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?

I'm recently diagnosed ND (a family member picked up on it and raised it with me) and I had therapists in the past that never realised or brought it up - and they diagnosed me with other things instead.

I tend to think they weren't very good at their job because of this. I wish someone had picked up on it years ago as I could've been much happier and self accepting as a result (as I am now, finally).

As an ND person I completely disagree. I think op sounds like a good therapist.

You could easily have asked this question with no reference to your position as a therapist and no information about your client. You could have just posed the question 'if you were having counselling would you want the counsellor to share with you that they had noticed autistic traits?' But you would have needed to ask all readers, not just diagnosed ND readers, because your client doesn't have a diagnosis. But you still wouldn't have got a clear answer, because only your client will react the way your client will react. No one can know that on here.

I’d want my psychotherapist to stay in his or her lane tbh.

I would want to know.
Though it doesnt sound particularly strong ND to me...
A lot of those things will be quite common

I think a lot of ND people dont realise they are boring people and if they do they cant think of something else they want to talk about.

I can't work out how to edit, but basically you could have just said what was in your title and not all the other stuff in your full post, which frankly is a breach. If I were you I'd have this taken down and do some reflecting. Look inward, not outward.

I'd feel really uncomfortable about them talking about me on Mumsnet, for starters, regardless of anonymity. Is there not a professional forum?

That is interesting
I did an online test for autism and came out as a 0 autistic however I do hate small talk, I tend to be understood as crass and blunt when say something for which I feel strong, I hate groups and gossip, I prefer men's company, one of my kids has some ND traits

Asking this on a public forum is not ethical practice. I’d ask for it to be removed.

I agree with PP who have questioned your approach here. Posting about a client on social media is not a good choice and further thinking that mentioning it in session 9 would give a couple of sessions to work through it, is terribly shortsighted. Your supervisor is right, you need to meet the client where they are, not where you would like to take them. Also be very careful if you are thinking of exploring your own neurodivergence, I hope you're exploring that in your own personal therapy.

My main reaction reading your post, was just no. All kinds of ethical ick.

Imagine you were describing a list of symptoms that get worse or better depending on where you are, what you're doing:
Extreme fatigue (feeling tired all the time)
Pain and swelling in the joints
Swelling in the hands, feet, and around the eyes
Headaches
Low fevers
Sensitivity to sunlight or fluorescent light
Chest pain when breathing deeply
Hair loss

You've been to the doctor and discussed the fatigue. Then you've been back and discussed the pain in your fingers. Then you've discussed the headaches. You're feeling frustrated because you have so many symptoms and no real answers.

Then, somebody says 'You know, all those things are a symptom of lupus...you might want to see your GP and get it checked.' You do, and you're diagnosed. Suddenly it all makes sense.

That's the reality for many people with ASD or ADHD. Imagine having counselling because you think there's 'something wrong with you' when your brain is simply wired differently?

Thank you for the post! I supervise lots of people - trainees/qualified staff as through the years I’ve moved up the ladder…and I’ve done a lot of ethics panels with trainees so I’m pretty sensitive to it - perhaps ott but without trust therapy can’t work I don’t think. I’m a little concerned that someone just starting out is trying to use “therapist talk” to stop any concerns about ethics, rather than reflect on whether there’s possibly some merit. Hopefully it’s the online forum nature of trying to win rather than this happening in life too - as I wonder if the OP is looking for the internet to give her a different answer to her tutors/supervisors. Thanks for your perspective!

My massage therapist has just qualified. To him he said it would be like, firstly supporting them, but then if the same things were coming up and he could see the pattern, he'd say gently we have been talking about this for a while now and I can see you are struggling, have you considered you might be neurodivergent. It's not something you may have considered and you may feel it's not relevant but incase it is here is a book recommendation. He asked me for books. I've been seeing him for 10+ years as a massage therapist.

He said that therapists really aren't generally trained in this area.

So you get lots of people in therapy who might actually be undiagnosed not realising or recognising it.

There's definitely a gap in training. So I wouldn't be wholly put off by people saying no don't mention it. Of course you can't diagnose someone. But if you have been working with them for a while and have a trusted relationship, and they are sat there constantly blaming themselves as is common with ND, it's arguably a kind thing to do to mention it.

