Beyond the screen: Why online counselling can be a neurodiversity-affirming choice

With thanks to our member, Jodie Thomas, for this blog.

For a long time, online counselling was framed as a compromise. A second-best option when in-person work wasn’t possible. A failsafe in times of pandemic and illness. But for many neurodivergent clients, working online isn’t a fallback at all; it’s the preferred, safer, and more accessible way to engage in therapy.

As counsellors, we may worry about what gets lost when we move online. The room. The shared physical presence. The creative materials neatly laid out on the table. And yet, when we really listen to neurodiverse clients, a different picture often emerges: one where online work reduces barriers, increases autonomy, and allows therapy to meet the client where they actually are.

For many neurodivergent people, the biggest challenge isn’t the therapy itself- it’s getting there.

Overloaded buses and trains, unfamiliar environments, sensory overload, navigating social expectations in waiting rooms or simply leaving the safety of home can all be significant stressors. By the time a client arrives for an in-person session, they may already be dysregulated, fatigued, or masking heavily. Many neurodiverse clients also arrive very early (to avoid the fear of being late) or very late (due to time blindness). Another stress, easier to avoid with online work. 

Online therapy removes many of these hurdles. No buses. No fluorescent lights. No forced small talk at reception. Just logging on from a familiar, controlled space. This can mean clients arrive at sessions with more capacity for emotional work, and this is what really matters.

Eye contact is often discussed in training as a marker of engagement, but for many neurodivergent clients, it can be uncomfortable, overwhelming, or actively distressing. Video platforms allow for a much gentler relationship with eye contact. Clients can look at the screen, away from it, or turn their camera off entirely, without the same social weight that would exist in a physical room.

This flexibility gives clients more control over how they are seen and how they show up. It also reduces the pressure to perform neurotypical engagement, allowing energy to be spent on the therapeutic process rather than on masking.

A common concern is that online work limits creativity. As a creative therapist, this was a concern of mine, but in practice, I’ve found the opposite.

Creativity is still very much accessible online; it just takes a different form. Clients may draw in their own notebooks, use digital art tools, bring objects from their space, share music, images, memes, or even use the chat function when words feel hard. Some clients feel more able to engage creatively when they are in their own environment, surrounded by familiar objects and sensory comforts. Yes, it can take a little more planning or mid-therapy dashes to retrieve materials, but it still has a powerful therapeutic benefit. 

For those who want to work in a neuro-affirmative way, I encourage you to explore the benefits of offering online alternatives. Whilst neurodiversity is a spectrum and needs are very individualised, having the option ensures you are not excluding a whole client group who are not engaging in face-to-face therapy. 

I speak from my own personal therapy journey when I say online counselling can be a life-changing experience.