By Dr Shanti Shanker  CPsychol. FHEA, Senior Lecturer, Department of Psychology, Bournemouth University & Trainee Counsellor. Dr Shanker will be leading online  Neurodiversity Training for STARS Dorset in September, details of which can be found here: www.starsdorset.org/Event/training-neurodiversity-in-counselling

The term “Neurodiversity” has been used since late 1990s, initially used by Judy Singer, a sociologist. Recently there is more use and awareness of this word, within Psychology and Counselling. Recent dialogues have been aimed to understand that the brain differences – hence the concept of “neurodiversity’” is to not class the brain (and/or neural) differences as deficit, but instead understand that differences are normal.  Specifically, putting it in the context of problem solving and/or school tasks, taking a step back to think that there is more than one way to reach a solution and allowing that creativity.

Common neurodevelopmental conditions come under the term “neurodivergent”, including autism, ADHD, dyslexia, etc. The idea of using this inclusive term is to highlight that certain developmental disorders lead to variations in the brain and that this is also normal. Most importantly accepting that there is no normal brain and/or mind. The concept of neurodiversity allows us to embrace the biodiversity and any cultural diversity (Armstrong, 2015). Within counselling one can focus on these strengths and adapt a more flexible approach.

Often due to the different developmental pattern, for example, individuals with autistic traits may often experience the lack the understanding of their (unique) needs by others, including counsellors (Dobiala et al., 2021). While there may be an empirical evidence and guidance of interventions for working with children who may have a diagnosis of autism (e.g. Greenspan & Wieder, 2014), there is not much guidelines and/or interventions for working with adults. Definitely, much less guidance and/or training is available for counsellors supporting them to understand the brain and/or any related neurological conditions. The concept of neurodiversity considers both the strength and weakness and respecting that individual difference.

Within the counselling and/or psychotherapeutic settings, anyone with a neurodivergent condition can benefit from therapeutic support. However, often having an expectation, which we term “normal” often lends itself to comparing and categorizing individual skills and/or thinking patterns.

When looking at the concept of neurodiversity from a counselling perspective, often applying traditional practice without informed can often worsen the mental wellbeing of a neurodivergent person (Mitran, 2021). For example, using cognitive behaviour therapy (CBT) without adapting it in individuals who have high analytical skills, and high levels of anxiety can worsen the anxiety. Similarly, using grounding techniques like breathing may be better when the person finds attending to information very challenging. For example, working with a client of mine who has autistic traits, occasionally finds it difficult to follow guided meditation and prefers to engage with more visualization. While working on complex trauma, this client verbalized that they find it difficult to regulate emotions and often experiencing the emotion is overwhelming, over sessions of therapy the client used imagery to talk about emotions. Techniques including play-dough, sketching and just fidgeting help the client manage the emotions they experience and over time are more aware and able to learn how to cope with emotions. Understanding of the neural network through psycho-education also enables them to make sense of what they experience.

Mitran (2021) has suggested a framework to incorporates structural plasticity and technology-based tools that support neurodiverse (ND) individuals which counsellors can use to tailor their therapeutic practice: 1) cognitive empathy; 2) perspective taking; 3) personal awareness; and 4) paradigm shifting. Often ND may find it difficult to understand metaphors (Simon et al., 2020) and or may have difficult in cognitive flexibility and may be more concrete in thinking (evidenced in patients who have a frontal brain injury, Salas et al., 2013).  

Counselling framework using examples that work in neurodiverse individuals needs more evidence and support. However, after any severe trauma we are aware that the body responses using the natural reaction and we respond with the flight and/or fight response. However, when supporting neurodiverse individuals cope with trauma, it is important to keep in mind their strengths and weakness and work with that in counselling to support their wellbeing.  Therefore, we can conclude that we need to not only bear in mind the principles of person-centered approach (which all of us in the therapeutic world are aware of) but also understanding the brain (and some of its functions) whilst learning to be flexible will support working with ND individuals.

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Dr Shanti Shanker, CPsychol. FHEA, is a Senior Lecturer, Department of Psychology, Bournemouth University & Trainee Counsellor (Integrative Approach), STARS, Dorset. She is also the founding Trustee of a Charity Sheetal Astitva (Pune, India) supporting local  mental health, research and education initiates (https:sheetalastitva.com). She will be leading an online day of Neurodiversity Training in September for STARS Dorset. Click here to find out more.

 

 

References:

Anon (2020). Raising awareness of The impact of autism in long-term

Armstrong, T. (2015). The myth of the normal brain: Embracing neurodiversity. AMA journal of ethics, 17(4), 348-352.

Cooper, R. (2009). Neurodiversity and Dyslexia: Compensatory strategies, or different approaches.

Dobiała, E., Stefańska-Klar, R., Rumińska, A., Gołaska-Ciesielska, P., Duras, M., & Janiak, W.  (2021) Challenges of psychological therapy work with autistic adults.

Greenspan, S. I., Wieder, S., & Braithwaite, D. (2014). Dotrzeć do dziecka z autyzmem: jak pomóc dzieciom nawiązywać relacje, komunikować się i myśleć: [Reach a child with autism. How to help children relate, communicate and think] Metoda Floortime. Wydawnictwo Uniwersytetu Jagiellońskiego.

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McGahey, P., & Szumko, J. (2006). Relationship at the heart of helping. In BRAINHE 2006 Conference.

McLean, S. (2022). Supporting children with neurodiversity.

Mitran, C. L. (2021). A New Framework for Examining Impact of Neurodiversity in Couples in Intimate Relationships. The Family Journal, 10664807211063194.

Salas, C. E., Vaughan, F., Shanker, S., & Turnbull, O. H. (2013). Stuck in a moment, Concreteness and psychotherapy after acquired brain injury. Journal of Neuro-disability & Psychotherapy, 1(1), 1-38.

Simon, G., Evans, M., Cano, F. U., Helps, S. L., & Vlam, I. (2020). Autism and systemic family therapy. In K. S. Wampler,

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