How do expert therapists perceive and treat autistic adults who are coping with co-occurring mental health challenges? This was the core question in a recently published new study, offering valuable insight into the perspective of professionals in the field.

The study, published in J Couns Psychol, 2026 Oct, examined psychotherapy processes for autistic adult clients without intellectual disability, who are also coping with other psychological conditions. It was based on the perspective of ten experienced psychotherapists specializing in Autism.

A New Understanding of Co-occurring Psychological Difficulties

One of the main conclusions that emerged from conversations with therapists is the perception that co-occurring mental health difficulties do not stem from "Autism itself," but rather arise from an interaction between autistic characteristics and an unaccommodating environment. In other words, mental distress is seen as a process of mutual vulnerability between the person and their environment.

Therapists emphasized a shift from approaches that focus on "fixing" autistic characteristics, towards interventions that promote psychological well-being and health. Psychological treatment, according to their method, should focus on reducing co-occurring mental difficulties, promoting self-acceptance, and reducing the need for social "Camouflaging."

Effective Tailored Treatment Principles

According to therapists, the most effective treatment is one that is personally tailored to the specific needs of each individual. They noted several characteristics of beneficial therapeutic practice:

  • Flexible and integrative approach: Combining different tools and techniques, adapted to the unique situation of the client.
  • Knowledge and awareness of Autism: A deep understanding of the autistic world, its unique needs and challenges.
  • Strong therapeutic relationship: Creating a solid therapeutic alliance, based on trust and mutual respect.
  • Promoting self-acceptance: Helping clients understand and accept their autistic identity as part of their being.

Therapists also reported challenges in treatment, such as misattunement, overload, or environmental limitations. These challenges required them to make adjustments, re-tune the therapeutic relationship, and provide containment.

The Message: Well-being and Mental Health Through Neurodiversity-Affirming Principles

The study findings indicate support from expert therapists for Neurodiversity-affirming principles. They see great importance in specific expertise in Autism, in personalized therapeutic strategies, and in systemic efforts to improve the social acceptance of autistic people. All this stems from an understanding that significant change in treatment results from a reorganization of self-understanding, regulation abilities, and involvement in relationships.

It is important to remember that this is a qualitative study, based on interviews with a relatively small number of therapists. Therefore, its findings indicate important trends and deep insights, but do not constitute absolute proof or broad statistical representation. Nevertheless, the study reinforces the call for a sensitive, tailored, and respectful therapeutic approach to the unique identity of autistic adults in Israel and worldwide.