Rethinking CBT for Neurodivergent People

"CBT is one of the most widely used and evidence-based psychological therapies. Yet for many neurodivergent people, it does not feel safe or helpful. This tension is increasingly visible. As one social media quote puts it: "CBT is not affirming at all at its core and most autistic leaders and agencies worldwide openly oppose any behavioural therapies for us.""

"Much of CBT's evidence base and many of its core protocols were not developed with neurodivergent experiences in mind. As a result, some people experience it as an approach that tries to 'normalise' difference-that is, to encourage individuals to mask, suppress or change their natural ways of thinking, feeling, or behaving to appear more typical-rather than understand distress."

"Techniques such as thought balancing and the concept of cognitive distortion can feel invalidating-sometimes described within the autistic community as a form of 'self- gaslighting,' particularly when experiences of rejection or discrimination are very real. At times, CBT can cause harm. But CBT is not a static model. It has always evolved, and it can continue to do so."

"There is a lack of specialist training available in neurodiversity-affirming CBT. While diversity is part of the core CBT curriculum, therapists are increasingly working with neurodivergent clients without the depth of training this requires. In short-term standardised therapies, there can be an over-reliance on protoc"

CBT is widely used and evidence-based, but many neurodivergent people experience it as unsafe or unhelpful. Core evidence and protocols were not developed with neurodivergent experiences in mind, leading some people to feel CBT aims to normalize difference by encouraging masking, suppression, or changing natural ways of thinking, feeling, or behaving. Techniques such as thought balancing and cognitive distortion can feel invalidating, especially when rejection or discrimination is real. CBT can cause harm when delivered without appropriate understanding. Standard CBT training often lacks specialist neurodiversity-affirming preparation, resulting in inappropriate goals and unhelpful or harmful therapy. Adapting existing CBT models is not enough; new co-created approaches are needed, and neurodiversity-affirming training improves safety, outcomes, and equity.

Read at Psychology Today