I'm about as ND as they come.

This, this this. So much this.

@Blinn I'm a former ed psych trained in systemic therapy and I'm also ND. But I'm not going to answer your question and here's why.

You may not know this, as counselling and psychotherapy courses are notoriously bad at teaching digital etiquette. But it is really poor practice to talk about your cases online. You don't know the qualifications of anyone here, you don't know if you really are getting advice from people who are actually trained and qualified. I know you haven't revealed names, but there is enough information in your post to risk a client recognising themselves

I would suggest seeking additional supervision, possibly from a supervisor specialising in ND if you are unhappy with the advice you have been offered. And for goodness sake, delete this. I'm sick of seeing therapists posting about their clients in inappropriate online forums. I've been a therapist myself and it's made me wary of therapists, the number of them I see posting details about their clients online. You're a trainee, so ok you might not know this is unacceptable, but please, please don't become a qualified practitioner who continues to do this. It erodes the trust of the public in what we do and the confidentiality we should hold priceless, if we are seen leaking all over the internet about our cases. It's unprofessional and unsafe. Just stop.

I haven't read the full thread because I think you're coming at this wrong tbh. Neurodiversity and neurodivergent were terms created by people who were already diagnosed under the medical model with a condition (initially Asperger's as was). So to try to diagnose neurodivergence is weird. Do you mean autism, adhd, dyslexia, learning disabilities etc?

I've reported it. This is not ok. And OP needs to do some reading and reflecting about digital etiquette for therapists.

I'm a clinical educator and I'm willing to bet the course doesn't teach the real world stuff and just has its head in the theory books.

There are no safe online spaces to ever talk about your clients as a mental health professional. It just shouldn't happen.

There is absolutely no identifying information in my thread.

There are many very active Facebook groups and Reddit groups actually.

Oh, it's Facebook and Reddit where my therapist is publishing maybe/maybe-not disguised accounts of my most private and sensitive affairs? Thank God, I thought it might be somewhere unsafe.

Don't be ridiculous. There is no identifying information in the post.

It's an interesting subject and there have been some really thoughtful replies. But try to get it deleted if you have taken offence.

We all know about those groups, a lot of them are notorious. Many of the ones on Reddit are in the US and rules vary across states and licensing boards there.

Just because there are other therapists doing it out there doesn't make it ok. The decent ones absolutely don't do it.

You've talked about confidential things your client has said in sessions, their traits...that could absolutely be identifying and it doesn't belong online in the public domain, it belongs in the therapy room. I can tell you, if I was a client and my therapist posted this level of detail about our conversations online, I would absolutely recognise myself. You're a trainee, you're making yourself extremely vulnerable by doing this. At this stage of your career, why take the risk?

You don't know who people are here who are giving you clinical input. They could be anybody. Your client might be a member on this forum too.

You also clearly have not thought about the light it paints your role and chosen profession in when therapists disclose details about the content of their clients' sessions on a forum like this that can be seen by anybody. We have an ethical duty not to bring the profession into disrepute.

Your defensive and petulant response here does not bode well for your future in the profession to be honest.

I sure hope, if this is a real case and you're genuine, that your client doesn't see this, or you'll have a lot more to worry about than people "taking offence" on Mumsnet.

And you want to be a therapist? Can you not put yourself in someone else's shoes for the five fucking seconds it would take to realise that it would be deeply upsetting to many people to realise they'd been read about and discussed by a load of random Redditors (or Facebook posters, or MNers) — regardless of whether anyone else would ever link that discussion to them personally? Or even to stumble across a discussion that seems like it could refer to them?

When I see a therapist, I expect my case may be discussed in supervision. I even understand that the therapist may choose to use my case for academic or research purposes, though I'd hope they'd seek consent if they wanted to publish anything about my case in a journal or book chapter, and that systems would be in place to ensure my safety and privacy. There's a difference between knowing your therapist may have discussed aspects of your case with another professional as part of the systems designed to protect clients and help therapist development, and being worried that some under-trained over-confident counsellor has dashed off a few paragraphs about you for the perusal of anyone who cares to click on the right webpage.