Therapy when you’re autistic

You might be autistic and want help with something, or you might have tried therapy and found it didn’t fit. Either way, you might be wondering whether therapy works for autistic people. Therapy is for what you want help with, such as anxiety, low mood or burnout, not for being autistic. This page covers what the research shows, what makes therapy fit, questions to ask a therapist, and ways to pay in Australia.

What the research shows

A review of 71 trials, with about 3,600 autistic children and adults, looked at what helps with anxiety and low mood (Linden and colleagues, 2023). All the trials had weaknesses that make their results less certain. Some forms of cognitive behavioural therapyCognitive behavioural therapy (CBT) A structured, practical form of talking therapy. It's built on a simple idea: what you think affects how you feel, and both affect what you do. More in the jargon decoder Close (CBT) may reduce anxiety and low mood in autistic children and adults. CBT is built on a simple idea: what you think affects how you feel, and both affect what you do. Mindfulness-based therapy may help autistic adults who’ve had mental health difficulties before. The reviewers recommend that autistic people have access to the same treatments as anyone else, tailored to the person.

A study of health records from England’s public talking-therapy services compared about 8,800 autistic adults with non-autistic adults who started in a similar place (El Baou and colleagues, 2023). More than half the autistic adults improved. Fewer of them improved than the non-autistic adults (about 56 in 100, compared with about 62 in 100), and a few more got worse (about 9 in 100, compared with about 7 in 100). The researchers concluded that therapy for anxiety and low mood may work for autistic adults, but less well than for others. That’s a reason to look for a therapist who adapts how they work, not a reason to rule therapy out.

What makes therapy fit

An Australian survey asked 130 autistic adults, mostly in Australia, how helpful they found a number of ways of adapting therapy (Paynter and colleagues, 2025). The changes rated most helpful were about the therapist’s attitude: a therapist who accepts that brains work differently and supports your identity as an autistic person. Almost every change was rated very helpful by some people and not helpful by others. No single change suited everyone. Most of the people who answered were women, and most had a university degree.

Reframing Autism is an Australian organisation whose work is created by or with autistic people. It describes a good provider as one who works “with your neurology, not against it” (Reframing Autism). So it’s reasonable to tell a therapist what helps you, whether that’s written summaries, fewer questions about feelings, or a different room, and to expect them to adjust.

Finding someone

Reframing Autism suggests questions to ask a therapist, including (Reframing Autism):

• “How would you describe autism?”
• How they adapt the way they work to each person.
• “Is your practice an autism-friendly environment?”

A good answer is specific. A therapist who adapts how they work can usually tell you how. How to find a therapist covers where to search and how to check someone is registeredRegistered For psychologists, psychiatrists and occupational therapists, registration with Ahpra is required, and using the title without it is an offence. Counsellors and psychotherapists can register with their national associations, which is voluntary. More in the jargon decoder Close. Whatever approachApproach (modality) The kind of therapy someone uses, such as CBT or psychodynamic therapy. You'll also see it called a modality. More in the jargon decoder Close they use, the fit with the person matters a great deal. Why who you see matters more than what they do explains why.

If you don’t have a diagnosis

You don’t need a diagnosis to see someone. A counsellorCounsellor Someone trained to help people talk through and work on difficulties. The title isn't protected in Australia, so it's worth checking a counsellor's training and registration. Medicare doesn't give a rebate for counsellors. More in the jargon decoder Close needs no referralReferral A letter from a GP, psychiatrist or paediatrician that you need for the Medicare rebate. You can see a psychologist without one if you pay the full fee. More in the jargon decoder Close and no diagnosis, and neither does a psychologistPsychologist Someone trained to assess mental health problems and treat them with therapy. It takes at least six years of study and supervised practice, and they're registered with Ahpra, the national regulator. Psychologists can't prescribe medication. More in the jargon decoder Close you pay in full. Would I benefit from therapy? covers how to think about whether therapy might help. Getting a diagnosis covers who can assess you and what’s involved, if you want to look into one.

Paying for it

There are several ways to pay for therapy:

• Full fee. Seeing a private psychologist, counsellor or psychotherapistPsychotherapist Someone trained in therapy, often for longer-standing patterns. Like counsellor, the title isn't protected in Australia, and Medicare doesn't give a rebate for psychotherapists. More in the jargon decoder Close directly. MedicareMedicare Australia's public health insurance scheme. For mental health, it gives rebates on sessions with psychologists and some other professionals, usually through a Mental Health Treatment Plan. More in the jargon decoder Close doesn’t cover counsellors or psychotherapists.
• Workplace programs. Many employers pay for a few sessions for their staff.
• Community services. Non-profit organisations and local community health centres provide low-cost care.
• headspaceheadspace A national youth mental health service for anyone aged 12 to 25, with centres around Australia and support online and by phone. It's free or close to it, you don't need a referral or a parent, and you can book it yourself. More in the jargon decoder Close. headspace offers free or low-cost support for people aged 12 to 25.
• Groups. Group therapyGroup therapy A trained professional, sometimes two, working with several people at once. It's a way of running therapy, and many approaches work in groups. More in the jargon decoder Close programs, which usually cost less per session.
• A Mental Health Treatment PlanMental Health Treatment Plan A document your GP writes with you. It makes you eligible for a Medicare rebate on up to ten individual sessions a calendar year: six, then a review with your GP, then the remaining four. The plan itself isn't therapy. More in the jargon decoder Close. Your GPGP (general practitioner) For most people, where getting help starts. A GP can write a Mental Health Treatment Plan, prescribe medication and refer you on, and some are trained to deliver a small number of structured therapy sessions themselves. More in the jargon decoder Close assesses whether a plan suits you. A plan gives you a Medicare rebateRebate The amount Medicare pays back towards a session. It comes back to you after you've paid, so what you pay yourself is the fee minus the rebate. More in the jargon decoder Close on up to ten sessions a calendar year.

Free and low-cost options has more on each of these.

If you’re under 25 and have an autism diagnosis confirmed by a paediatricianPaediatrician A medical specialist in children's and young people's health. If you already see one, they can refer you directly for rebated sessions with a psychologist, without a GP plan. More in the jargon decoder Close or psychiatristPsychiatrist A medical doctor who has specialised in mental health. Psychiatrists can diagnose, prescribe and do therapy, though many spend most of their time on medication and diagnosis rather than weekly sessions. More in the jargon decoder Close, there’s a separate Medicare plan for autism and some other conditions. It gives a rebate on up to 20 sessions with a psychologist and some other health professionals, on referral. Ask your GP or the specialist how this fits with a Mental Health Treatment Plan.

If you also have attention deficit hyperactivity disorder (ADHD), CBT for ADHD covers a version of CBT adapted for ADHD.

If things are difficult right now, Lifeline is on 13 11 14, the Suicide Call Back Service is on 1300 659 467, and Kids Helpline is on 1800 55 1800 for anyone aged 5 to 25. In an emergency, call 000. Crisis and emergency support has the full list.