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Exposure therapy can be a valuable tool for reducing fears and phobias, but when it comes to treating Autistic, ADHD, and some other neurodivergent individuals, it requires a nuanced approach. 📊✨
Exposures can lead to trauma for neurodivergent people—especially children. Research shows that Autistic people are more likely to be exposed to adverse experiences AND more likely to experience PTSD. ⚠️
Failed exposures are more likely when the target is a sensory issue. Autistic, ADHD, and other neurodivergent people have brain wiring that makes sensory experiences more intense. Exposure to loud noises is used to target spies and as torture. For people with systems made to detect more sensory input, desensitization may not make sense. These may not respond to desensitization and may be traumatic. Responses from neurodivergent people may be based on physiological responses and learned fear responses to painful or startling experiences and not a true anxiety disorder. This may actually be Distinct Anxiety, or anxious feelings related directly to aspects of their Autism or ADHD. Forced and even voluntary exposure is potentially distressing and harmful. 🚫😟
To make matters more complicated—because, of course—there are millions of undiagnosed Autistic and ADHD adults, specifically. 🤯
How do you know if exposure presents a potential risk to your client?
🧐 Could this be a sensory issue and not an anxiety one? Investigate the triggers and be on the lookout for responses that are not fear of some specific outcomes but visceral recoil. Aversions to sensations like loud spaces, touching forbidden textures, body-based fears are all possible signs of sensory processing issues.
🤔 Could this person be Autistic, ADHD, or SPD? Consider if the person might display signs and traits of a condition with a sensory component.
❓ Have they tried it before? Ask the client if they have tried to expose themselves before and what the result was.
💡 Are there ways we can support this client right now? Explore possible sensory accommodations with the client. Could earplugs, sunglasses, sitting outside at a restaurant, or some other change help the client support a body-based trigger?
🚦 If it might be sensory, but exposure still seems like an option, provide full informed consent. If you and your client decide to go forward with exposure, move more slowly than usual and use a trauma-informed approach.
You’re the expert in human behavior and interventions to support your clients, and the client is the expert on themselves. You make a great team, and together, you can support your client, even if that means teaching skills to accommodate the issue and shelving exposures for that client. 💪 #ExposureTherapy #FailedExposures #SensoryTrauma #TherapyTrauma #Accommodations #TherapistTips
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