Made Simple:
EMDR with Neurodivergent Clients

In one sentence: Therapists can support neurodivergent clients in EMDR through affirming adaptations that respect sensory needs, communication styles, special interests, and processing rhythms.

In one paragraph: EMDR therapists already tailor their practice to their clients’ needs, but what if therapists have trouble understanding the unique needs of neurodivergent clients? Drawing on my experience as an autistic woman, EMDR Consultant, and doctoral researcher, I share seven considerations to help therapists support neurodivergent clients.

Tailoring EMDR Therapy for Neurodivergent Clients

We know that neurodivergent individuals are at an increased risk of experiencing trauma. That means that there is a clear need for EMDR-trained therapists to support this population.

Let me first emphasize that this will not require learning a new modality. After all, we already adapt therapy to the needs of our clients every day.

Working with neurodivergent clients does not require reinventing the protocol. I use the standard EMDR protocol every day and have witnessed meaningful progress and powerful moments of healing.

Yet many therapists are unsure about how to adapt EMDR to the needs of neurodivergent clients. To this end, I will share a few considerations grounded in my clinical and personal experience as a neurodivergent woman and EMDR Consultant completing doctoral research on therapeutic treatment methods for autistic women.

But first, a note on terminology. In this article, I use “neurodivergent” primarily in reference to attention deficit hyperactivity disorder (ADHD) and autism spectrum condition (ASC). I use “autism spectrum condition” instead of “disorder” to reflect both my own language preference and a neurodiversity-affirming approach, seeing autism as a different neurotype, not as a disorder in need of fixing.

7 Considerations for Neurodivergent Clients in EMDR Therapy

1. Pre-Processing Preparation

Before processing even begins, consider how the therapeutic environment might affect regulation and the ability to stay regulated. Lighting, sound, and session length can all make a meaningful difference, even in virtual sessions.

While discussions about session length may unfold over time as clients become more familiar with the therapeutic process, conversations about the physical environment, such as whether the lighting feels too dim or too bright or whether the office and white noise machine sounds are distracting, can happen right away.

I also offer options for these elements, such as changing the sound on the white noise machine or turning it off completely, using a lamp instead of overhead lighting, or opening the curtains to allow natural light into the therapy space.

2. Sensory Needs

EMDR is inherently sensory. Whether we are resourcing, reprocessing, or using an interweave, it is important to stay aware of how sensory input may affect clients. Neurodivergent clients may also process sensory and emotional information differently, which can influence how they experience EMDR and how insight develops.

Approaching this with flexibility and curiosity can lead to a more effective and affirming process by making space for clients to express emotions, insights, and experiences in ways that feel natural and comfortable to them.

If clients are searching for words between sets, invite them to share their experience in their own way. This might include somatic descriptions, sensations, or images that are not tied to specific emotions, and that is still valuable clinical information that can be incorporated into your work together.

3. Processing Time

Processing time varies for everyone and can be influenced by many factors, including stress, time of day, or sensory load. Some neurodivergent clients may process quickly, while others benefit from more time during or between sessions.

Recent research indicates some Autistic individuals take in more information at one time than do their neurotypical peers. To avoid sensory overload, I am always mindful of the additional time some clients may need between sets to process information and share what was noticed. This does not mean processing is slower. There is simply more information to work through.

Some neurodivergent clients may even arrive at their next session having developed deeper insight into the previous session’s EMDR experience. When that happens, take some time at the start of the session to talk through what was noticed and what it means to the client.

4. Bilateral Stimulation

Much like neurotypical individuals, neurodivergent clients are all different and unique. Because of this, spending some time trying out different methods of BLS to see which ones feel right for your client may be helpful, and I suggest having a second option ready in case a change is needed.

It is also important to note that reprocessing speed and the number of sets really depend on the individual. Of course, we use slower BLS for resourcing and faster BLS for reprocessing, but even terms like "fast" and "slow" are subjective and need to be discussed with each client.

What I find works best is to first select the type of BLS, and then try out different speeds to see what feels most comfortable, while still following the guideline of using a faster speed for reprocessing and a slower speed for resourcing.

5. Communication Style

Much of EMDR involves abstract language like “go with that” or concepts like the “window of tolerance,” which can be confusing for some neurodivergent clients. Because of this, I focus on speaking in more concrete terms, while still keeping the tone warm and supportive.

I find it helpful to first explain the overall process and then walk through each phase step by step when we get there. I explain what happens at the beginning of each phase, what might be experienced during that phase, and even what to expect during reprocessing or installation.

I also take time to explain common phrases like "go with that" or "notice that" in very clear, concrete terms, and when I use these phrases in session, I make sure to specify exactly what I want them to go with or notice, so there is no confusion.

As a side note, I have found that using visuals can be very helpful. Often, I introduce a new concept at the end of a session and show visuals at that time, giving clients an entire week to take in the new information before we begin using it in our work together.

6. Special Interests

A special interest is an intense area of focus that is common among neurodivergent individuals. You may have already noticed that working with neurodivergent clients is one of mine.

Incorporating a neurodivergent client’s special interests into EMDR sessions can support engagement, build rapport, and enhance regulation throughout the therapeutic process. Special interests can even be used in resourcing to create a more affirming and effective therapeutic experience.

7. Emotional Awareness and Interoception

Some neurodivergent clients may experience differences in interoception, which is the ability to recognize and interpret internal body signals like hunger, tiredness, or emotional cues. These differences can make it harder to identify, describe, or experience emotions in the moment. As a result, emotional awareness may emerge over time or be communicated through alternative language or somatic descriptions rather than traditional emotion words.

If the client’s goal is to develop feelings identification skills, then I support that pursuit. If not, I use their words and descriptions throughout the session, allowing them to feel comfortable and understood in the moment.

Final Thoughts

Working with neurodivergent clients does not require reinventing the protocol. I use the standard EMDR protocol every day and have witnessed meaningful progress and powerful moments of healing. When EMDR is thoughtfully adapted, neurodivergent clients often feel validated, understood, and empowered, all essential parts of the therapeutic process.

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If you’re interested in a consultation, workshop, or speaking engagement with the author, Lisa Saviñon, contact lisa@thriveandfeelpsychology.com or visit her website.