A Descriptive Report on the Psychotherapy Experiences of Adult Autistic Laypeople: Service Utilization, Therapeutic Process Familiarity and Preferences, Client-Therapist Factors, Perceptions of Harm, and Considerations for Those Without Experience

Although research on the topic has taken off in recent years, little remains known about the psychotherapy and counseling service utilization and preferences of autistic persons. Adult autistic laypeople (N = 229) were thus recruited for an exploratory, mixed-methods study. Results indicate that most autistic people have some experience and/or familiarity with psychotherapy and counseling and that from those experiences they have small to moderate preferences, as evidenced by scores on the Cooper-Norcross Inventory of Preferences (C-NIP), for therapist directivity; encouragement of emotional expression and therapist-guided exploration of the therapeutic relationship; focus on the client’s present and future; and warm support and unconditional positive regard rather than strong challenge and confrontation. Respondents valued their therapists holding systemic and social justice-oriented perspectives and preferred their therapists use identity-first language in reference to autism; and held favorable attitudes towards psychotherapy-adjacent supports like medication and self-help books. Most respondents with therapy experience believed they had experienced at some point a “seemingly or overtly harmful” event in meeting with their therapist. These and other findings are discussed. The study also examines considerations relevant to the future use and development of the C-NIP measure.