Exploring Autism Therapy: Resources, Insights, and Support

For over a decade, Ana David has had a therapist who truly sees, understands, and cares for her. But even she can attest to the difficulty of finding a therapist for autistic adults. Before she found her current therapist, David had several traumatic experiences in the healthcare system.

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Unfortunately, David’s story is all too common. Many autistic people have had negative experiences in therapy. If this is true for you, you’re not the problem. Typically, the real issue is a mismatch in therapeutic approach.  

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The effectiveness of therapy for autistic adults depends heavily on the therapeutic relationship, says Dr. Kelly Whaling, Research Lead and Licensed Clinical Psychologist at Prosper Health. It also depends on whether therapy is adapted to your personal support needs. These may be quite different from those of people whose cognitive function aligns with social norms (also known as neurotypicals). That’s why autism affirming therapy is so important.  

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In this guide, we’ll explore how to find a therapist who truly supports you on your terms, so that you can be partners on your journey toward better mental health.

For me, nervous system dysregulation begins at the center of my body: a quaking, liquid feeling that leaves me unsettled. I have episodes of verbal shutdown, and may engage more in stimming: rocking back and forth, humming to myself, and bouts of anger that have no outlet. It’s in times like these that I try and re-center myself through deep breathing, reducing sensory input, and leaning on my support systems. 

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Autistic people often experience heightened nervous system responses, which can lead to dysregulation, especially in overwhelming environments. This can lead to chronic stress, shutdowns, meltdowns, and sensory overwhelm. Addressing dysregulation can improve quality of life, positively impacting physical health, emotional regulation, sensory processing, and mental health over all. 

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In this article, we’ll discuss tools to help autistic adults shift out of dysregulation and offer strategy suggestions to become more regulated and maintain equilibrium. However, as always, it’s best to consult with a healthcare professional before starting any new therapeutic techniques.

A few years back, a new friend invited me to the restaurant where she worked so we could hang out after her shift. When I arrived, she was nowhere to be found — and when I texted her, she explained she’d gone home because it was too hot. I was really frustrated and wished she’d told me about the change of plans before I left my house.

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Cue my response: “Okay, I understand,” signed with a heart for good measure. If only I’d known of the DEAR MAN DBT skill!

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The DEAR MAN technique comes from DBT’s interpersonal effectiveness module, which teaches strategies for asking for what you need, setting boundaries, maintaining relationships, and protecting your self-respect. It exists because sharing our true feelings and opinions can be hard. Many of us — especially those who are autistic or otherwise neurodivergent — have been afraid to speak up, advocate for ourselves, or ask for change. Setting boundaries, including saying “no,” can also be challenging.

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This isn’t a personal failing, and it doesn’t mean we’re bad at communicating. It does mean that, at least in certain situations, we might benefit from structure. “DEAR MAN helps because it provides a predictable framework for navigating difficult conversations,” says  Jacqueline Shinall, PsyD, a clinical psychologist at Prosper Health. 

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In this article, we'll discuss how to use DEAR MAN skills to ask for what you need and say "no,"  deal with common challenges, and adapt the skill if you’re autistic or have ADHD. We’ll also explore how to practice ahead of time using a DEAR MAN worksheet.