Neurodiversity and the Person-Centred Approach – Why One-Size-Fits-All Therapy Is Over
- Brainz Magazine
- 3 days ago
- 11 min read
Blending Person-Centred therapy with coaching and DBT, Aleksandra Tsenkova helps people worldwide heal trauma, unpack emotional wounds, and step into confidence.
Neurodiversity is no longer a niche concept reserved for clinical reports or diagnostic manuals. It has become part of mainstream culture, reshaping how we talk about identity, communication, work, and well-being. As more individuals explore whether they might be autistic, ADHD, dyslexic, or otherwise neurodivergent, therapy clients are becoming increasingly clear about what they want, a space where they are not pathologised, not squeezed into a model, and not asked to perform “normality.”
Instead, they are seeking something much more radical, and much more human, a therapeutic relationship built on acceptance, collaboration, and trust in their lived experience.
This is exactly where the person-centred approach (PCA) feels not just relevant but urgently necessary. In a world moving beyond diagnostic labels and towards understanding the full spectrum of human minds, PCA offers a way of working that honours difference without hierarchy, and diversity without deficit.
While psychotherapy has historically centred on correcting behaviour or alleviating symptoms, the neurodiversity movement reframes these goals.[10] [20] It invites clinicians to see clients not as problems to be fixed, but as individuals navigating an environment that is often not designed for them. When combined with contemporary research, from neurodiversity affirming frameworks to polyvagal theory, PCA becomes a powerful, modern therapeutic lens.[17] [12] [8] It allows therapy to evolve from “treatment” to collaborative meaning making, from “managing deficits” to supporting self-understanding, and from “fixing” to accompanying.
Neurodiversity: A culture shift, not a clinical trend
The growing number of adults identifying as autistic, ADHD, or otherwise neurodivergent is often dismissed as a cultural “fad,” but this oversimplification misses a profound reality. People are finally gaining language for experiences they have carried their entire lives. For many, discovering the concept of neurodiversity feels like someone turned on a light in a room they did not know they were sitting in the dark of. It offers a framework that makes sense of lifelong patterns, sensitivities, relational dynamics, executive functioning difficulties, creative strengths, or emotional intensity, that were previously mislabelled as personal failings or character flaws.[2] [10]
Social media and online communities have accelerated this shift. Platforms like TikTok and Instagram have become hubs where people recognise themselves in others’ stories. What once required clinical gatekeeping is now accessible, shared, and relatable. The workplace has also changed. Corporate neurodiversity training, employee resource groups, and open conversations about accommodations are helping people re-evaluate their histories through a more compassionate lens.[23]
Research supports what many neurodivergent adults have been saying for decades. Studies consistently show that individuals diagnosed later in life often experience a deep sense of relief and identity validation.[11] Understanding their neurotype helps them rewrite internal narratives, replacing decades of shame with self-compassion and coherence.[2] Rather than “finally receiving a label,” they receive a context.
This cultural shift marks a move away from deficit-based models that frame neurodivergence as something broken, disordered, or dysfunctional. Instead, neurodiversity affirming frameworks emphasise variation, individuality, and non-pathologising perspectives.[1] [8] In this landscape, therapy is no longer about correcting difference. It is now about understanding the person who lives within that difference.
It is here that the person-centred approach naturally finds its home. Its emphasis on empathy, acceptance, autonomy, and genuine human connection aligns seamlessly with a movement that prioritises dignity, identity, and the right to self-define.[7] Neurodiversity asks the world to make room for all kinds of minds, and the person-centred approach does the exact same thing within the therapeutic space.[17] [12]
Why person-centred therapy fits neurodivergent clients naturally
Person-centred therapy offers something many neurodivergent clients rarely encounter: a space where they do not need to mask, translate themselves, or justify their ways of being. At its core, the person-centred approach is grounded in unconditional positive regard, empathic understanding, and the therapist’s congruence, conditions that directly address the most common wounds reported by autistic and ADHD adults, chronic misunderstanding, misinterpretation, and pressure to fit into neurotypical norms.[24] [17] [12]
In PCA, the client is recognized as the expert on their inner world.[7] This principle alone makes the approach profoundly supportive for neurodivergent individuals who often enter therapy already carrying years of being told that their reactions, behaviours, or needs are wrong, too much, or not enough. Instead of imposing external interpretations or corrective frameworks, the person-centred therapist listens for the client’s own meaning-making, trusting their unique lived experience as the guiding compass.[9] [13] This shift, from being evaluated to being believed, can be deeply healing.
