Accommodations in Therapy: How to Advocate for Your Neurodivergent Needs

Jun 29

Author: Mokshvi Shah, BS Northeastern University Student

Published: June 2025

Ensuring Your Therapy Space is Truly Supportive

Therapy is meant to be a space of growth, healing, and support. However, if you're neurodivergent, whether you’re autistic, ADHD, dyslexic, or live with sensory processing differences, the traditional therapy environment may not always work in your favor. For many, it can feel like therapy is designed for a neurotypical person. You may struggle with sensory overload, have difficulty staying focused during sessions, or find it hard to communicate your needs. But here’s the good news: You have the right to ask for accommodations in therapy. By advocating for yourself, you can make sure your therapeutic experience is as comfortable, productive, and effective as possible.

Why Accommodations Matter in Therapy

Accommodations are adjustments made to ensure that therapy is accessible and effective for you. For neurodivergent individuals, this might mean changing how sessions are structured, what tools are used, or how information is communicated. Therapists are trained to support you in the way that works best for you-and you are the expert on your own needs. By advocating for accommodations, you’re ensuring that the therapy environment allows you to thrive, rather than feel excluded or overwhelmed.

Accommodations may help with:

Reducing anxiety or overwhelm
Improving focus and engagement
Ensuring you can communicate effectively
Helping you feel comfortable in the therapy space

These changes can empower you to be an active participant in your healing journey, rather than feeling like therapy is something that happens to you.

Types of Accommodations You Can Request

Depending on your needs, accommodations can vary. Here are a few examples:

1. Session Structure and Environment

Shorter or longer sessions: Some individuals with ADHD or sensory processing differences may benefit from shorter, more frequent sessions, while others might need longer sessions for deeper exploration.
Sensory adjustments: You might ask for the lights to be dimmed, a quieter room, or a specific type of seating to avoid distractions or sensory overload.
Movement breaks: If sitting still for long periods is hard for you (especially for people with ADHD), requesting a “movement break” or the option to fidget with something can help you stay focused.
Virtual sessions: If traveling or being in an office setting feels overwhelming, virtual therapy might be a better fit.

2. Communication and Processing

Written summaries: If verbal processing is difficult, ask your therapist to provide written summaries of key points or takeaways from each session.
Use of visual aids: For individuals with ADHD or autism, having visual aids or diagrams during discussions can make concepts easier to understand.
Clarification time: If processing complex or emotional topics feels overwhelming, request time to pause, process, and clarify points before continuing.

3. Pacing and Approach

Adjusting the pace: If you need more time to process or feel overwhelmed by fast-paced sessions, ask your therapist to slow things down and give you space to reflect.
Alternative therapeutic methods: If talk therapy feels challenging or inaccessible, there are other approaches, like art therapy, play therapy, or movement-based therapies, that can support you in different ways.

4. Routine and Expectations

Clear expectations: If unexpected changes or unclear instructions cause anxiety, it may be helpful to request clear session structures or agendas ahead of time.
Frequent check-ins: Some people find regular check-ins about how things are going in therapy (and if adjustments are needed) to be reassuring and helpful.

How to Advocate for Your Needs

Advocating for accommodations in therapy can feel intimidating, especially if you’ve been taught to minimize or hide your needs. But advocating for your needs isn’t just about asking for adjustments, it’s about ensuring you have the tools and support to heal in a way that works for you. Here’s how to approach it:

1. Know Your Needs

Reflect on what makes you feel supported and what tends to trigger anxiety, overwhelm, or frustration during therapy. Write down specific examples such as, “I find it hard to focus if there are too many distractions” or “I process information better when I can write things down.”

2. Start the Conversation Early

It’s best to start discussing accommodations at the beginning of therapy or as soon as you realize something isn’t working for you. Let your therapist know that you’re interested in discussing how to make therapy more effective for you.

3. Be Honest About What’s Working and What’s Not

You don’t need to feel “bad” or “difficult” for needing accommodations. Be clear and honest about how you’re experiencing therapy. If something feels off, tell your therapist what would make things feel better. The goal is to work together to find the most effective approach.

4. Ask for Flexibility and Adjustments

You can ask for specific accommodations, like the ones mentioned above. Don’t be afraid to request what feels most comfortable. You might need to experiment with a few options to find the right fit.

5. Collaborate on Solutions

Your therapist may have suggestions based on their experience, but remember that you are the expert on your own experience. Work together to co-create a therapy plan that fits your needs.