Neurodiversity Celebration Month in April is a time to honor neurological differences, whether that’s ADHD, autism, sensory processing disorders, dyslexia, or something else. Everyone processes information and experiences the world differently, so it is important to accept and value all approaches. To celebrate Neurodiversity Celebration Month, we asked EMDRIA members for video or written responses to the following question:
*** Dr. Helen Butlin, RP, Ontario, Canada – “Culturally responsive EMDR case conceptualization for neurodivergent clients requires holding neurodifference and trauma as simultaneously present and mutually implicated — not competing diagnoses but entrained realities requiring binocular clinical vision. Autism, ADHD, and Aut-ADHD are not iterations of diagnostic error; neurodifferences are neurological identities shaping how clients present, communicate, process imagery, emotion, experience their body, and critically, the therapeutic relationship itself. Without this lens, structural dissociation frameworks risk pathologizing masking and misreading hyperphantasia, aphantasia, and synesthesia, amongst other newly emerging neurocapacities as dissociative symptoms — re-enacting the lifelong harm of environments that failed to see the neurodivergent person accurately. It is important not to exclude this rapidly expanding body of research and lived experience accounts, nor dismiss neurodifference as misdiagnosis of structural dissociation or identity-seeking. For those whose late recognition of a lifelong neurological identity finally makes sense of their lifeworld, that recognition can be profoundly healing. Cultural responsiveness requires that the therapeutic lens honours rather than forecloses it.”
*** Sabrina Sartori Rocha Chouinard, LISW, Iowa, USA – Note for subtitles on the videos, play the video and click on the ‘CC’ icon in the upper right-hand corner for closed captioning.
*** Kathy Couch, LCSW, Idaho, USA – “Culturally responsive EMDR case conceptualization for neurodivergent clients begins before the first protocol decision. It begins with the clinician’s willingness to interrogate the ableist assumptions embedded in our training — assumptions about what a regulated nervous system looks like, what “appropriate” affect means, and whose communication style is considered the default. Ableism in clinical practice is rarely intentional. It lives in the benchmarks we use, the timelines we expect, and the resourcing scripts we hand clients without asking whether they fit. For neurodivergent clients, neuroception is not a dysfunction to work around — it is a lens through which every phase of EMDR must be understood (Porges, 2011). Cultural responsiveness here is clinical precision. The adaptive information processing model assumes the system is oriented toward healing — but only when the conditions for processing are genuinely safe (Shapiro, 2018). For neurodivergent clients, safety is not a universal standard. It is a co-constructed one. The framework was never broken. Our ableist application of it sometimes is.”
*** Alyssa Desroches, LCSW, Connecticut, USA
*** Angelica Figueroa, LCSW, PMH-C, California, USA – “As an AuDHD Latina therapist, there are many factors to consider! The first is the therapist receiving additional training in adapting EMDR Therapy to neurodivergent folx. The next factor to consider is a robust Phase 1 that focuses on sensory needs, understanding of the power dynamics and oppressive dynamics of intersecting identities, cognitive processing style, varying needs, how our brains house memories, alexithymia, aphantasia, etc., and understanding the special interest/s (ie. eye sparkle) of the therapy participant to assist with a solid Phase 2. Conceptualizing the case needs to include addressing ableism and psychoeducation on the effects of oppressive systems to guide the therapy participant in unlearning and undoing generational messaging and trauma about the way we navigate the world.”
*** Melissa Galiotto, LPC, Pennsylvania, USA – “I think a culturally responsive EMDR case conceptualization for clients who identify as neurodivergent requires going beyond standard protocol and thoughtfully integrating neurodiversity, identity, and context into each phase of treatment. That might look like: during history taking, inquiring about systemic invalidation and feeling misunderstood or bullied; using concrete language; being aware of sensory and environmental considerations, such as adjusting the lighting or tone; having a safe word and monitoring for dissociative episodes; considering the cultural sensitivity and primary concerning symptoms; and psychoeducation on masking and window of tolerance and imagery.”
*** Dr. Corrie Goldberg, Illinois, USA
*** Cathy Hanville, LCSW, Pennsylvania, USA – Note for subtitles on the videos, play the video and click on the ‘CC’ icon in the upper right-hand corner for closed captioning.
