EMDR Therapy with Neurodivergent Clients: Three Things to Consider

By CompassionWorks

As we honor Autism Awareness Day and celebrate Neurodiversity throughout April, it’s a meaningful moment to reflect on how we as EMDR therapists can deepen our understanding of neurodivergent clients—and more importantly, meet their needs in therapy with greater sensitivity and skill.

Whether you’re working with clients with autism, ADHD, or heightened sensory experiences, one thing is clear: a one-size-fits-all model of therapy won’t work.

Here are three key considerations when using EMDR with neurodivergent clients.

Adapt the Preparation Phase Thoughtfully

Many neurodivergent clients benefit from an extended preparation phase. Emotional awareness, sensory regulation, and trust-building may take longer—and that’s okay.

Consider:

• Using visuals, metaphors, or social stories to introduce emotional language and body awareness.
• Breaking sessions into predictable routines with clear beginnings and endings.
• Collaborating with caregivers (especially for child clients) to co-create safety.

Assessing readiness may mean redefining how we view connection and emotional insight.

Modify BLS and Processing to Prevent Overarousal

Neurodivergent clients—especially individuals with autism or ADHD—may become easily dysregulated by standard bilateral stimulation.

To support regulation:

• Use shorter BLS sets with more frequent check-ins.
• Allow clients to pause, stop, or modify the pace (e.g., with remote-control language like “rewind” or “pause”).
• Try alternative BLS forms (tapping, sound, or visual tracking) based on sensory preferences.

Also, remember: Some clients may need more targets or repeated exposure to build generalization.

Honor Communication & Cognitive Differences

Not all clients can easily rate their distress, verbalize cognitions, or imagine future scenarios.

Helpful adaptations:

• Skip or adjust SUD/VoC ratings when they become stuck points.
• Use objects, drawings, or role-play to access imaginative or future template work.
• Offer body-based prompts instead of verbal ones (e.g., “Where do you feel that in your body?”).
• Avoid starting dialogue during cognitive interweaves—stick to processing unless necessary.

Neurodivergent clients aren’t resistant—they’re processing differently.

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Want to Go Deeper?

If you’re ready to explore these strategies in more detail, join our upcoming live online workshop:

• Using EMDR Therapy with Neurodivergent Clients
• April 19, 2025 | Live Online
• Earn EMDRIA CE credits
• $149 early bird (through April 12)

Led by Dr. Amanda Martin and Dr. José Carbajal, this workshop dives into real-case adaptations, therapist barriers, and video demonstrations of modified EMDR work.

️ SAVE YOUR SPOT!

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Final Thought

As therapists, we don’t need to “fix” neurodivergent clients—we need to support them in healing trauma, building resilience, and reclaiming emotional safety on their terms. And EMDR can be a powerful resource when delivered through a lens of flexibility, inclusion, and trust.