If you were ND but didn't realise, and you went to see a psychotherapist and the suspected that you were - would you want to know?

[Blinn]

Name change for this.

I am a trainee psychotherapist and have a client who didn't declare any neurodiversity, however has strong ND traits. Struggles with worrying about "boring" people when talking about their special interest. Always aware if people are talking about their special interest then thinking a lot about how to talk to them about it. Always felt different, is always aware of how they 'present' to others, is a 'different person' in different social situations among other things. Gets overwhelmed and exhausted trying to 'fit in'in social situations.

I have talked to my supervisor and practice manager and they say just meet the client where they are and don't offer advice, which is what I'm currently doing.

I've done some CPD on neurodiversity but that was more about working with clients who are living with ND already.

I really value this client and want to do the best for them. They seem to enjoy the sessions and have told me how much they are helping.

I wondered what people who are ND thought about this?

Yikes! I’m not sure I would like you as a therapist.

The strange thing is you are assuming they definitely are ND (based on your title etc) but as far as I can see you aren't qualified to make that assessment.

All you can know is that they have some ND traits?

That would totally be your perogative!

No, I said I suspect. I've also said I am not qualified or intending to diagnose.

We're not in your therapy room now. This is not only a shitty thing to post, but also IMO somewhat unprofessional. Looks like someone attempting to gain credibility and "win" on an online forum by pulling the therapist card, creating the appearance of psychotherapy techniques/language to use against someone you've never met, don't know, haven't spoken to, and who hasn't consented to you "wondering" about their feelings in a pseudo-psychotherapeutic manner.

WRT your original question: depends on your training, expertise, qualifications, experience, and the expectations of the client. Unless you've actually got legitimate, significant specialist expertise in this area, your "suspicions" don't, and shouldn't, carry much more weight than the "suspicions" of their friends, colleagues, or relatives. The trouble is, your role and position as a (trainee) therapist will lend apparent epistemic value to all kinds of things you say, whether you're actually qualified in those fields or not. These "suspicions" may seem FAR more significant and have the potential to be far more impactful or even damaging coming from you than from someone else. You are a trainee for a reason. Listen to your supervisor and practice manager.

ETA: and I'm posting on this thread because you said you wanted to hear from "ND" people as to what they would want in this situation. I have an ASD diagnosis and I value honesty and integrity. If I were having these kinds of difficulties and asked you what you thought, I'd want your honest thoughts and opinions, but I wouldn't necessarily want unprovoked "wonderings", and I'd certainly want you to contextualise your opinions by explaining exactly where the limits of your expertise lie.

Sounds like the client has the self-awareness to think they’re different and to embark on psychotherapy, so it would seem unlikely they’ve not already Googled through loads of forums and info and already have a good idea that they might meet criteria for a ND label. It seems to be ubiquitous /common knowledge these days (or am I just reading too much mumsnet lol).

No, I said I suspect. I've also said I am not qualified or intending to diagnose.

The problem with sharing your suspicions is that any client will view their therapist as someone with additional knowledge and insight otherwise why would they see you. That means your suggestions carry more weight for them.

From what you've written you are 6 sessions into this work, you're a trainee and know there are wider issues to consider for your client. It's far too early both in terms of the work and your training to be effectively telling someone you think they are neurodivergent.

You have already been given direction from someone in the service. - I'd be following that advice and exploring in supervision what made you seek further, random, anonymous advice. You sound both dismissive and defensive in your responses to folk who have posted in good faith. @Psychologymam has made very good points in terms of you posting - whether you've concocted part of the situation or not.

Part of your role is to instil confidence in the profession, in fact it's an ethical requirement, so possibly reflect on whether your posting and your subsequent responses are doing that. It's ok to get thinks off key - you are still training and have some growing to do. No amount of CPD will take the place of really grounding yourself in your core modality and understanding what you're trying to do in the therapeutic relationship. Get that sorted and you'll have a better sense of what you do and don't need to share with your client.