*** Kionna Howell, LPC, Pennsylvania, USA
*** Summer Johnke, LCSW, New York, USA – Note for subtitles on the videos, play the video and click on the ‘CC’ icon in the upper right-hand corner for closed captioning.
*** Dr. Leona Kashersky, PsyD, California, USA “A culturally responsive EMDR case conceptualization for neurodivergent clients requires clinicians to move beyond deficit-based frameworks and recognize neurodivergence as a valid form of human diversity. Many neurodivergent individuals carry cumulative trauma from environments that demanded masking, compliance, or conformity rather than understanding. Experiences such as chronic sensory overwhelm, social exclusion, correction of natural communication styles, and repeated messages of “being too much or not enough” often form the core trauma networks that emerge in EMDR treatment. Effective conceptualization requires curiosity about how neurobiology, identity, and environment intersect. Clinicians must flexibly adapt pacing, preparation, and bilateral stimulation to match sensory needs, processing style, and cognitive load. Most importantly, therapists must listen carefully to how clients understand their own neurodivergence. When clinicians center dignity, reduce pressures to mask, and contextualize distress within relational and systemic environments, EMDR can support trauma resolution while strengthening identity, self-trust, and authenticity.”
*** Mishma Kumar-Jonson, AMHSW, MScPol, Victoria, Australia – “Culturally responsive EMDR case conceptualisation with neurodivergent participants begins with understanding neurodivergence as a valid way of being human and not something to be fixed. Many neurodivergent communities hold rich cultures, languages, and ways of relating that clinicians must approach with humility, respect, and care, recognising how identity and belonging shape distress and healing. An intersectional and minority stress lens is also essential, as systemic factors such as ableism, racism, queerphobia, and class shape both trauma exposure and access to ongoing safety. Adapting EMDR to a person’s neurodivergent characteristics, sensory needs, and processing styles is central to understanding how they navigate a neuro-normative world and what identity-affirming adaptive resolution looks like for them. Cultural responsiveness also involves recognising that trauma may be ongoing rather than historical, which shapes how targets are identified and processed. Centring lived expertise keeps the work collaborative, flexible, and grounded in the participant’s reality.
*** Dr. Tiffini Lanza, LCSW, Pennsylvania, USA – Note for subtitles on the videos, play the video and click on the ‘CC’ icon in the upper right-hand corner for closed captioning.
*** Dru Perren, LPCC-S, Ohio, USA
*** Laura Phillips, LCSW, Virigina, USA – “As a neurodivergent therapist working primarily with neurodivergent clients, I start with this: many clients enter therapy without a diagnosis. Don’t assume someone (at any age) is neurotypical simply because they haven’t been identified. Stay curious. Make interpretations cautiously about limited eye contact, friendship patterns, speech differences, or inconsistency in functioning. I have not met a neurodivergent client without trauma. Their trauma is often chronic and ongoing. Lives shaped by misunderstanding, rejection, masking, loneliness, or shame. Be aware that strengths can coexist with regulation challenges, and functioning varies day-to-day. Neurodivergent clients are often processing a backlog of information and may need more time to identify and integrate experiences. Creative expression is often beneficial rather than relying only on spoken communication. You might integrate sand tray, artwork, or movement into sessions. Presume competence. EMDR is an effective therapy for neurodivergent clients when their nervous system is affirmed and accommodated.”
*** Kristina Spurlock, LMHC, Washington, USA – “As a therapist specializing in working with neurodiverse adults, it is imperative to ask neurodivergent folks about their history with therapy, gauge what helps them feel safe, assess their expectations of the therapeutic relationship, and ask about any sensory issues or processing needs. It is then the therapist’s job to incorporate these preferences into the EMDR therapy experience. It needs to be a highly tailored and client-led approach. Therapists need to be proficient enough in EMDR to flexibly adjust the wording, assessment methods for distress, and/or bilateral stimulation to better help the client process without losing the mechanism that makes EMDR effective.”
