Thanks to the folks at Unpaywall (“an open database of 24,420,070 free scholarly articles”), I’ve finally been able to read an article from the Journal of Clinical Psychology called, “The impact of accommodating client preference in psychotherapy: A meta‐analysis”.

Among the paper’s findings is that “clients whose preferences were not matched or who were not given a choice of their treatment conditions were 1.79 times more likely to prematurely terminate than clients who were matched to their preference or who were given a choice of their conditions”. The authors also found “a small, but meaningful difference in outcomes in favor of clients who were given their preferred psychotherapy”.

In the end, they concluded “that accommodating client preferences exert a positive influence on therapy dropout and treatment outcomes” and recommend that such accommodations be identified and enacted.

My interest in this paper stems from something I’ve written about before: the need to adapt established methods of psychotherapy not only to “client preference” but to client neurotype.

In the case of something like autism, many of whose elements seem to work upon the brain in ways that are very similar to trauma (if not, in fact, ways that are actually trauma), this might mean having to address the fact that much of typical psychotherapy is conducted in small, claustrophobic settings, involving both socially-performative interaction and intense literal observation by the therapist.

These all are things that themselves, and in any other environment, can tend to create stress for the autistic brain. There’s no reason for that suddenly to be untrue in a psychotherapeutic setting. With the lack of escape, these stressors arguably could be even greater in that setting.

So, if it’s generally true that accommodating simple client preference can reduce early termination of treatment while increasing meaningful treatment outcomes, surely it’s specifically true that accommodating an autistic brain’s actual susceptibility to sensory and social trauma is at least as important.