Can autistic people use the same therapy services as everyone else?

Yes, they can. Research shows that, with the right adjustments, mainstream talking therapies can successfully support autistic people with mental health conditions. Our conversations with people with lived experience again show how often simple changes made by services and therapists can make a huge difference. 

Autistic people have the right to the same mainstream services as everyone else. Also, services have a legal duty to make reasonable adjustments under the Equality Act 2010 - to make sure health services are accessible to all disabled people. This includes autistic people.

So, tell us about the work you have been doing… 

With funding from the Pears Foundation and support from the mental health charity Mind, we wanted to look into what we could do to make sure that talking therapies work just as well for autistic people as they do for anyone else. In order to do this, we needed to speak to autistic people about their lived experience and highlight the work some therapists are already doing to adapt their support for autistic people. 

First, we formed an advisory board of autistic people and professionals working in the fields of mental health and autism to oversee the project and provide feedback on each step. 

Next, we asked autistic people what they need from mental health services. Our survey reached over 2,000 people.

Then, we held a number of in-depth conversations with autistic people who had experience of talking therapies, so we could really understand what adaptations and adjustments have made the biggest positive difference to them. 

Finally, we spoke to a number of talking therapy professionals who are successfully working with autistic people with mental health conditions to understand what they think works well and why, as well as what barriers they as therapists face and how these could be overcome. 

What was the result?

We used the recommendations from both groups to create a Good Practice Guide for talking therapy professionals working with autistic adults and children. The guide includes lots of practical changes that services and professionals can make to improve their practice and make sure talking therapies work better for autistic people.

Can you tell us what some of these practical changes are? 

Everyone’s needs will be different. All therapists should be delivering person-centred care and should adapt their practice to suit the individual’s needs, autistic or not. However, some key adaptations that autistic people can find especially helpful include:

• making the physical environment in both the waiting room and therapy rooms less overwhelming. This could be by allowing someone to wait in their car instead or by making sure the therapy room is not full of clutter
• being flexible about service delivery, by offering longer or shorter sessions to suit the needs of the person
• providing clear, concise and specific information about what to expect from their service and sessions before therapy starts. This could be in the form of a letter or email detailing how long the session will be, what will be expected of the person attending, and setting an agenda
• making communication adaptations to meet the needs of the person they’re supporting. This means if a client needs to write something down to help them understand the points being made, giving them pen and paper to do so. Or if they need their therapist to write something down, vice versa
• discussing adaptations and adjustments with the person attending the service and reminding them that these can be made throughout the therapy process. 

These are often small practical changes that can make a huge difference for many autistic people.

Can you ask for reasonable adjustments yourself?

Yes, you can. It is the responsibility of the service you are using to understand your needs and make adjustments where necessary. But if you know there are some specific things that help you, you can ask for them. Remember, not all adjustments are possible as some may be dependent on the size and resources of the service. However, where it is possible and reasonable to do so, services should make changes to suit your needs. We created a guide to asking for reasonable adjustments as well as a template for a letter or email you can send to services yourself.

What has been the impact of this work?

Since publishing the Good practice guide, we have received overwhelmingly positive feedback from therapists about how easy and practical the guide is to use. 

Our work has also been referenced and acknowledged as part of the Government’s national strategy for autistic people. At the end of last year, we hosted an autism and mental health roundtable event, bringing together NHS England and the Department of Health and Social Care, professional bodies, and autistic people with experience of mental health services. We discussed how to make sure all talking therapy professionals working with autistic people can make reasonable adjustments. 

We're now working with the NHS on an online training module about how to make adjustments to talking therapies for autistic people. We hope this project leads to better support for autistic people.

Further information

• Read our Good practice guide for professionals delivering talking therapies for autistic adults and children. You could also tell your therapist about this guide
• Read our guide to asking for reasonable adjustments and use our template for sending a letter or an email
• Read our advice and guidance about autism and mental health
• Read our advice and guidance about loneliness
• Read Abdullah Shahjan’s Story from the Spectrum on his experience as an autistic therapist, and contributing to our Good practice guide
• Join our online community to meet like-minded people and share your experiences