*** Johanna Stacy, LMHC, Washington, USA
*** Linda Storm, RP, Ontario, Canada – “Culturally responsive EMDR case conceptualization with neurodivergent clients begins with a shift in clinical stance. Neurodivergence must be understood as a legitimate variation in human cognition rather than a deficit requiring correction. This perspective changes how clinicians interpret trauma history, sensory processing, emotional regulation, and relational safety within therapy (Dwyer, 2022; Pellicano & Den Houting, 2022). Effective case conceptualization, therefore, requires more than technical EMDR competence. Clinicians must understand how neurodivergent sensory and cognitive processing influences trauma encoding, pacing, and the client’s tolerance for stimulation during processing. Collaboration with clients to adapt procedures becomes essential because many neurodivergent adults have long histories of masking, invalidation, and diagnostic overshadowing within healthcare systems (Mazurek et al., 2023). Culturally responsive EMDR practice also requires attention to relational power dynamics. Neurodivergent clients frequently enter therapy after repeated experiences of misattunement or being misunderstood by authority figures. A neurodiversity-affirming stance helps prevent therapists from interpreting autistic coping strategies as resistance or dysregulation (Chapman & Botha, 2023). When EMDR is grounded in neurodiversity-affirming knowledge, skills, and attitudes, the therapy room becomes a place where neurological difference is respected rather than corrected. That shift in clinical stance creates the conditions necessary for trauma processing to be accessible and psychologically safe for neurodivergent clients.”
*** Jaclyn Taylor, LMHC, New York, USA – Note for subtitles on the videos, play the video and click on the ‘CC’ icon in the upper right-hand corner for closed captioning.
*** Rachel Totten, LICSW, Vermont, USA
*** Angela VanDyke, LPC, Virginia, USA – “Culturally responsive EMDR for neurodivergent clients starts with one core truth: they want to feel seen. As both a clinician and someone with ADHD, I hear the same themes over and over—‘People don’t get me,’ ‘This world wasn’t built for me,’ ‘Therapy isn’t made for someone like me.’ Many have worked with multiple therapists and still felt unheard. Neurodivergent clients are often trying to find balance in a world that feels either too rigid or too chaotic. EMDR helps because it offers structure without pressure, flexibility without overwhelm. The rhythm, pacing, and predictability create safety, while the client stays in control of how fast or slow we move. When we honor sensory needs, communication styles, and processing differences, EMDR becomes a space where neurodivergent clients finally feel understood—and healing becomes possible
*** Fizzah Zaidi, LCPC, Illinois, USA – “A key factor in working with neurodivergent clients is recognizing that much of their lived experience is shaped by shame. Repeated experiences of not fitting in or facing rejection often lead to persistent negative self-talk and a fragile sense of belonging. This can be intensified when clients feel disconnected not only socially, but also within their own cultural context. It is important to explore how clients understand themselves within their culture and what belonging means to them, as well as their goals for EMDR.
*** Dr. Gianluca Zazzi, Clinical Psychologist, Pontremoli, Italy – “A culturally responsive EMDR case conceptualization for neurodivergent clients begins with recognizing neurodivergence not as pathology, but as a natural variation in neurodevelopment. This perspective helps clinicians move away from deficit-based assumptions and toward a strengths-informed framework. Clinically, therapists should consider differences in sensory processing, attentional patterns, communication styles, and emotional regulation. These factors may influence pacing, preparation phases, and the choice or modulation of bilateral stimulation. Flexibility within the EMDR protocol is often essential. It is also important to recognize that many neurodivergent clients carry cumulative relational trauma related to chronic misunderstanding, masking, social exclusion, or invalidation across developmental contexts such as school, family, and work environments. A collaborative and respectful therapeutic stance is therefore central. When clinicians validate neurodivergent identity and adapt EMDR treatment accordingly, therapy can facilitate not only trauma resolution but also greater self-understanding, safety, and psychological integration.”
“What factors help ensure a culturally responsive EMDR case conceptualization for clients who identify as neurodivergent?”
