Book Review: "On Being an Autistic Therapist"
Book Review: "On Being an Autistic Therapist". Edited by Max Marnau
In the rapidly evolving landscape of neurodiversity-affirming mental health practice, "On Being an Autistic Therapist" emerges as a groundbreaking contribution that fundamentally challenges long-held assumptions about autism and therapeutic practice.
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A Groundbreaking Collection of Autistic Voices
This anthology brings together the voices of 23 autistic therapists who collectively reframe autism not as a deficit, but as a distinct cultural and linguistic perspective that offer strengths to the therapeutic profession. The book is edited by Max Marnau, who confirmed that she is autistic in her early 60s after a varied career that included study at Cambridge and Oxford, Ergo, what makes this collection revolutionary is not merely its subject matter but its methodological approach to illuminating the reader about autistic people..
Structure and Organisation
The book is organised into four thoughtfully structured sections.
Section A, "Finding What Works," explores various therapeutic modalities through an autistic lens, from River Marino's fascinating insights on monotropism and flow states to Kristina Takashina's embodied experiences of dance movement therapy.
Section B, "To Be That Self Which One Truly Is," delves into the profound journey toward authenticity, with powerful accounts of late diagnosis and the reclamation of therapeutic identity.
Section C, "Autistic Therapists for Autistic People," examines the unique dynamics of shared neurotype in therapy.
Section D addresses the critical gaps in current educational frameworks, including the transcript of a conversation between Vauna Beauvais and Eoin Stephens, discussing crucial considerations for the transformation of training programs for therapists in order to enable therapistd to better serve the autistic client population.
The Content
Reframing Autism as a Cultural Perspective
Rather than positioning autistic therapists as anomalies within a neurotypical profession, authoors in the book present autism as a cultural and linguistic difference that brings valuable perspectives to therapeutic work.
Katherine Balthazor's framing of autism as "a language and a culture" offers a paradigm shift in how we conceptualise neurodivergence, suggesting that therapy between autistic individuals operates as a form of cultural congruence rather than an exception to standard practice.
Challenging the Empathy Myth
The anthology powerfully challenges harmful stereotypes, particularly the persistent myth that autistic individuals lack empathy. Contributors like Chan Shu Yin, who describes feeling clients' emotions "viscerally in my own body," and Kathy Carter, who writes about the nuanced empathy of autistic therapists, provide compelling counternarratives to such misconceptions.
The book introduces Milton's concept of the "double empathy problem," highlighting how communication differences between neurotypes have been misinterpreted as empathic deficits. Dr Damian Milton, a senior lecturer at the University of Kent, and a late-identifying autistic person himself, wrote and published the paper to counter myths and judgments about autistic peoples communication and empathy as judged in relation to non-autistic people. He argued that such myths came about only as a result of contrasting autistic people against neuronormativity as an assumed ideal standard, and subsequently defining autistic people as defective or sub-standard in comparison. If you are not familiar with the explanation and argument that he puts forward by way of the double empathy problem you can access Miltons original paper here.
The Impact of Late Diagnosis
A striking pattern emerges across many contributions of this book: the experience of late diagnosis / late identification of being autistic. Most contributors discovered in adulthood that they are autistic, often after establishing careers as therapists. This results in particularly poignant reflections on masking and authenticity in therapeutic practice. Sylvia Liu's description of masking as "losing whole interactions" with a "huge opportunity cost of lost meaningfulness" captures the profound impact of navigating professional life while suppressing authentic autistic expression.
Intersectionality and Multiple Identities
The book also makes important contributions to understanding intersectionality in autism. Sharon Xie's account of navigating both Asian American and autistic identities, Rebecca Antrim's exploration of autism and chronic illness, and Wilma Wake's perspective as part of "the lost generation" of older autistic women provide essential insights into how autism intersects with other aspects of identity and experience.
Innovation in Therapeutic Practice
What distinguishes this work from other literature on autism is its emphasis on lived experience as expertise. The contributors don't merely adapt existing therapeutic frameworks; they fundamentally reimagine what therapy can be when informed by autistic perspectives.
Romy Graichen's "Neurodiversity-Affirming Supervision" and Elinor Rowlands' innovative work with digital environments and soundscapes demonstrate how autistic therapists are creating entirely new approaches to clinical work.
Vauna Beauvais talks of re-conceptualing what is the role of therapist for autistic clients, given that client population do not need a therapist in the same way and do not benefit from the same interventions as allistic clients. Something that the details of which are explored, discussed and reflectively practiced in their training courses for qualified therapists at Vanguard Neurodiversity Training.
Practical Implications for All Therapists
For non-autistic therapists, the book offers invaluable insights into creating more accessible therapeutic environments. Concrete recommendations include
reconsidering sensory elements of practice spaces,
examining implicit communication expectations,
recognising how typical supervision models may inadvertently disadvantage neurodivergent practitioners.
