Nothing About Us Without Us
Building Inclusive Practices: Part one in a Series
Building Neurodivergent-Affirming Therapy Practices at Mental Health Centers: Embracing “Nothing About Us Without Us”
“Nothing About Us Without Us” is a core principle from the disability rights movement that emphasizes the need for people directly affected by policies or services to have a voice in shaping them. For mental health practitioners, this principle is a foundational guide to building a neurodivergent-affirming practice.
Applying this principle means actively involving neurodivergent clients—such as those with autism, ADHD, and dyslexia—in the design and decision-making processes of their therapy experience. By embracing neurodivergent perspectives, mental health centers and solo practitioners can ensure that their practices are relevant, affirming, and genuinely supportive of neurodivergent people.
The importance of this principle is evident when we consider the history of therapy’s failure to serve the neurodivergent population. They report many popular forms of treatment used with neurodivergent people to be harmful.
For example, the autistic community has widely criticized Applied Behavior Analysis( ABA) for focusing on behavior modification while often disregarding clients’ autonomy and comfort, at times pushing them to mask or suppress natural behaviors to fit neurotypical expectations. This history highlights why centering neurodivergent voices is essential to creating genuinely affirming, empowering therapy environments.
Why “Nothing About Us Without Us” Matters in Therapy for Neurodivergent Clients
Mental health practices have been designed without input from neurodivergent individuals, and the result has been an environment that can feel unwelcoming, irrelevant, or even harmful.
Therapy that affirms neurodivergent identities is vital to helping clients feel safe, valued, and understood!
Including neurodivergent voices ensures that therapy approaches, goals, and strategies align with clients’ priorities.
Benefits of Including Neurodivergent Voices in Therapy:
Empowerment and Respect: Giving clients a voice in shaping their therapy builds trust and demonstrates respect for their expertise.
Increased Relevance: Co-creating therapy goals and approaches with neurodivergent clients makes therapy more effective and engaging.
Reducing Stigma and Promoting Equity: This approach helps therapists avoid reinforcing neurotypical biases and instead values neurodivergent traits as natural and valid.
Risks of Ignoring Neurodivergent Input
Without neurodivergent perspectives, therapy practices can unintentionally ( or intentionally in some cases) encourage clients to mask or hide their authentic selves, which can contribute to stress burnout and trauma.
Practical Ways to Include Neurodivergent Voices in Large Mental Health Centers
For larger mental health centers or practices, including neurodivergent voices, may require creating formalized, accessible channels for client input.
Here are some practical ways to do this:
1. Hire Neurodivergent Therapists
One of the most effective ways to include neurodivergent perspectives is to hire neurodivergent therapists. Neurodivergent therapists bring valuable lived experience and insights that improve understanding, empathy, and connection with neurodivergent clients. Their perspectives enrich the therapeutic environment and help the entire practice become more inclusive.
Benefits of Neurodivergent Therapists: Neurodivergent therapists often instinctively understand the unique challenges and strengths associated with neurodivergent experiences, allowing them to build trust and empathy with clients in ways that neurotypical therapists may find challenging.
Creating an Inclusive Workplace: Mental health centers can support neurodivergent therapists by offering flexible scheduling, sensory-friendly spaces, and professional development on neurodivergent-affirming approaches, which strengthens the team and enriches client care.
2. Feedback Channels
Implement anonymous surveys, feedback forms, text surveys, or suggestion boxes to allow neurodivergent clients to share their thoughts. Provide alternative formats like visual scales or audio feedback options to make participation accessible to different communication styles.
For example, you could ask:
“What adjustments would make your experience more comfortable and supportive?”
3. Advisory Panels
Form advisory panels of neurodivergent clients, family members, or advocates who meet regularly to discuss practice policies and client needs. These panels allow clients to offer direct input on how the center operates and can lead to more responsive, relevant services.
4. Collaborative Goal-Setting
Train therapists to work with neurodivergent clients to set goals rather than follow rigid clinical checklists. By inviting clients to identify what they find meaningful, therapists foster a sense of partnership and respect for client autonomy.
For instance, instead of setting goals based on traditional benchmarks, ask:
“What would feel most meaningful for us to work on together?”
5. Policies Informed by Neurodivergent Input
When creating or revising policies—such as those involving sensory accommodations, scheduling, or appointment reminders—include neurodivergent perspectives to ensure they meet real needs. Policies designed with neurodivergent input are more likely to promote a welcoming and supportive environment.
Example: A sensory-friendly policy might allow clients to choose between text or email reminders rather than phone calls, reducing potential anxiety and respecting communication preferences.
Practical Steps for Individual Practitioners to Apply “Nothing About Us Without Us”
Individual practitioners can also embrace this principle by incorporating small but intentional changes in how they work with neurodivergent clients:
1. Regularly Check In About Policies and Comfort
Make it standard practice to check in with neurodivergent clients about their comfort with therapy logistics, such as session reminders, waiting room environments, or session structure. Ask questions like:
“Is there anything we could adjust to make this process more comfortable for you?”
2. Discuss Session Structure and Preferences for Engagement
Ask clients how they’d like each session to flow, offering flexibility for those who prefer a structured session and others who may want to set the agenda.
Try asking:
“Would you like me to guide our sessions more, or would you prefer to set the direction yourself?”
3. Approach CBT Techniques Cautiously and With Client Input
While Cognitive Behavioral Therapy (CBT) can be beneficial, some neurodivergent clients may find its structured approach too restrictive. Be transparent about the techniques you plan to use and invite client feedback.
For example:
“How does this approach feel for you? Would you like us to adjust it to fit your preferences better?”
This shows that you respect each client’s unique comfort level and needs.
4. Gather Client Feedback Routinely and Respect Their Choices
Provide routine opportunities for neurodivergent clients to share their feedback on therapy. Offering multiple formats, like visual scales, written suggestions, or audio recordings, allows clients to communicate in natural ways.
Consider ending sessions with:
“How did today’s session feel? Can we adjust anything to make it more comfortable next time?”
Why “Nothing About Us Without Us” is a Social Justice Practice in Therapy
Implementing “Nothing About Us Without Us” isn’t just about effectiveness; it’s a commitment to social justice. By actively involving neurodivergent voices, mental health centers challenge ableist practices, reduce power imbalances, and create more equitable spaces. This approach shifts therapy from mere accommodation to inclusion, respect, and empowerment.
Reflective Questions for Practitioners and Centers
“What changes can I make today to bring neurodivergent voices more directly into my therapy practice? How can I apply ‘Nothing About Us Without Us’ as a core value in my client interactions?”
Looking Ahead in the Series
In our following newsletter, we’ll discuss Double Empathy Theory: Building Two-Way Understanding in Therapy and explore how understanding communication differences can strengthen the therapist-client relationship in neurodivergent-affirming ways.
By embracing “Nothing About Us Without Us,” mental health centers and practitioners can transform therapy into a truly affirming, collaborative, and empowering experience for neurodivergent individuals.
Thanks for Reading!
www-kristen-mcclure-therapist.com