*** Dr. Helen Butlin, RP, Ontario, Canada – “Culturally responsive EMDR case conceptualization for neurodivergent clients requires holding neurodifference and trauma as simultaneously present and mutually implicated — not competing diagnoses but entrained realities requiring binocular clinical vision. Autism, ADHD, and Aut-ADHD are not iterations of diagnostic error; neurodifferences are neurological identities shaping how clients present, communicate, process imagery, emotion, experience their body, and critically, the therapeutic relationship itself. Without this lens, structural dissociation frameworks risk pathologizing masking and misreading hyperphantasia, aphantasia, and synesthesia, amongst other newly emerging neurocapacities as dissociative symptoms — re-enacting the lifelong harm of environments that failed to see the neurodivergent person accurately. It is important not to exclude this rapidly expanding body of research and lived experience accounts, nor dismiss neurodifference as misdiagnosis of structural dissociation or identity-seeking. For those whose late recognition of a lifelong neurological identity finally makes sense of their lifeworld, that recognition can be profoundly healing. Cultural responsiveness requires that the therapeutic lens honours rather than forecloses it.”
*** Sabrina Sartori Rocha Chouinard, LISW, Iowa, USA – Note for subtitles on the videos, play the video and click on the ‘CC’ icon in the upper right-hand corner for closed captioning.
*** Kathy Couch, LCSW, Idaho, USA – “Culturally responsive EMDR case conceptualization for neurodivergent clients begins before the first protocol decision. It begins with the clinician’s willingness to interrogate the ableist assumptions embedded in our training — assumptions about what a regulated nervous system looks like, what “appropriate” affect means, and whose communication style is considered the default. Ableism in clinical practice is rarely intentional. It lives in the benchmarks we use, the timelines we expect, and the resourcing scripts we hand clients without asking whether they fit. For neurodivergent clients, neuroception is not a dysfunction to work around — it is a lens through which every phase of EMDR must be understood (Porges, 2011). Cultural responsiveness here is clinical precision. The adaptive information processing model assumes the system is oriented toward healing — but only when the conditions for processing are genuinely safe (Shapiro, 2018). For neurodivergent clients, safety is not a universal standard. It is a co-constructed one. The framework was never broken. Our ableist application of it sometimes is.”
- Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton & Company.
- Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.
*** Alyssa Desroches, LCSW, Connecticut, USA
*** Angelica Figueroa, LCSW, PMH-C, California, USA – “As an AuDHD Latina therapist, there are many factors to consider! The first is the therapist receiving additional training in adapting EMDR Therapy to neurodivergent folx. The next factor to consider is a robust Phase 1 that focuses on sensory needs, understanding of the power dynamics and oppressive dynamics of intersecting identities, cognitive processing style, varying needs, how our brains house memories, alexithymia, aphantasia, etc., and understanding the special interest/s (ie. eye sparkle) of the therapy participant to assist with a solid Phase 2. Conceptualizing the case needs to include addressing ableism and psychoeducation on the effects of oppressive systems to guide the therapy participant in unlearning and undoing generational messaging and trauma about the way we navigate the world.”
*** Melissa Galiotto, LPC, Pennsylvania, USA – “I think a culturally responsive EMDR case conceptualization for clients who identify as neurodivergent requires going beyond standard protocol and thoughtfully integrating neurodiversity, identity, and context into each phase of treatment. That might look like: during history taking, inquiring about systemic invalidation and feeling misunderstood or bullied; using concrete language; being aware of sensory and environmental considerations, such as adjusting the lighting or tone; having a safe word and monitoring for dissociative episodes; considering the cultural sensitivity and primary concerning symptoms; and psychoeducation on masking and window of tolerance and imagery.”
*** Dr. Corrie Goldberg, Illinois, USA
*** Cathy Hanville, LCSW, Pennsylvania, USA – Note for subtitles on the videos, play the video and click on the ‘CC’ icon in the upper right-hand corner for closed captioning.
*** Kionna Howell, LPC, Pennsylvania, USA
*** Summer Johnke, LCSW, New York, USA – Note for subtitles on the videos, play the video and click on the ‘CC’ icon in the upper right-hand corner for closed captioning.
*** Dr. Leona Kashersky, PsyD, California, USA “A culturally responsive EMDR case conceptualization for neurodivergent clients requires clinicians to move beyond deficit-based frameworks and recognize neurodivergence as a valid form of human diversity. Many neurodivergent individuals carry cumulative trauma from environments that demanded masking, compliance, or conformity rather than understanding. Experiences such as chronic sensory overwhelm, social exclusion, correction of natural communication styles, and repeated messages of “being too much or not enough” often form the core trauma networks that emerge in EMDR treatment. Effective conceptualization requires curiosity about how neurobiology, identity, and environment intersect. Clinicians must flexibly adapt pacing, preparation, and bilateral stimulation to match sensory needs, processing style, and cognitive load. Most importantly, therapists must listen carefully to how clients understand their own neurodivergence. When clinicians center dignity, reduce pressures to mask, and contextualize distress within relational and systemic environments, EMDR can support trauma resolution while strengthening identity, self-trust, and authenticity.”
