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The Process Of Therapy For Neurodiverse Couples

The Process Of Therapy For Neurodiverse Couples
The Process Of Therapy For Neurodiverse Couples

If you are a neurodiverse couple seeking help with your relationship what can you expect to happen in the therapy process?

First, keep in mind that the process will depend upon the unique circumstances of your relationship; your therapist’s training, experience and personal style; and the goals you and your therapist agree upon. Every couple and every therapist is different, hence any description of what will occur has to be broadly general and applicable only to a certain degree for every particular situation.

With that caution in mind, here are the most the important elements of therapeutic work with neurodiverse couples, gleaned from my experience and the descriptions of other therapists who specialize in this area. For our purposes, I am focusing on couples where one person has Autism Spectrum Disorder (ASD) and the other does not.

Assessment Phase

The initial step, and perhaps the most important one in couples therapy, is determining each person’s motivation and ability to change. Unless both people want to improve the relationship nothing the therapist can do will make a significant difference. This is true for the neurotypical partner as well as the partner with Autism Spectrum Disorder.

Assessing motivation involves determining each person’s expectations for the relationship, the couples’ willingness to work for change, the compatibility of their goals and needs for the relationship, how realistic their objectives are, and how capable each person is to bring about the change they want.

It also includes assessing the barriers to change, both within each person and between the partners. Whether it is an unspoken desire to maintain the status quo, fear of expanded intimacy, unwillingness to make concessions, perceived or real limitations to change, or whatever other obstacle it might be, obstructions of any kind have to be identified and discussed in order for the therapy process to work.

The Contract

Couples therapy requires an agreement with all parties as to what each person will do to bring about change. This is true of the individual partners and the therapist.

A contract, which need not be written and instead can be a verbal agreement, should acknowledge the fact that both partners must make accommodations in order for the relationship to improve. This is not to say that each partner is equally responsible for the relationship problems. How is it possible to divide responsibility so exactly? But in the give-and-take of any relationship, each person contributes something to what is taking place. Accordingly, each person has to make some adjustments for change to happen.

An agreement of what the partners will do to improve their relationship should be spelled out clearly and with as much specificity as possible. The goals of the therapy should also be clearly stated. There should be frequent follow-up assessments of progress towards these goals, re-assessments of any barriers to change, and recalibration of the goals and strategies of the therapy.

Oftentimes, one or both partners will feel a desire to end couples therapy before the stated goals have been met. Ideally, a contract should include an agreement to discuss this desire before any decision is made.


A major technique in work with neurodiverse couples is to pay careful attention to the interactions between the partners in the therapy session. For example, is one partner stonewalling? What resistance to change emerges as the therapeutic work proceeds? Is one person blaming the other and why? Are there any attempts to sabotage progress? These interactions form a foundation for change, as they provide a real time window into the core problems of the couple.

A more specific technique involves teaching the Autism Spectrum Disorder partner how to read the intentions, wishes, and feelings of the neurotypical partner and how to then respond in a matching way.

Work with both partners to develop their relationship connection is also important for neurodiverse couples, many of whom suffer from unrecognized and unfulfilled needs and wants. Writing down things each partner needs to help feel connected, sharing that list, and working on one specific item in-between therapy sessions is an invaluable step towards creating the love and support necessary for intimacy to flourish.

Future Techniques

Once the assessment has taken place, a contract has been put into place, and therapeutic work is underway, a process unique to neurodiverse couples can take place. In an upcoming blog I will expand on the list of techniques and strategies specific to this process.

You can read about similar articles here.

Dr. Kenneth Roberson is an Autism Spectrum Disorder psychologist offering Therapy for Neurodiverse Couples in San Francisco, California for over 30 years.


Dr. Kenneth Roberson

Dr. Kenneth Roberson is an Adult Autism Psychologist in San Francisco with over 30 years of experience. Click below to ask a question or schedule an appointment.

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