ADHD informed? ADHD-affirming? What do these terms mean?

When you are looking for a therapist and you have identified that you would like to work with someone who can help with your ADHD, you might find yourself lost in a sea of terminology that seems to indicate competence. Right now, if you are in Ontario, the field of psychotherapy is regulated. That means you need to have been approved to work as a psychotherapist by a regulatory body. I belong to the College of Registered Psychotherapists of Ontario. But social workers, nurses, and others are allowed to practice the controlled act of psychotherapy as well. Each governing body has their own practice standards, ethics, and governance. That means when you see someone call themselves neurodiversity-informed for example, it doesn't actually mean that much objectively. So what might these terms signal to clients? And, what duty do we have has a profession to create some consensus

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Informed v. affirming

When someone uses the word 'informed' to describe their practice it generally indicates that they have knowledge of, and hopefully extra continuing education in that area. A lot of the time there are certification courses that can be taken, but our governing body (CRPO) doesn't actually regulate any of those. So it is really up to the discretion of the practitioner how they describe themselves. There are different modalities, like Internal Family Systems, or EMDR that have their own 'institutes' that provide training and certification. But it is important for clients to understand that having taken a course does not mean competence to practice. It is okay to ask a potential therapist what their training and experience is like. Now, the other important point I want to make is that being informed about something doesn't actually make you affirming. You can know a lot about something and still practice in ways that are harmful or that are unhelpful.

When someone uses the word affirming, what I have come to understand through linguistical context in therapist social spaces, is that they mean they are non-judgmental. I think this is a great starting point. But if we are truly practicing in a client-centered way it generally means that we would be non-judgmental of all clients. So if a therapist is singling out a particular population, what does that even mean? I want to encourage people who are looking for a therapist to ask them what makes their approach affirming.

Some Thoughts

As with all therapists who are starting out, I have had my own evolution in practice, the trainings I have, and how I have described myself. I have also been searching for a framework or guide for the way I approach my client groups. And I have a lot of compassion for the early therapist in me who wasn't as specific and wasn't as confident. As I grow into this role and embody this work more fully, I have come to some guideposts for what I consider an affirming approach with my ADHDers. A lot of my own assertions were echoed in the work "An Experience Sensitive Approach to Care with and for Autistic Children and Young People in Clinical Services" by McGreevy et. al (2026).

In general this article asks us to use a client centered approach and trust the client as the expert of their own experiences. Carl Rogers would be smiling. Anyone practicing with a Rogerian style knows to let the client reveal themselves and to work collaboratively with them, but I think sometimes we can let the idea of expertise or ego get in the way of that fundamental. I am going to review two of the sections from the McGreevy article in this blog.

Insiderness/ Objectification - In this section McGreevy et al. (2026) describe the phenomenon of inner-subjectivity and how identity is formed and understood and how even well-meaning practitioners might project characteristics and deny the inner subjectivity of the child. They explain that a child's understanding of self is also made up of their assumptions of what others think of them (McGreevy et al. 2026). I have seen it countless times in therapy, a client thinking they are lazy, unintelligent, bad at planning, etc. When really they may be the most dynamic, motivated, and detail oriented people I have met. They have accepted stories about themselves echoed over and over by teachers, parents, siblings, partners and now have very often created a mean internal dialogue that says the same thing. Social media has given way to some new narratives about ADHD, a superpower, a dysregulated nervous system. Clients and therapists alike are shifting from one external narrative to another. We have to challenge our need for ease here and actually learn to meet the client and help them to develop their own compassionate voice. All traits are neutral, we don't need to find excuses for them. McGreevy et al. (2026) also suggest getting the family involved to help foster a general sense of understanding and compassion within the family system. I could not agree more. I believe in order for an ADHDer to build secure attachments they need to be met with this compassion and understanding. We need to do more to support caregivers and partners to enable them to do this. Compassionate interventions are not new to therapy, I generally always incorporate them in my work with clients, drawing on Kristin Neff, or deconstructionist frameworks depending on the client. Depending on the modality a therapist practices, it can look different, or be called something different. But fostering self-compassion should be included in any work with an ADHDer if they are approaching it from an ADHD-informed or ADHD-affirming place.

Togetherness/ Isolation - McGreevy et. al (2026) also discuss the need for autistics to bond with those of like neurotype to protect against feelings of alienation they might feel in other spaces. In like-neurotype groups the children could bond over shared experiences, challenges, and ways of being without the need to conform (McGreevy et al. 2026). This concept is very similar to an intervention for acculturation where it is a known benefit, and protective factor for immigrants to socialize with their cultural group. In Sandra Collins' book Culturally Responsive and Socially Just Counselling she says that socializing within their cultural group can help immigrants with acculturative stress by helping them feel connected with people who experience the same challenges as them, where they can engage in cultural practices, and where they can code-switch into a more natural state (in other words not mask or alter certain parts of themselves). It seems it would naturally follow that ADHDers need the same kind of space where they can allow their traits to exist in a non-judgmental space with peers who may be experiencing similar things and where they can exist freely without the burden to cover up-or mask their personality. It would also follow that a therapy space that also allows them to be uniquely themselves would also be the most helpful. But how do therapists actually create that space? A lot of people might think they are practicing in affirming ways if they provide things like fidgets. But I want to offer that beyond those external things, what is most important is presence. And our presence in session is something we always need aware of and that we need to analyze critically.

In future blogs I will explore the other points made by McGreevy et al. (2026). For now, I ask clinicians and clients alike does your therapeutic space feel affirming? Therapists, how do you make sure you allow for your client's inner subjectivity? How do you create a space free from judgement and where you do not further alienate your client? Are you using appropriate terminology to describe your work? Do you continue to pursue training? Do you have a space for generative conversations that will allow you to deepen your therapeutic practice and engage with material that is new and ever-evolving?

References

Collins, S. (2022). Culturally responsive and socially just counselling: Teaching and earning guide.

McGreevy, E., Quinn, A., Law, R., Botha, M., Evans, M., Rose, K., Moyse, R., Boyens, T., Matejko, M., & Pavlopoulou, G. (2026). An experience sensitive approach to care with and for autistic children and young people in Clinical Services. Journal of Humanistic Psychology, 66(1), 107–133.