A look at “Indicators of efficacious psychotherapy for patients with late diagnosis of autism spectrum disorder: how to create an effective neurodiversity-affirming therapeutic approach? A cognitive behavioural theoretical perspective” by Angelika Kleszczewska-Albińska (2026)
Imagine spending thirty years thinking you were a slightly wonky horse, only to discover you were a unicorn all along. Relief? Certainly. But also, perhaps, grief for the years spent trying to fit in with the herd, and anger that nobody noticed sooner. This short Polish paper asks what therapy should look like for adults who receive an autism diagnosis later in life.
What the author proposes
This is a theoretical paper rather than a study. The author draws on existing research and her own clinical experience as a CBT therapist.
She starts with the emotional landscape of a late diagnosis. It can bring relief and a new self-understanding, and over time can soften years of self-blame. It can also bring sadness, regret, confusion, anger and even a wobble in identity. Many late-diagnosed adults have spent decades masking (hiding or camouflaging their natural ways of being to fit in), which is linked with exhaustion, anxiety and depression.
She is also critical of traditional behavioural approaches that aim to make autistic people seem less autistic, noting they may increase masking and harm wellbeing.
Instead, she sets out a practical framework for neurodiversity-affirming therapy in four parts:
- Understand the whole person. Explore their history, strengths, motivation and any co-occurring difficulties, and share the formulation with the client so they can correct it.
- Adapt every session. Offer flexible scheduling, clear (including written) communication, visual cues, a sensory-friendly room, and use special interests as resources rather than distractions.
- Work with thoughts, feelings and identity. Make room for feelings about the diagnosis, build an identity that includes being autistic, find authentic alternatives to masking, set boundaries and develop self-compassion.
- Keep people safe. Pay attention to executive functioning, substance use, suicide risk and burnout.
The overall message is that therapy should empower and build resilience, treat the autistic person as the expert on their own life, and not try to “treat” neurodivergence itself.
A grain of glitter ✨
There’s an awful lot here that rings true, and the framework is a useful checklist for any therapist. But it’s worth knowing what this paper is and isn’t.
It’s one author’s informed opinion. None of the proposals has been tested, which the author openly acknowledges, describing it as a starting point for much-needed research.
The paper also wobbles a little in its own affirmation. It uses “high-functioning”, a label many autistic people find unhelpful because it can hide very real struggles. It talks about helping clients distinguish “typical and abnormal experiences”, and it still credits ABA with benefits even while criticising it. These tensions are common in a field that’s still finding its footing, but they show how hard it is to fully shake off older frameworks.
There’s no mention, either, of autistic people being involved in shaping the proposals. “Nothing about us without us” would be a natural next step.
Why this matters
If you’ve recently been diagnosed as an adult, you may be riding a whirlwind of feelings. All of them are valid, including the contradictory ones. This paper reflects what many late-diagnosed people say they need: a therapist who adapts to them, understands masking, welcomes their interests and doesn’t treat autism as the problem to be fixed.
Finding out you’re a unicorn mid-life is a lot. You deserve a stable that fits your hooves.