Transforming Therapeutic Education
The final section on training presents a compelling case for transforming therapeutic education to include autism as core curriculum rather than specialty content. Chapter 22 merits special attention for its transformative implications for therapeutic education. In this pivotal chapter, Vauna Beauvais and Eoin Stephens—both experienced therapists who discovered later in life that they are autistic—present a compelling case for revolutionising how we prepare therapists to work with autistic clients.
The Glaring Gap in Therapeutic Training
The chapter takes the form of an in-depth interview that reads with remarkable intimacy, allowing readers to witness the parallel journeys of two established therapists making meaning from both discovering the implications of being an autistic person while simultaneously recognising the profound gaps in their professional training. What makes this contribution particularly valuable is its dual perspective: both Beauvais and Stephens speak from positions of considerable professional authority while also sharing the vulnerability of initially having practiced for years without understanding their own neurotype.
Beauvais's stark observation that "Nobody at all, ever, in the whole time, spoke about autism on our training programme" serves as a damning indictment of current therapeutic education. The implicit message she identifies—"You don't need to know about autism because as a psychotherapist you will not work with autistic clients"—reveals a blind spot in therapeutic training. That training program was attended over 25 years ago. Society has moved on and it is now well known that there have always been a proportion of the general population who are autistic, including therapy clients.
Therapy as Cross-Cultural Communication
The chapter's strength lies in its methodical dismantling of harmful myths about autism that permeate therapeutic practice. Stephens systematically addresses three particularly damaging misconceptions: that autistic people are unsociable, unemotional, and unempathic. His candid admission of having "bought into" these myths himself before his diagnosis offers a powerful model of professional humility and growth. This section provides an essential framework for therapists to examine their own internalised misconceptions about autism.
Particularly valuable is the chapter's reframing of therapy with autistic clients as "cross-cultural counseling." This perspective shift moves beyond mere accommodation to position the neurotypical-neurodivergent therapeutic relationship as one requiring genuine cultural competence. The authors argue that just as therapists would prepare to work with clients from different cultural backgrounds, they must develop similar competencies in understanding autistic culture and communication.
Evidence-Based Call for Change
The chapter offers compelling evidence for this approach through research from the National Autistic Society, which found that "the most important thing for autistic adults was that they wanted therapists to understand autism." This finding, presented alongside examples of harmful therapeutic practices that result from lack of understanding, creates an urgent case for educational reform that readers will find difficult to dismiss.
Interestingly, in the April 2025 edition of ‘Therapy Today’, the professional journal for members of the British Association of Counselling and Psychotherapy, features therapists expert views and discussions about ‘When Therapy Causes Harm”. Not only is it a progressive stance to cover such a subject, and finally bring to the attention of the hundreds of thousands of therapists in the UK that harm is indeed possible by well-intentioned but uninformed therapists, but to see the front cover itself boldly display it, indicates that it is something that greatly matters. Erin Stevens, an autistic therapist is one such contributor in this edition. If you are a member of BACP you can access that issue here.
Neurodivergent Leadership in Education
What distinguishes this chapter from standard calls for improved autism education is its emphasis on neurodivergent leadership in training development. Beauvais and Stephens describe founding Vanguard Neurodiversity Training precisely because they recognised that autism education hadn’t been informed by autistic professionals. Their model of training—which prioritises lived-experience of autistic people, alongside knowledge from clinical expertise and learning points backed by research data and professional publications—helps trainees understand autistic people from the inside, and in doing so their educational approach offers a concrete alternative to traditional top-down approaches.
Rethinking Therapeutic Boundaries
The authors also address the complex question of disclosure, something that many autistic clients seek to discuss in depth with their therapist. Given that there are genuine real-life risks associated with innocently spilled-out disclosure, newly identified adults are well-advised to process the meaning and implications of realising that they are autistic first. In this way they can discover, via explorative conversations in therapy, why they may disclose, to whom, when, and for what benefits (for example to deepen mutual understanding between the client and their friends, or to offer a framework for reasons to seek modifications to job role processes or environments).
A Vision for the Future
The chapter concludes with a note of optimism that stands in counterpoint to its critical assessment of the current state of therapeutic education. Stephens observes that "Understanding of autism and autistic people's ways of thinking, being and doing, is moving at a very fast pace now," suggesting that the field is at a turning point where meaningful change is possible. The authors' obvious dedication to being part of this transformation—evidenced by their own training initiatives—provides readers with both a critique and a path forward to understanding and accessing training in neuroaffirming therapy.
Implications for Educational Institutions
For therapeutic educators, clinical supervisors, and training program directors, Chapter 22 could be considered required reading. It provides not just a critique but a roadmap for institutional change within the profession.
The authors' combined experience—as therapists, as trainers, and as autistic individuals—gives their recommendations unparalleled credibility. Their call for autism to be integrated into core therapeutic curriculum rather than relegated to specialty training represents a fundamental challenge to current educational models that the field could do well to heed.