Autonomy sits at the heart of person-centred practice, and with it comes the cultivation of an internal locus of evaluation.[24] Neurodivergent clients frequently grow up relying on external feedback to understand what is appropriate, acceptable, or normal.[10] PCA helps them reconnect with their own sense of rightness, their preferences, pacing, sensory boundaries, emotional rhythms, and values. This empowerment aligns beautifully with neurodiversity affirming therapy, which centres self-knowledge rather than compliance.[18]
The collaborative nature of person-centred therapy also allows the therapeutic environment to adapt to the individual, rather than expecting the individual to adapt to the model. This means sessions can honour a client’s sensory needs, soft lighting, movement, stimming, or reduced eye contact, as well as their communication style, whether that includes scripting, tangential thinking, silence, or rapid-fire association.[24] [6] [7] Even pacing can be tailored. Some clients process slowly and need spaciousness, others thrive with verbal flow. PCA makes room for all of it.
In a field where autism and ADHD have often been approached through medicalised or pathologising lenses, the gentleness of PCA offers a corrective. It does not assume deficit, disorder, or dysfunction. It assumes humanity. Instead of aiming to fix behaviours, PCA focuses on relationship, one that is safe, equal, validating, and grounded in deep respect.[9] For neurodivergent clients who have spent much of their lives feeling scrutinised, misunderstood, or pressured to conform, this relational approach can feel not only refreshing, but revolutionary.
Lived experience as expertise, challenging therapist-centred knowledge
A recurring theme among neurodivergent adults in therapy is the sense of being misunderstood or minimised by clinicians who rely exclusively on textbook descriptions, diagnostic criteria, or behavioural assumptions.[6] [10] When therapy is framed around what the professional believes they know about autism or ADHD, the client’s lived reality can be overshadowed, or worse, invalidated. For many, this dynamic replicates a lifetime of being told that their perspective is incorrect, exaggerated, or unreliable.
The person-centred approach inherently challenges this imbalance. Rooted in equality within the therapeutic relationship, PCA rejects the notion that the therapist holds superior knowledge about who the client is or how they should be.[9] Instead, the client’s personal experience becomes the most authoritative source of insight in the room. This shift is profoundly liberating for neurodivergent individuals who often arrive with finely tuned awareness of their sensory profiles, coping strategies, communication preferences, and emotional needs, insights that can far exceed what any clinical manual can offer.[2]
Contemporary psychotherapy is also moving in this direction. Across research and practice, there is growing recognition of the value of lived experience, whether through participatory research, co-production of services, or neurodivergent led advocacy.[4] These movements highlight what PCA has emphasised for decades, the people living the experience are best positioned to describe and understand it.[7] [13] When therapists step down from the traditional expert pedestal and step into genuine relational partnership, therapy becomes safer, more responsive, and more meaningful.
By centring lived experience, PCA effectively dissolves the power imbalances that have historically harmed neurodivergent clients.[3] [19] The relationship becomes collaborative rather than corrective. The client leads rather than conforms. And within that dynamic, many neurodivergent individuals discover something rare, a space where their insight is not just welcomed, but trusted. This alone can be transformative.
The science behind safety, polyvagal theory, and the need for a regulated relationship
Polyvagal theory offers a scientific lens for something Carl Rogers recognised long before neuroscience could confirm it. Humans thrive not under scrutiny or correction, but in environments where they feel safe, attuned to, and accepted.[3] [9] [8] According to Stephen Porges’ work, our nervous systems are constantly scanning for cues of safety or threat, a process called neuroception.[15] [16] For neurodivergent individuals, who often navigate sensory overwhelm, chronic social masking, or a history of being misunderstood, this internal alarm system can be activated far more easily and more often.[19] [10]
Many autistic and ADHD adults arrive in therapy already in a state of heightened arousal. Years of needing to mask their behaviours, modulate their tone, rehearse conversations, or manage unpredictable environments can take a toll on the nervous system. When therapy replicates these pressures by being directive, evaluative, or rigid, it inadvertently reinforces a state of threat rather than guiding the client toward regulation.[14] [16] Polyvagal-informed practice highlights that safety is not just a psychological experience, it is a physiological one.[16]
This is where the person-centred approach aligns seamlessly with cutting-edge neuroscience. The PCA therapist’s congruence, empathy, and unconditional positive acceptance offer powerful signals of safety.[9] [7] Congruence communicates honesty and predictability. Empathy communicates deep understanding without judgement. Together, these signals allow the client’s nervous system to soften, settle, and engage.[9] In other words, the relational conditions Rogers described function as physiological regulators and not just therapeutic ideals.[16] [13]
A predictable, accepting therapeutic environment strengthens the alliance, allowing both body and mind to relax into genuine connection. For neurodivergent clients, this may mean allowing stimming, reducing sensory input, adjusting tone, pacing sessions slowly, or giving permission for silence.[4] [2] These seemingly small shifts can profoundly influence the autonomic nervous system, helping it move from chronic defence into states of social engagement and safety.
