When Lived Experience Is Clinical Expertise - Why autistic therapists aren’t good at their jobs “despite autism”, but because of it
This blog post is based on the findings of Dr. Hogan’s newly published article in Autism in Adulthood: When Lived Experience Becomes Clinical Expertise: Perspectives of Autistic Mental Health Therapists. Read the story behind the research, along with the full accepted manuscript, here.
Let’s get one thing out of the way:
Autistic people are not accidentally competent therapists.
We are not “surprisingly empathetic.”
We are not “high-functioning exceptions.”
And we are definitely not succeeding in spite of being autistic.
According to a new qualitative study of licensed autistic psychotherapists in the U.S., autistic therapists are effective because of their autistic minds—and often at great personal cost within systems that weren’t built for them.
Grab a comfy stim toy. Let’s unpack it.
Autistic Therapists: Not a Myth, Not a Fluke, Not a Liability
This study centered the voices of eight licensed autistic therapists—actual clinicians with actual licenses, actual clients, and actual expertise. Revolutionary, apparently.
Using in-depth interviews (with accommodations baked in—questions sent ahead, cameras optional, movement allowed), researchers explored what it’s really like to be autistic on the clinician side of the couch.
Spoiler:
✨ It’s powerful
✨ It’s meaningful
✨ It’s exhausting
✨ And the system is… not great about it
Theme #1: Authenticity Is Not “Unprofessional”—It’s the Work
Autistic therapists reported that their best clinical work happens when they stop pretending to be neurotypical.
That means:
Stimming in session
Avoiding forced eye contact
Communicating directly instead of doing “therapist voice”
Saying “I don’t do faux professionalism” and meaning it
Instead of weakening the therapeutic alliance, this authenticity strengthened it—especially with autistic clients.
Clients felt:
Seen
Understood
Less ashamed
Less broken
Turns out, when your therapist actually gets it “on a bone-deep level,” therapy works better. Wild.
Theme #2: Shared Neurotype = Deeper Connection (Who Knew?)
Autistic clients actively sought out autistic therapists—often after being misunderstood, misdiagnosed, or quietly harmed in previous therapy.
Autistic therapists didn’t have to:
Guess what shutdown feels like
Pathologize sensory overload
Translate everything into neurotypical emotional jargon
They already knew.
Lived experience became clinical attunement.
Not a bias—an asset.
Theme #3: The Workplace Is the Problem (Shocking, I Know)
While therapy rooms could be affirming, professional environments were often not.
Autistic therapists reported:
Unrealistic workloads
No decompression time between sessions
Multitasking demands that ignored cognitive load
“Professionalism” standards rooted in neurotypical norms
Disclosure to colleagues? Risky.
Many therapists feared:
Being seen as incompetent
Losing credibility
Being quietly sidelined
Some who disclosed were literally ghosted by colleagues.
So yes—many autistic therapists mask at work.
And no—that doesn’t end well.
Theme #4: Autistic Burnout Is Not Just “Work Stress”
Participants were crystal clear:
Autistic burnout is different. And dangerous.
It’s not just being tired.
It’s long-term exhaustion, loss of skills, sensory overwhelm, and nervous system collapse caused by chronic misfit—not personal failure.
Preventing burnout required:
Spacious schedules
Lower caseloads
Sensory control
Long breaks
Intentional rest
Saying “no” early and often
Translation: accommodations aren’t “nice extras.” They’re survival tools.
Theme #5: Autistic Traits = Clinical Superpowers
Let’s talk strengths—because there were many:
Pattern recognition that helped identify core issues fast
Hyper-empathy and deep emotional attunement
Focused presence that clients felt immediately
Direct communication that cut through nonsense
Flow states in session where everything else faded out
For many therapists, autism itself became a special interest. They knew the research, the lived experience, the nuance—because this wasn’t abstract. It was personal.
As one therapist put it (repeatedly, because it mattered):
“We are really good therapists.”
Yes. You are.
Theme #6: Advocacy Isn’t Optional When You’re Autistic and Paying Attention
Many participants didn’t just practice therapy—they actively pushed for systemic change.
They taught classes.
They challenged outdated models.
They called out harmful practices.
They begged institutions to listen to autistic voices.
One therapist summed it up with the energy of someone who has tried everything else:
“Learn better. Listen. Maybe learn something.”
Honestly? Fair.
So What Does This Mean?
This study challenges a deeply embedded myth:
That autistic people are somehow unfit for mental health work.
In reality, autistic therapists:
Improve care for autistic clients
Bring innovation to clinical practice
Expose the limits of deficit-based models
And reveal just how exclusionary our systems still are
The problem isn’t autistic clinicians.
The problem is environments that demand masking, punish difference, and call it professionalism.
Final Takeaway (Say It Louder)
Autistic therapists don’t need fixing.
They need accommodations.
They need inclusion.
They need systems willing to evolve.
And autistic clients?
They deserve therapists who don’t just study autism—but live it.
Because lived experience isn’t a weakness.
It’s expertise. 🧠✨