I’m not trying to gate keep knowledge by sharing professional norms with you - you’re both denying you’re doing anything wrong and suggesting you made up the whole post. I would suggest bringing it to your supervisor and if they agree you this is a good forum then you’ve no issue - I was a nasty troll trying to make you feel bad. If they have other thoughts perhaps you’ll consider those. The problem with seeking advice on Mumsnet is the temptation to dismiss, deny and to attack the other perspective. I get paid to give supervision to trainees so I’m not debating this with you any more. It’s your choice as to what kind of therapist you wish to be.

Thank you - a kinder more empathetic post than mine so hopefully your wise words will be heard!

I’m a psychotherapist/MH nurse and, although I come from a psychiatric/behavioural background, this is one of the reasons I don’t like diagnoses much of the time. For one thing, for the purposes of the piece of work you’re currently undertaking it really does not matter if your client is ND or not. The skills you’re helping your client to learn and the rapport you’re building should be specific to them, rather than a hypothetical textbook case study. All people are different and even if they had a particular diagnosis, they would still need supporting as an individual. This is particularly pertinent when it comes to trauma as, as you probably know, trauma, and the subsequent need to process difficult situations, feelings and sensations, can cause us to behave in ways that may intersect with behaviours more commonly witnessed in people that are neurodivergent. Bearing this in mind, some skills for, for example, ASD may be relevant and others may not be. Pick and choose what you think they might find helpful and discard the rest. People do not need a diagnosis to benefit from learning particular skills and so a diagnosis should not change how you support them.

I hope OP listens to this post.

The defensiveness and attacking opposing views and the lack of personal insight does not make for a very good therapist. And my posts pretty much sum up why I would make a terrible therapist. 😂

I think if you're in therapy then you likely are desperate to know what makes you the way you are and I would personally want to know.

I agree. I would want to know. People can waste years focusing only on psychological emotional aspects when having some ND awareness could bring them huge clarity and relief.
OP doesn't need to diagnose, and would be clear that’s not what she is offering, and the limitations of her own qualifications to suggest diagnoses. But to be diligent OP should collect and reflect back her observations of the client. Client decides whether or not to pursue it. That would good care in my book.

I think if you're in therapy then you likely are desperate to know what makes you the way you are and I would personally want to know.

Would you want to know from a trainee who is adding 2+2, who has done a bit of CPD, is working beyond the limits of their training and on the basis of spending 6 hours in your company though?

No one gave me any clues about my behaviors when I was younger so I kept on trying to keep up with everyone else and I failed. Depression and booze did not help as coping mechanisms.
I do hope you can find a way to lead this client to further self discovery.

I feel I must point out that neither my supervisor, tutor or practice manager feel as though I am working beyond the limits of my training. If they did I would refer in straight away. My client is of course fully aware that I am a trainee.

I think this is a really interesting question that gets to an issue at the heart of integrative psychotherapy. For me, if it's ok to be more active than a psychodynamic psychotherapist would be, why is it not ok to suggest this? If it's ok to be active, how active is too much? And when we say 'meet the patient where they are', do we just stay there forever?
It's always seemed very contradictory to me.

As an aside, without giving too much away I have had the least interventionist form of psychotherapy and did (eventually) wonder aloud whether I might be autistic. My therapist responded with the classic 'mmm' - but his tone (I knew him very well by this stage) told me everything I needed to know!

I think that if you can gently suggest that they might want to look into it, that would be very helpful of you. In my experience, I was thoroughly assessed for trauma first anyway as part of the process, but that may vary depending on where you are. If someone had mentioned the possibility to me 20 years ago I might have avoided a lot of unpleasantness.

Thank you.

I think this is something that ought to be raised in clinical practice rather than mumsnet to be honest.

Lots of ND people enjoy reading forums such as this to understand people's perspectives and problem solving skills. I'd be mortified if I was in therapy and saw people throwing their two pence in on a popular website.

I feel I must point out that neither my supervisor, tutor or practice manager feel as though I am working beyond the limits of my training. If they did I would refer in straight away. My client is of course fully aware that I am a trainee.

It's beyond the limits of your training to be suggesting neurodivergence based on very limited knowledge of the client while also knowing trauma is in the mix. It's also beyond the limits of your training to do so when you know you don't have time to follow up such a suggestion with your client. The professional advice from people who presumably know you and know your skill and experience level is to leave it alone and work with your client, suggesting they know it's either not your role or beyond your training level.

