Working Effectively with Neurodivergent Adults using Functional Analysis as Your Guide: Improve Mental Health, Build Self-Compassion, Self-Acceptance, and Pride in Identity Using a Neurodiversity-Affirming Approach
Drew Carr, Ph.D.
The frequency of autism and attention-deficit hyperactivity (ADHD) diagnoses has exploded in recent years in both children and adults (Davidovitch et al., 2021; Yoo, 2013). This proliferation is largely due to a better understanding of autism and ADHD presentations in previously under-represented groups including adolescent and adult women and BIPOC communities (e.g., Kielsgard & Brown, 2021; Quinn & Madhoo, M. 2014). With this has come a gradual reduction in the stigma attached to these diagnoses in the public and a flourishing self-advocacy and social justice movement.
This change also brings new challenges for mental health professionals. Neurodivergent adolescents and adults have higher rates of sleep problems, depression, anxiety, suicidal ideation, and psychiatric hospitalization (Martini, et. al., 2022), reduced self-compassion (Beaton, Sirios, & Milne, 2020 & 2022; Cai, Gibbs, & Love, 2022), and higher rates of completed suicide than non-neurodivergent peers (Hedley & Uljarevic, 2018). As a result, large numbers of diagnosed and undiagnosed neurodivergent adolescents and adults are presenting in therapy, often having accumulated several misdiagnoses before their neurodivergence is identified (Au-Yeung, 2019). Mainstream psychology is struggling to meet the needs of these clients. Clinicians and researchers need new skills in how to identify undiagnosed individuals who mask their neurodivergence, how to use their existing skills effectively this neuro-minority, and how to work an affirming way with this often-marginalized group.
Contextual behavioral science has much to offer members of the burgeoning neurodivergent community. In particular, clinical behavior analysis offers the ability to re-examine what was previously defined as ‘disordered behavior’ and explore different functional targets for neurodivergent people. Ongoing functional assessment (Sandoz et. al. 2022) can guide the individual towards values-led behavior while improving the clinician’s sensitivity to the individual differences that are accepted and celebrated within the neurodivergent community. Using functional analysis, the clinician can help to improve wellbeing in a contextually sensitive manner and create new opportunities for self-compassion that can alleviate suffering for neurodivergent people in the long-term (Lunsky, et.al., 2022).
Using an experiential approach that blends ‘head’, ‘heart’ and ‘hands’, this workshop will focus primarily on the needs of older adolescents and adults however the principles will also be applicable to younger clients. Participants will first be presented with a clear and concise understanding of the fundamentals of neurodiversity-affirming practice including the use of language, social model of disability, ‘double empathy problem’, intersectionality, and minority stress. They will then explore how neurodivergence presents in therapeutic settings when clients are masking their differences, the impact this can have on mental health, and what to do when the client presents in neurodivergent burnout.
Building on the fundamentals of clinical behavior analysis and operating within a neurodiversity-affirming framework, participants will work through a series of interactive and exploratory activities using case studies, small group discussion, and role plays to hone their ability to apply ongoing functional analysis with clients. Participants will learn how to identify the function of ‘clinical’ behaviors that might also serve helpful functions for neurodivergent people. Examples will include challenging behaviors for clinicians to manage in clinical practice, such as compulsions occurring within obsessive-compulsive disorder, body-focused repetitive behaviors such as skin-picking and hair-pulling, bingeing, purging, self-harm, and suicidal ideation. Treatment approaches will center on creating positive change by building skills in self-soothing, self-regulation, self-compassion, self-acceptance, and pride in identity.
Participants will leave with a nuanced approach that will enhance their effectiveness in therapeutic practice and further develop their ability to improve the wellbeing, self-compassion, and self-acceptance of neurodivergent clients. Participants will be provided with handouts, checklists, and practice guides to support the implementation of new skills within a neurodiversity-affirming practice.
About Jennifer Kemp, MPsych (Clinical):
Jennifer Kemp, BSc(Psych)Hons, MPsych(Clinical), GradDipApplSc(Psychology of Coaching), MAPS, FCCLP. Jennifer Kemp is a privately practicing Clinical Psychologist based in Adelaide who works with older adolescents and adults experiencing perfectionism, eating disorders, body image problems, life-long anxiety, obsessive-compulsive disorder (OCD), and chronic illness. Most of these clients are neurodivergent. Using a neurodiversity-affirming approach, Jennifer weaves together acceptance and commitment therapy (ACT), behaviour therapy and compassion-focused approaches to help her clients improve their mental health, develop self-compassion skills and move towards self-acceptance. Jennifer balances her practice with writing, presenting, and supervision consultations. She is the author of “The ACT Workbook for Perfectionism: Build Your Best (Imperfect) Life Using Powerful Acceptance & Commitment Therapy and Self-Compassion Skills” and a sought-after speaker, trainer, and podcast guest, delivering live workshops and webinars to professionals internationally, including for the Australian Psychological Society, Association for Contextual Behavioral Science (ACBS), and International OCD Foundation (IOCDF) among others.
About Drew Carr, Ph.D.:
Andrew (Drew) R Carr Ph.D. is a psychologist at the VA Sierra Nevada Health Care System and in Inner Space psychological Services. His primary clinical interest is working with individuals with co-occurring frontoexecutive and mental health symptoms, such as ADHD, TBI, and post-concussive individuals. He also has a background in working in men’s health, neurobehavior, spirituality, neuropsychological assessment, training and supervision, and coaching. He established Momentum Center for Clinical Excellence, a training program for psychologists in Los Angeles. He also served as director of clinical training at various institutions. He has received advanced training in diverse CBS and CBA psychotherapies and regularly trains and researches in these fields
On completion of this program, participants will be able to:
- Describe the principles of neurodiversity-affirming practice including the social model of disability, double empathy problem, and use of best-practice, affirming language, and how to use this to improve the accessibility and outcomes for neurodivergent people in therapy
- Describe neurodivergence beyond the limits of DSM pathology-based criteria
- Adapt case conceptualizations to include the interaction of neurodivergence with contextual factors including minority stress and discrimination, and how this leads to higher rates of trauma, severe mental illness, misdiagnosis, poorer lifetime treatment outcomes, and higher rates of completed suicide
- Utilize ongoing functional analysis to distinguish between ‘disordered’ behavior and important neurodivergent needs and preferences
- Apply functional analysis and compassion-focused strategies to target neurodivergent burnout, sensory sensitivities, masking, inertia, meltdowns, shutdowns, isolation, and sensitivity to rejection
- Deliver therapeutic interventions that help neurodivergent clients to create a world that works better for them, built upon self-advocacy, self-compassion, self-acceptance, and pride in identity
Target Audience: Beginner, Intermediate, Advanced, Clinical, Research
Components: Conceptual analysis, Literature review, Experiential exercises, Didactic presentation, Case presentation, Role play
Package Includes: A general certificate of attendance