In this section, we outline
- how talk therapy can help autistic people,
- what to expect from a talk therapy session and
- how therapists can make their practice a more autism-friendly environment.
What is Talk Therapy?
This is an umbrella term for a number of approaches such as counselling, psychotherapy, CBT (cognitive behavioral therapy) and mindfulness. It can be delivered one-on-one or in group settings. What type of therapy you choose and how it is delivered depends on your needs and comfort level.
What Happens in a Typical Therapy Session?
There are a number of things that can happen during a therapy session. Typically, a therapy session will start by discussing your past week or the time that has gone since your last session. If you had any challenges during this time you might discuss these a little bit more in-depth, discussing how you felt and what you could have done to make this experience easier for you. If you have experienced trauma, your therapist is a good person to talk to about this. You may feel like you are reliving the trauma by going back over it with your therapist but they will be able to help you develop skills to make these challenges easier and allow you to feel some relief from the experience.
In talk therapy, your therapist might work on some skill-building activities with you looking at things like mindfulness, emotion regulation, anxiety building and resilience building. Sometimes, before you leave your therapy session you might finish the session with something more relaxing for you whether it be watching a video on YouTube or even something as simple as discussing your special interests. Finishing the therapy session with something you enjoy means that hopefully you will leave the session feeling positive
Is it effective?
Although autism is not a mental illness, autistic people will often struggle with co-occurring mental health difficulties such as anxiety. Talk therapy is a great way of managing anxiety regardless of the population. Talk therapies are certainly suitable for autistic people and can be very helpful to help you manage any worries or anxieties you might have
How Can Therapy Help Me?
When anxiety builds up within us we can become extremely stressed both emotionally and physically and we may experience a meltdown. It is important that we have an outlet for any anxious feelings we experience so that it doesn’t build up within us. Talk therapy can be one of those outlets. In therapy, you can talk about any difficulties, worries or challenges you are experiencing and release some of the anxiety surrounding these things. Therapy is also an opportunity to speak about how you are, how you feel about your family, how you feel about the world around you and anything else you would like to discuss
Do All Therapists Take Autistic Clients?
All therapists, once they have completed their essential training they should have an understanding. It is important that therapists should broaden their services to accept a wider range of clients and should expand their level of service to meet the needs of autistic people. Although professionals working in talk therapy should have the training and a basic understanding of autism but that they might not feel they are fully capable of meeting your needs.
It might be useful to check in advance with your therapist if they have experience of working with autistic clients before or to check what their level of understanding is to ensure you can receive the best therapy fit for you.

How Can a Therapist Make Therapy More Comfortable For Autistic People?
There are a number of ways that a therapist can make the therapy environment as comfortable as possible for autistic clients. If you are a therapist below are some suggestions of ways that you can make your talk therapy services more autism-friendly.
Consider lighting: You should avoid any kind of fluorescent lighting in the room. Also, flickering light can be distracting or anxiety inducing for autitsic people so it might be best to leave candles unlit during your therapy session. Always ask your client how the environment is for them, they will be an expert at monitoring their own sensory environment.
Be clear in your use of language: When giving instructions to your clients be very clear in what you are saying. Give one piece of information at a time using literal language. Avoid using any metaphors or figures of speech. Be precise in when and where you will meet for your therapy sessions and be clear in the boundaries surrounding an appropriate therapy relationship and contact hours.
Provide stim toys: The word “stimming” describes self-stimulating behaviors, usually involving repetitive sounds or movements. An autistic person might “stim” in order to help them regulate their environment by providing them with extra sensory input. Providing a number of small stim toys for your clients to use such as fidget spinners, gravity timers or silicone noodles will provide your clients with a means to regulate their environment and allow them to feel more comfortable to stim within the therapy environment
Create an open space: Make sure your therapy setting isn’t cluttered and that there is enough room to move around. Encourage your autistic client to stand up and walk around or pace the room if they feel they need to, this may be another way by which they regulate their environment.
Get to know your client’s special interests: Getting to know what your client’s special interest is a simple yet effective way of establishing a relationship with them. You can use their special interest as a way to help them relax before the end of a session or to help them leave the session with a more positive outlook. Expressing interest in their special interest is a great way of building a trusting and positive relationship with one another.
Consider using visuals or role play to support your client: Your autistic client may find it difficult to understand some social rules and this may be increasing their anxiety. Using simple visual representations of a scene or creating a social narrative is a great way to help your client visualise a certain scenario. Alternatively, you can practice role play with your client to help them learn how to manage certain social settings.
Be open to various methods of communication: Your client might use an app to communicate or might prefer to record messages for you rather than speak face to face. Be open and accepting of various methods of communication and be patient with your client, this will help them feel relaxed and accepted. Also, be mindful that eye-contact might be something that your client struggles with. Consider providing a virtual therapy service in which you might deliver therapy via Zoom or Skype.