I note you're only responding positively to people who are agreeing they would want to know. It's ok to find the work uncomfortable, and to feel restrained by the direction you've been given. It's also ok to question why you're been told to work in a particular way, but that also needs to be coupled with reflection on why it feels important to you to tell this client something that may cause them harm (per previous posters), when you don't have time to work through it with them, why you're ascribing your feelings of sadness to your client and why you need them to reframe their feeling of being weird. That's where the work is - addressing those issues will make you a much better therapist, telling your client something which helps you avoid sitting with their feelings won't.

As someone else said upthread, it all depends on the kind of therapist you want to be.

I think you have said too much in your original post and further comments, because although you haven't given any details about your client, there's enough to mean any clients who are seeing or have seen a trainee integrative counsellor for 12 sessions presenting with complex trauma, thinking themselves weird, etc. etc. to wonder if it's about them. It could therefore affect the therapeutic process of others, not just your client, who see it.

I'm a qualified therapist myself, so I understand how difficult it is — a few years on, I still find supervisors, peers, books, professional bodies and counsellors' forums all seem to give conflicting guidelines and opinions. The ethical guidelines are for each individual therapist to navigate, with few precise answers.

The person-centred guideline pp posted above is excellent and I'd follow that. Perhaps ask for this thread to be removed though, because it is a bit too detailed, or edit so it just contains your question, no details at all?

Also, for further cpd I recommend Online Events workshops on autism and also authentistic.org (although these are for working with diagnosed clients, I think a live workshop would give you opportunities to ask your questions).

Wrt your original question, I think we're at a time of changes in therapy, where shifts in social and political awareness in the mean there's more understanding of inclusivity and diversity, but the profession is still finding its way. More traditionally, therapists would not usually suggest diagnoses, but there are, as pp above have discussed, situations where it might now be considered helpful and appropriate. It really is down to the individual client and the therapeutic relationship.

Personally, I think I'd feel dismissed and labelled if a therapist suggested I was neurodivergent, because it might feel like an attempt to "fix" rather than hear me. I'd prefer it if a therapist let me bring it up then explored it from a neutral stance. But that's me — others will feel differently.

Yes, it's bordering on negligence if you don't bring it to their attention however be extremely clear you are not in a position to diagnose.

You might want to say something along the lines of (if autism suspected)

You've mentioned (if they have)

• feeling different
• struggles with understanding and reading people
• finding things that are too loud or quiet over whelming
• feeling calmest when perusing specialist interests

What does is sound like hearing this list? This is only reflecting back what they've given you and it might be enough to give them a lightbulb moment. You might want to gently ask them if they'd be happy for you to share a thought you're having and that the themes in their story is similar in some ways to a particular client group that identified as autistic. Youre not saying that this is them and you're not a diagnoser but it was an interesting similarity.

Thats enough to let them decide if they want to pursue this - chances are they have suspect they are autistic or have autistic family member so know a bit about it, if they don't take much from what you've said then you just move on.

I'm a ND therapist. I get that you want to find out info from a wide source of people, hence posting here. But please consider the following!

Confidentiality & Social Media: A Professional Responsibility

As counsellors, maintaining boundaries is key to building trust. But how does this translate in the digital age, where social media is part of everyday life?

Confidentiality is non-negotiable: Sharing even the smallest client detail on social platforms can break the trust that is foundational in the therapeutic relationship. This includes anonymised or vague references—clients may still recognise themselves.

Privacy matters: It’s essential to keep in mind that online discussions can reach far beyond your immediate audience. What may seem like a casual exchange or innocent post could have far-reaching consequences, especially if client confidentiality is compromised.

Talking about clients on social media: The BACP's guidelines are clear—counsellors should refrain from sharing any details about clients on social platforms, even in professional groups. Discussing clients online, even with anonymized details, is a breach of confidentiality and the professional trust clients place in you.

Think before you post: Whether it’s sharing professional experiences or seeking advice, be mindful of what’s shared. Ensure you’re operating within professional boundaries at all times, both offline and online.

Not my words, but from 'the counselling tutor' Facebook group.