How Therapists Can Support Clients with Autism

I recall not that long ago reading a referral letter from a GP to an adult mental health service. The GP was referring a man with a diagnosis of Asperger’s syndrome for support with anxiety and depression. The final line read something like ‘Due to his Asperger’s I know therapy is unlikely to be helpful’. I suppose the man should have been grateful his GP decided to refer anyway, rather than not or being told his Asperger’s syndrome diagnosis meant he couldn’t get any help?

I know, from experience, that this is not the belief of many GPs, or indeed, many other health professionals. However, I continue to witness in practice the challenges those with autism and/or learning disability experience in being referred to and accessing psychological therapies. There is a wealth of evidence documenting the mental health issues experienced by people with autism and/or learning disability. Government and clinical policies such as ‘Reasonably Adjusted’ and the Green Light Toolkit provide clinicians and services with a framework in which those with autism and/or learning disability can access mental health services as would those without such diagnoses.

So what can we as therapists do, to apply this guidance and enable individuals with autism and/or learning disability access the services we offer clients? From my experience, there are a few key things which all practitioners can do to take a step or two in the right direction.

Ensuring we have an understanding of autism and learning disabilities and how such diagnoses may contribute to a psychological understanding of someone’s difficulties. Websites such as the National Autistic Society and British Institute of Learning Disabilities are good places to start.

Understanding that autism and learning disability, as with any other diagnosis, will vary in meaning and impact for each individual. Take the time to understand the person’s strengths and difficulties so you can adapt your approach to these.

Consider the environment we work in. Are waiting areas calm and quiet or busy and chaotic? Are there bright lights and distractions or different levels of light and minimal distractions?

Make some practical adjustments to our style of working. Considering things such as length of sessions, how much information we present in one go and ways in which concepts and formulations are explained can all be easily adapted. Perhaps someone needs a shorter session as they struggle to attend for any longer than this, maybe they need a bit longer as they need more time to process. Perhaps someone needs the language we use to be concrete and clear, or simplified and concise rather than drawing upon metaphors and complex psychological terms. Simply checking that what we have said makes sense to the other person and giving extra time to process that information can go a long way.

Being aware that someone’s expressive language may mask difficulties with verbal comprehension and processing difficulties.

Appreciating that we all have preferred styles of learning and understanding the world and this is no different for those with autism and/or learning disabilities. For example, supporting verbal information with drawings, diagrams and visual conversations – writing down key points together to help those who may process more visually, get the most out of sessions.

As clinicians, it’s important we work within our areas of expertise and recognise when specialist services are needed. However, autism and learning disability diagnoses should not be an exclusion criteria. We all have a role to play in improving access to psychological therapies for these clients.