When we integrate polyvagal theory with the person-centred approach, a clear truth emerges. Safety is the foundation of all healing, and safety is created not through expertise or intervention, but through relationship. Rogers knew this. Neuroscience is simply catching up.
One size fits no one, moving away from protocol-driven therapy
Traditional mental health treatments often rely on standardized protocols like structured worksheets, predetermined interventions, and rigid session plans that assume all clients will benefit from the same sequence of steps.[20] [5]. While these approaches can be helpful for some, they can feel deeply alienating for many neurodivergent individuals, whose needs, sensory profiles, and communication styles may not align with prescriptive therapeutic models.[2] For autistic or ADHD adults, being asked to fit into a predetermined framework often echoes earlier experiences of being pressured to mask, comply, or perform well enough to be understood.[17] [12] [10]
Increasingly, research supports a move toward collaborative, individualized treatment models that prioritise co-created goals, flexible pacing, and shared decision-making.[5] Studies across various modalities have shown that therapy is more effective when the client feels involved, respected, and empowered, elements that are particularly vital for neurodivergent clients who frequently report feeling overwhelmed or invalidated by directive, instructional approaches.[7] [22] When therapy becomes a checklist, many clients are left feeling like they’ve failed the model rather than recognising that the model simply failed to adapt to them.
This cultural shift within psychotherapy reflects a broader understanding that human minds are diverse, and therapeutic care must accommodate that diversity. Neurodivergent clients often have nuanced insights into what supports them and what doesn’t. Some may need movement or sensory breaks. Others may require slower pacing. Many benefit from open-ended exploration rather than skills-driven homework.[2] [22] But these needs cannot be met if therapy is bound to a rigid protocol.
The person-centred approach naturally resists this rigidity. Instead of relying on predefined tools, PCA invites the individual to lead the direction, depth, and rhythm of the work.[24] [9] [13] The therapist follows the client’s unfolding experience rather than steering it. This flexibility is not a lack of structure, but a structure built around the person rather than imposed upon them.
PCA’s adaptability communicates a powerful message, you don’t need to become someone else to heal. Instead, the therapeutic process shapes itself around who the client already is.[12] In a world that often asks neurodivergent people to change to fit the environment, this reversal, where the environment adapts to them, can be life-changing.
A future beyond normality: Therapy as partnership, not correction
As our cultural understanding of neurodiversity evolves, so too must our vision of what therapy can be. The growing recognition that difference is not disorder, and that variation in human minds is both natural and valuable, creates space for a therapeutic paradigm that moves beyond correction, compliance, or normalization.[12] [5] Instead, therapy becomes an act of partnership, a collaborative exploration of what it means to be fully oneself in a world that often misunderstands or constrains difference.
In this future, therapy is not a place where clients are subtly pressured to appear more “typical,” communicate more “appropriately,” or conform to norms that have never supported their well-being. It becomes a place where all minds are welcomed, not despite their differences, but because of them. A place where neurodivergent experiences are not only acknowledged but honoured. And where people don’t need to mask to be understood, nor shrink parts of themselves to be accepted.[2] [8] [22]
The person-centred approach naturally supports this vision. Carl Rogers’ model doesn’t assume that the therapist knows best or that there is a single correct way to feel, think, relate, or heal. Instead, it invites the client into a relationship where their inner wisdom is not only recognised but central.[9] [13]
In many ways, the neurodiversity movement and the person-centred approach speak the same language, dignity, autonomy, authenticity, and trust in the person’s inherent worth.[16] [13] As these ideas continue to gain traction, therapy has the opportunity to become not only more compassionate, but more human. And in that shift lies the possibility of a future where mental health care truly reflects the diversity, richness, and complexity of the people it serves.
Note: This article draws on themes explored in greater depth in my debut book, a heartfelt exploration of the person-centred approach and its transformative power, exclusively on Amazon.
Read more from Aleksandra Tsenkova
Aleksandra Tsenkova, Psychotherapist, Author, Speaker
Aleksandra Tsenkova supports individuals on their healing journey by integrating Person-Centred therapy, coaching, and DBT. She helps people process emotional pain, recover from trauma, and rebuild inner trust to step into their confidence. With a deep belief in each person’s capacity for growth, she creates space for powerful self-discovery and lasting transformation. Her work is grounded in a passion for empowering others to reclaim their voice and unlock their potential. Through her writing, Aleksandra invites readers into meaningful conversations about healing, resilience, and personal freedom.
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