How ‘On Being an Autistic Therapist' Serves Different Professional Readers
For Professional Therapists
Professional therapists will find "On Being an Autistic Therapist" transformative for their clinical practice regardless of their neurotype. The book offers invaluable insights into autistic ways of experiencing the world, communication preferences, and sensory processing that can inform more effective therapeutic approaches with autistic clients.
Non-autistic therapists will discover how common therapeutic practices may unintentionally create barriers for autistic clients, from sensory-overwhelming environments to implicit social expectations that hinder authentic engagement. The book provides practical alternatives that create more accessible therapeutic spaces for all clients.
For autistic therapists who may not yet recognise their neurodivergence, these accounts could provide the revelatory mirror that many contributors describe - the profound recognition of oneself in others' experiences. Already-identified autistic therapists will find validation, community, and possibly some extra strategies for professional approaches.
Perhaps most valuably, all therapists will gain perspective on how the conventional therapeutic emphasis on neuronormatively reading non-verbal cues, spontaneous emotional expression, and social reciprocity may need thoughtful reconsideration when working across neurological differences. The contributors' accounts illuminate paths toward more flexible, individualised therapeutic approaches that honor diverse neurological styles.
For Clinical Supervisors
Clinical supervisors will find this book essential for developing truly inclusive supervisory practices. The accounts of autistic therapists' experiences with supervision—both positive and negative—offer concrete guidance for creating supervisory relationships that support neurodivergent supervisees.
Amy Walters' chapter on neurodiversity-affirming supervision provides a comprehensive framework for adapting supervisory approaches, from offering alternative communication channels to reconsidering assumptions about professional presentation. Supervisors will learn how traditional evaluation metrics may inadvertently penalise autistic therapists for differences in communication style rather than assessing their actual clinical effectiveness.
The book also illuminates how supervision can either exacerbate or mitigate professional burnout for autistic therapists. Supervisors will gain understanding of autistic burnout as distinct from general occupational burnout, with specific strategies for supporting sustainable practice.
Perhaps most importantly, clinical supervisors will discover how they can become critical allies for autistic therapists navigating professional systems. The contributors' accounts repeatedly highlight how even a single supportive supervisor made profound differences in their professional development. The book offers supervisors concrete ways to create safer spaces for disclosure, authentic professional development, and the integration of neurodivergent perspectives into clinical work.
For Trainers of Therapists
For those responsible for designing and implementing therapist training programs, this book delivers a compelling case for fundamental educational reform. Vauna Beauvais and Eoin Stephens' chapter directly addresses the glaring absence of autism in therapeutic education, offering both critique and constructive alternatives for creating autism-inclusive programs for counsellors and psychotherapists in training.
Trainers will gain critical insights into how current educational practices may inadvertently exclude neurodivergent trainees through inaccessible teaching methods, sensory-overwhelming environments, and implicit social demands. The contributors offer specific recommendations for accommodations that benefit not only autistic trainees but enhance learning for all students.
Beyond accessibility, the book makes a powerful case for integrating autism into core therapeutic curriculum rather than treating it as a specialty topic. Trainers will find compelling arguments for viewing work with autistic clients as a form of cross-cultural counseling requiring specific competencies that all therapists should develop.
Perhaps most significantly, trainers will be challenged to reconsider fundamental assumptions about therapeutic practice that are based in neurotypical experiences and may not serve all clients effectively. The contributors offer alternative frameworks that honor neurodivergent ways of connecting, communicating, and processing emotion that can enrich therapeutic education for all trainees.
By incorporating these perspectives into training programs, educators can, not only, prepare the next generation of therapists to work more effectively across neurological differences, but also help upskill the many therapists for whom working with autistic clients was never covered at the time they trained and qualified as a therapist. Moreover, training organisations can create more inclusive educational environments for neurodivergent trainees to thrive.
Limitations of this book
If there is any limitation to this groundbreaking work, it may be that its revolutionary perspective could initially challenge readers deeply embedded in traditional therapeutic frameworks. The book is very firm in its rejection of the pathologising medical model of autism. And this may require significant paradigm shifts for some practitioners.
Conclusion and Significance of this Book
"On Being an Autistic Therapist" is essential reading not only for autistic therapists seeking professional community, but also for neurotypical practitioners, clinical supervisors, and educators committed to creating truly inclusive mental health services for autistic clients.
By centering autistic voices and lived experience, Marnau has assembled a collection that doesn't merely add to the literature on autism—it fundamentally transforms how we understand both autism and therapeutic practice. This book marks a pivotal moment in the evolution toward neurodiversity-affirming mental healthcare, offering both practical wisdom and profound theoretical reconsiderations that will influence the field for years to come.
Author: Vauna Beauvais
Purchase The Book
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The Authors Discuss the Book at an Online Launch: https://onlinevents.co.uk/courses/book-launch-on-being-an-autistic-therapist-meet-the-authors/
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