• Bring any comfort objects with you.

• Pets are very welcome!

• Comforting drinks are encouraged, and snacks are welcome as long as they aren’t interfering.

Activity

• Stim whenever and however you would like.

• Engage in another activity, such as drawing, knitting, pacing the room

• Take notes for concentration or memory help

Communication

• Communicate with your therapist in whatever way works best for you.

  • Nonverbal, incomplete, or jumbled communication

  • Very direct communication

  • Give your therapist direct feedback, tell them whatever is on your mind unfiltered

• Request adjustments in your therapist’s communication

• Ask to change the subject for any reason

• Communicate directly about what’s working or not working for you in therapy

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Thanks for reading! As a reward, here's my co-therapist Simba with his

favorite comfort object -

Are there any other accommodations that you've found helpful for therapy? Share them in the comments below!