*** Mishma Kumar-Jonson, AMHSW, MScPol, Victoria, Australia – “Culturally responsive EMDR case conceptualisation with neurodivergent participants begins with understanding neurodivergence as a valid way of being human and not something to be fixed. Many neurodivergent communities hold rich cultures, languages, and ways of relating that clinicians must approach with humility, respect, and care, recognising how identity and belonging shape distress and healing. An intersectional and minority stress lens is also essential, as systemic factors such as ableism, racism, queerphobia, and class shape both trauma exposure and access to ongoing safety. Adapting EMDR to a person’s neurodivergent characteristics, sensory needs, and processing styles is central to understanding how they navigate a neuro-normative world and what identity-affirming adaptive resolution looks like for them. Cultural responsiveness also involves recognising that trauma may be ongoing rather than historical, which shapes how targets are identified and processed. Centring lived expertise keeps the work collaborative, flexible, and grounded in the participant’s reality.
*** Dr. Tiffini Lanza, LCSW, Pennsylvania, USA – Note for subtitles on the videos, play the video and click on the ‘CC’ icon in the upper right-hand corner for closed captioning.
*** Dru Perren, LPCC-S, Ohio, USA
*** Laura Phillips, LCSW, Virigina, USA – “As a neurodivergent therapist working primarily with neurodivergent clients, I start with this: many clients enter therapy without a diagnosis. Don’t assume someone (at any age) is neurotypical simply because they haven’t been identified. Stay curious. Make interpretations cautiously about limited eye contact, friendship patterns, speech differences, or inconsistency in functioning. I have not met a neurodivergent client without trauma. Their trauma is often chronic and ongoing. Lives shaped by misunderstanding, rejection, masking, loneliness, or shame. Be aware that strengths can coexist with regulation challenges, and functioning varies day-to-day. Neurodivergent clients are often processing a backlog of information and may need more time to identify and integrate experiences. Creative expression is often beneficial rather than relying only on spoken communication. You might integrate sand tray, artwork, or movement into sessions. Presume competence. EMDR is an effective therapy for neurodivergent clients when their nervous system is affirmed and accommodated.”
*** Kristina Spurlock, LMHC, Washington, USA – “As a therapist specializing in working with neurodiverse adults, it is imperative to ask neurodivergent folks about their history with therapy, gauge what helps them feel safe, assess their expectations of the therapeutic relationship, and ask about any sensory issues or processing needs. It is then the therapist’s job to incorporate these preferences into the EMDR therapy experience. It needs to be a highly tailored and client-led approach. Therapists need to be proficient enough in EMDR to flexibly adjust the wording, assessment methods for distress, and/or bilateral stimulation to better help the client process without losing the mechanism that makes EMDR effective.”
*** Johanna Stacy, LMHC, Washington, USA
*** Linda Storm, RP, Ontario, Canada – “Culturally responsive EMDR case conceptualization with neurodivergent clients begins with a shift in clinical stance. Neurodivergence must be understood as a legitimate variation in human cognition rather than a deficit requiring correction. This perspective changes how clinicians interpret trauma history, sensory processing, emotional regulation, and relational safety within therapy (Dwyer, 2022; Pellicano & Den Houting, 2022). Effective case conceptualization, therefore, requires more than technical EMDR competence. Clinicians must understand how neurodivergent sensory and cognitive processing influences trauma encoding, pacing, and the client’s tolerance for stimulation during processing. Collaboration with clients to adapt procedures becomes essential because many neurodivergent adults have long histories of masking, invalidation, and diagnostic overshadowing within healthcare systems (Mazurek et al., 2023). Culturally responsive EMDR practice also requires attention to relational power dynamics. Neurodivergent clients frequently enter therapy after repeated experiences of misattunement or being misunderstood by authority figures. A neurodiversity-affirming stance helps prevent therapists from interpreting autistic coping strategies as resistance or dysregulation (Chapman & Botha, 2023). When EMDR is grounded in neurodiversity-affirming knowledge, skills, and attitudes, the therapy room becomes a place where neurological difference is respected rather than corrected. That shift in clinical stance creates the conditions necessary for trauma processing to be accessible and psychologically safe for neurodivergent clients.”
