I recently came across a professional workshop focused on Acceptance and Commitment Therapy (ACT) and neurodivergence. At first, I was disappointed that I could not attend. But after reading through the outline more carefully, I realised something interesting: much of what was being presented was not necessarily a brand-new therapeutic technique, but rather research and discussion about why ACT appears to fit well with many neurodivergent clients.
That got me thinking about my own clinical experiences.
Acceptance and Commitment Therapy, commonly referred to as ACT (pronounced as the word “act”), is a therapeutic approach that focuses less on trying to eliminate difficult thoughts and emotions and more on helping people respond to them differently. The goal is to increase what psychologists call psychological flexibility: the ability to stay present, make room for uncomfortable internal experiences, and still move toward actions that matter.
For many neurodivergent individuals, particularly those with ADHD or Autism Spectrum Disorder (ASD), that framework often makes intuitive sense.
Research over the past several years has increasingly supported the use of mindfulness-based, acceptance-based, and behavioural approaches with both ADHD and ASD populations. These approaches appear particularly helpful in areas such as emotional regulation, impulsivity, distress tolerance, self-criticism, and executive functioning.
What I find especially interesting, however, is not simply whether ACT “works,” but how differently the same concepts may need to be translated depending on the person sitting in front of you.
For example, let’s imagine a fictional client named Jane, who lives with ADHD. During session, we are discussing the ACT concept of allowing thoughts to come and go without fighting them. I use the common mindfulness analogy of thoughts being like clouds floating across the sky.
Jane lights up.
Within seconds, she is expanding the metaphor herself.
“Well, some of my clouds are thunderstorms,” she laughs. “And some are just annoying little mosquito clouds that won’t leave me alone.”
The metaphor becomes emotionally engaging for her. It gives shape and movement to an internal experience that previously just felt overwhelming and chaotic. By the end of the conversation, she is creating her own language around “storm systems,” “mental weather,” and “getting sucked into tornadoes.” The analogy helps her connect insight to action.
Now imagine another fictional client, Joe, who lives with ASD.
When I try the same “thoughts are like clouds” analogy, Joe stares at me blankly.
“What do clouds have to do with thoughts?” he asks.
The metaphor falls completely flat.
So instead, we shift into something far more concrete.
I explain that the brain sometimes produces repetitive thoughts automatically, much like a computer generating pop-up notifications. The goal is not necessarily to eliminate every notification, but to decide which ones deserve attention and which ones can remain in the background while he continues what he is doing.
That clicks.
Same therapeutic principle. Different translation.
This difference is actually reflected in some of the emerging research. Studies exploring mindfulness and acceptance-based therapies for adults with ASD have noted that overly abstract or metaphor-heavy language can sometimes create confusion rather than clarity. Researchers have found that many individuals benefit from shorter exercises, more direct language, increased structure, and practical examples tied closely to lived experience.
In contrast, many individuals with ADHD seem to thrive on novelty, emotional resonance, humour, storytelling, and layered analogies. Metaphors can capture attention in a way that straightforward explanations sometimes cannot.
Of course, no two neurodivergent individuals are identical. Some autistic clients love metaphor. Some ADHD clients hate it. These are not rigid rules. But they are patterns many clinicians begin to notice over time.
What I appreciate about ACT is that it leaves room for this flexibility. The heart of the therapy remains the same:
- making space for difficult internal experiences
- becoming less entangled with thoughts
- reconnecting with values
- taking meaningful action even when discomfort is present
But how those ideas are communicated can — and probably should — change depending on the person.
For me, that is one of the more meaningful lessons emerging from this growing body of neurodivergence research. Effective therapy is not simply about choosing the “right” model. It is also about understanding how different minds process language, emotion, attention, and experience.
And sometimes the most important clinical skill is not learning an entirely new therapy.
Sometimes it is learning a better translation.
Suggested Reading
Conner, C. M., & White, S. W. (2017). Feasibility and preliminary efficacy of individual mindfulness therapy for adults with autism spectrum disorder. Journal of Autism and Developmental Disorders.
Wakelin, C., Willemse, M., & Munnik, E. (2023). A review of recent treatments for adults living with attention-deficit/hyperactivity disorder. South African Journal of Psychiatry.
Harris, R. The Happiness Trap.
Harris, R. ACT Made Simple.
A Taylor'd Life 