The short answer to this question is none! I am a speech & language therapist, and this is a wonderful profession to have, but the only therapy that I offer is family focused adapted cognitive behaviour therapy (CBT), specialising in autism. This is bespoke to neurodivergent individuals and their families and the way that they process information and experience the world.

Many different professions can train to do adapted CBT, not just psychologists, e.g., speech therapists, occupational therapists, nurses, teachers, social workers. I spent 3 years training at the Anna Freud Centre and University College London (UCL), and have a MSc in Adapted CBT specialising in supporting autistic people.

Research suggests that children need to be at least 7 or 8 to access CBT. I work with children from 7 up to 18 and I work with young adults (up to 25).

NICE Guidelines recommend the following:

• Emotion recognition training. Many neurodivergent people have difficulty recognising how they feel and being able to use language to tell others.

• Greater use of written and visual information and structured worksheets. Auditory processing is often slower, and many neurodivergent people have to work hard to filter out background sounds to focus on what someone is saying. Visual processing is a strength and supports auditory processing in sessions, which reduces stress and makes information more accessible.

• A more cognitively concrete and structured approach. Using visuals helps make information more concrete, e.g., I make an agenda with the young person, I use rating scales, diagrams, graphs to measure anxiety.

• Involving a parent or carer to support the implementation of the intervention, for example, involving them in therapy sessions. At least one parent is always in my therapy sessions, we work as a team.

• Maintaining attention by offering regular breaks. Having a parent with us reduces pressure and stress, I use a lot of humour, and we always take breaks when the you person needs them. My sessions do not feel formal.

• Incorporating the child or young person’s special interests into therapy if possible. I try to do this and to have sensory resources and activities I know that they like.

I use variations of all of the above, and bespoke adaptations to the individual I am working with. I include strategies and ideology from other approaches, e.g., Acceptance Commitment Therapy (ACT), Mindfulness. I use anything that works for the person I am working with.

I have a family focused approach so at least one parent is always involved, but often both, I have had grandparents in sessions too, and siblings. My aim is to help everyone understand each other so that:

• They can adapt the environment to make it more accessible and less stressful.
• They can reduce the risk of misinterpreting and misunderstanding each other.
• They can carry on conversations outside of therapy sessions.
• They can help young people generalise strategies as this is very difficult for neurodivergent people.

I work with young people on their own when they are older, e.g., 18 +, if they want to have sessions on their own, or if the family is very complicated and there are reasons not to work with parents and child together, such as safeguarding concerns.

Most therapy for people who are not neurodivergent is a certain number of sessions, which is based on research and is the optimum amount of appointments needed to achieve good outcomes. However, this is not the case for therapy with autistic people. I am very flexible. I do not have a set number of sessions in my mind as I do not know how long it will take to
build a relationship, to start to transfer what we are learning, to feel ready to reduce sessions. I do not want to work with people for longer than necessary, but I do not want to end sessions too soon, either. The number of sessions I do depends on the person and how their needs.