April is Autism Acceptance Month, a time to move beyond awareness and toward genuine understanding and support for individuals with autism. While autism has long been discussed in mental health and educational spaces, acceptance means recognizing that people with autism don’t need to be “fixed.” Instead, they need environments, relationships, and support systems that honor their neurodivergence.
At The DBT Center of Utah, we believe that mental health treatment can be affirming and accessible to meet the needs of individuals with autism. While there is not a robust amount of research on DBT and it’s success in treating autism, the research that is available shows that Dialectical Behavior Therapy (DBT) can be effective in the long run, or over time, in helping individuals experiencing autism manage intense emotions, navigate relationships, and build distress tolerance.
How is Acceptance Different from Awareness?
Acceptance involves creating mental health spaces where individuals with autism feel seen, supported, and respected for who they are rather than feeling pressured to conform to neurotypical expectations.
For many neurodivergent individuals, accessing mental health care can present unique challenges. Often in history, therapy approaches emphasized masking autistic traits rather than supporting authentic self-expression. While the mental health field is evolving toward greater acceptance, elements of masking can persist in treatment. We believe that asking someone to conform to neurotypical expectations can be invalidating and hurt the therapeutic relationship.
How is DBT effective for Individuals with Autism?
DBT is an evidence-based therapy that provides structured, skills-based support for distress tolerance, interpersonal effectiveness, and emotion regulation, all of which can be helpful for autistic individuals. DBT was initially designed for the treatment of individuals experiencing chronic suicidality or emotion dysregulation. However, throughout years of research, DBT has been found to be effective for a wide variety of individuals. DBT addresses issues that individuals with autism may experience: intolerance for distress, interpersonal challenges, or difficulty regulating emotions. By focusing on acceptance and skill-building, DBT helps clients with autism:
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Understand and manage emotions without suppressing them
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Manage sensory or emotional distress with concrete coping skills
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Develop communication skills to enable self-advocacy
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Accept that they may have unique needs and use skills to meet their needs
While DBT was not originally designed for individuals with autism, nor does The DBT Center of Utah necessarily specialize in helping individuals with autism, DBT’s dialectical approach and practical skills can effectively address a wide variety of concerns.
What gets in the way of DBT working with individuals who experience Autism?
The key issue of why DBT may not work with someone who has autism or experiences neurodivergence is that DBT has a specific structured approach to addressing mental health concerns. DBT is skills, implementation, and assignment based. As such, DBT has a specific structure of meeting with a therapist once per week, attending a 2-hour skills group once per week, checking in on weekly assigned group skills practice worksheets and skills application activities, and completing a daily diary card for individual sessions. These assignments and skills application activities require some ability to maintain a personal schedule and accountability – whether with family, community, or partner help or on their own. Many people with autism struggle to complete skills practice assignments or show up to their therapeutic sessions weekly or maintain a consistent personal schedule. The result of these struggles is that the effects of DBT often take longer to show up in the life of a person experiencing autism.
To successfully apply DBT, the DBT therapist and neurodivergent individual will often try many different approaches or problem solving techniques to find what works best for the individual to set and reach their goals and understand how the DBT skills work in their life. Often therapists can get frustrated by not finding what works for their client quickly and the client may give up before a solution is found. If the therapist and individual are willing to accept that it will take time to find what works for them, and it may take longer than the 1.5 years DBT prescribes to understand and implement the DBT skills in their life, then there can be great success in improving the quality of the individual’s life, relationships, professional success, and ability to live an independent life.
