Neurodiversity-Affirming Therapy
with Rachel Santellano, LSW
I work with neurodivergent teens and adults who feel overwhelmed, misunderstood, or stuck despite trying therapy or skill-based supports before. Our work focuses on understanding how your brain functions, building practical strategies for daily life, and addressing the emotional impact of living in a neurotypical world. This service is a good fit for ADHD, late-identified neurodivergence, school stress, and identity adjustment.
Therapy for Neurodivergent Teens and Adults — Beyond Just Coping
Many of the neurodivergent teens and adults I work with have already tried therapy, coaching, or skill-based supports. They may understand that their brain works differently, yet still feel stuck, overwhelmed, or quietly frustrated that things aren’t getting easier. Often, the missing piece isn’t effort or insight — it’s that their neurodivergence has been treated in isolation, without addressing the emotional impact of living that way in a largely neurotypical world.
I provide neurodiversity-affirming therapy that looks at the whole picture. That includes how your brain works, how you’ve learned to adapt, and how years of misunderstanding, pressure, or self-blame may still be affecting you. My work is collaborative, practical, and grounded in respect — not about fixing you, but about helping you live more effectively and with less internal friction.
When Treating Neurodivergence Alone Isn’t Enough
Many neurodivergent people have spent years being told — directly or indirectly — that they are too much, not enough, or doing life “wrong.” Even well-intentioned support can focus so heavily on productivity, organization, or behavior that it misses the emotional cost of constantly adapting.
If you’ve worked with providers who focused only on tools or strategies and still felt misunderstood, that experience makes sense. Neurodivergence doesn’t exist in a vacuum. It shapes identity, relationships, self-esteem, and nervous system regulation. Therapy becomes more effective when we address both how your brain works and what it has been like to live that way over time.
Understanding the Neurodivergent Identity Cycle
In my work with neurodivergent teens and adults, I often see people move through a recognizable — but deeply personal — identity cycle. Therapy works best when we understand where you are in that process and what you actually need right now.
The first phase is about understanding how your neurodivergence shows up in your life. Before skills or strategies can help, we need clarity. That means looking closely at how your brain affects work or school, relationships, emotional regulation, motivation, energy, and self-talk. Many people arrive in therapy having spent years confused or ashamed without language for what they were experiencing. Naming these patterns often brings relief and reduces self-blame.
The second phase focuses on skill-building and adaptation. Once you understand how your brain functions, therapy becomes more practical. We work on systems, communication strategies, emotional regulation tools, and realistic expectations for living in a neurotypical world with a neurodivergent brain. This phase is about agency — learning how to work with your mind instead of constantly pushing against it.
The third phase is about integration and identity. This is where we address what it has meant to live as a neurodivergent person over time. For those identified later in life, this may include unpacking years of shame, anxiety, or experiences that felt invalidating or even traumatic. The goal isn’t to make neurodivergence your entire identity — or to erase it — but to build a sense of self where neurodiversity is one aspect of who you are, no more defining than your profession, appearance, or background. It’s something that requires awareness and adjustment, but not something that determines your worth.
People move through these phases at different speeds, and many revisit them as life transitions. Therapy isn’t about forcing a stage. It’s about meeting you where you are and helping you move forward with clarity and self-respect.
How I Work with Neurodivergent Clients
I work with neurodivergent teens, young adults, and adults using an approach that balances understanding with accountability. Sessions may include emotional processing, practical problem-solving, skill development, and honest conversations about what is and isn’t working.
For teens, this often includes supporting autonomy while also collaborating with parents when appropriate. For adults, especially those diagnosed later in life, therapy often includes reworking long-held narratives about failure, motivation, or capability. My goal is to help you build systems that support your life — not force yourself into systems that don’t fit.
What I Help With
- ADHD and executive functioning challenges
- Emotional regulation and overwhelm
- Shame, anxiety, and self-criticism
- Burnout and chronic stress
- Motivation, follow-through, and consistency
- Relationship and communication challenges
- Late diagnosis and identity adjustment
Is This Approach a Good Fit?
This work is a good fit for people who want more than surface-level strategies. If you’re open to understanding your patterns, experimenting with new ways of working, and addressing the emotional layers that often come with neurodivergence, therapy with me may be helpful.
You don’t need to have everything figured out. Therapy can be a place to build clarity, confidence, and a more compassionate relationship with yourself — while still working toward meaningful change.
Frequently Asked Questions About Neurodiversity-Affirming Therapy
Do you work with both teens and adults?
Yes. I work with neurodivergent teens, young adults, and adults, adapting therapy to developmental stage and individual needs.
Do you only focus on ADHD?
ADHD is common in my work, but I support a range of neurodivergent experiences. Therapy is tailored to how your brain works and how that affects your life.
Is this just skills-based coaching?
No. While we work on practical strategies, therapy also addresses emotional regulation, identity, and the impact of past experiences.
Do you involve parents when working with teens?
When appropriate, yes. Parent involvement is collaborative and focused on supporting growth, not controlling behavior.