- Chapman, R., & Botha, M. (2023). Neurodivergence-informed therapy. Developmental Medicine & Child Neurology, 65(3), 218–220. https://doi.org/10.1111/dmcn.15384
- Dwyer, P. (2022). The neurodiversity approach(es): What are they and what do they mean for researchers? Human Development, 66(2), 73–92. https://doi.org/10.1159/000523723
- Mazurek, M. O., Sadikova, E., Cheak-Zamora, N., Hardin, A., Sohl, K., & Malow, B. A. (2023). Health care needs, experiences, and perspectives of autistic adults. Autism in Adulthood, 5(1), 51–62. https://doi.org/10.1089/aut.2021.0069
- Pellicano, E., & Den Houting, J. (2022). Annual research review: Shifting from ‘normal science’ to neurodiversity in autism science. Journal of Child Psychology and Psychiatry, 63(4), 381–396. https://doi.org/10.1111/jcpp.13534
*** Jaclyn Taylor, LMHC, New York, USA – Note for subtitles on the videos, play the video and click on the ‘CC’ icon in the upper right-hand corner for closed captioning.
*** Rachel Totten, LICSW, Vermont, USA
*** Angela VanDyke, LPC, Virginia, USA – “Culturally responsive EMDR for neurodivergent clients starts with one core truth: they want to feel seen. As both a clinician and someone with ADHD, I hear the same themes over and over—‘People don’t get me,’ ‘This world wasn’t built for me,’ ‘Therapy isn’t made for someone like me.’ Many have worked with multiple therapists and still felt unheard. Neurodivergent clients are often trying to find balance in a world that feels either too rigid or too chaotic. EMDR helps because it offers structure without pressure, flexibility without overwhelm. The rhythm, pacing, and predictability create safety, while the client stays in control of how fast or slow we move. When we honor sensory needs, communication styles, and processing differences, EMDR becomes a space where neurodivergent clients finally feel understood—and healing becomes possible
*** Fizzah Zaidi, LCPC, Illinois, USA – “A key factor in working with neurodivergent clients is recognizing that much of their lived experience is shaped by shame. Repeated experiences of not fitting in or facing rejection often lead to persistent negative self-talk and a fragile sense of belonging. This can be intensified when clients feel disconnected not only socially, but also within their own cultural context. It is important to explore how clients understand themselves within their culture and what belonging means to them, as well as their goals for EMDR.
Some cultures use shame or humbling as motivation, which can be especially harmful for individuals with ADHD, where rejection sensitivity plays a significant role. This may lead to people pleasing, rigidity, or perfectionism. Clinicians should understand the client’s cultural and family value systems and help reframe harmful internalized messages. The goal is to support clients in developing an internal sense of worth that is not defined by external or cultural expectations.”
*** Dr. Gianluca Zazzi, Clinical Psychologist, Pontremoli, Italy – “A culturally responsive EMDR case conceptualization for neurodivergent clients begins with recognizing neurodivergence not as pathology, but as a natural variation in neurodevelopment. This perspective helps clinicians move away from deficit-based assumptions and toward a strengths-informed framework. Clinically, therapists should consider differences in sensory processing, attentional patterns, communication styles, and emotional regulation. These factors may influence pacing, preparation phases, and the choice or modulation of bilateral stimulation. Flexibility within the EMDR protocol is often essential. It is also important to recognize that many neurodivergent clients carry cumulative relational trauma related to chronic misunderstanding, masking, social exclusion, or invalidation across developmental contexts such as school, family, and work environments. A collaborative and respectful therapeutic stance is therefore central. When clinicians validate neurodivergent identity and adapt EMDR treatment accordingly, therapy can facilitate not only trauma resolution but also greater self-understanding, safety, and psychological integration.”
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Additional Resources
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Date
April 17, 2026
Topics
ADHD/Autism/Neurodiversity
Practice & Methods
Case Conceptualization, Your EMDR Practice