ADHD and autism therapy for adults

If this sounds familiar

You’ve spent years working twice as hard to look like you’re keeping up. You can hyperfocus for hours on the right thing and can’t start the wrong one to save your life. You mask so well that people don’t believe you’re struggling, which somehow makes it lonelier. Maybe you were told you were smart but lazy, too sensitive, or not living up to your potential. Maybe you only recently started to wonder if your brain just works differently.

Maybe you got through school on raw ability and hit a wall the first time nobody was setting your deadlines. Maybe the wall came later, when the job got bigger or the kids arrived or the thing that used to hold it together stopped working. Plenty of people find me in their thirties, forties, or fifties, after a diagnosis in the family made them look sideways at their own history.

If any of that lands, you’re in the right place. A lot of the adults I work with are neurodivergent, and I come to this from lived experience as much as training. You won’t have to explain what rejection sensitivity is, or why a “simple” task can feel impossible, before we can get to work.

What we might work on

• Making sense of a late ADHD or autism discovery, and grieving the years before you knew
• Burnout, and rebuilding after running on empty for too long
• Unmasking safely, and figuring out who you are underneath it
• Rejection sensitivity, shame, and the harsh inner critic
• Executive function and systems that actually fit your brain, instead of ones built for someone else’s
• Relationships, communication, and setting boundaries without the guilt spiral
• Rebuilding self-trust after years of being told you were the problem
• Sensory load, and building a week that does not leave you flattened by Thursday
• Deciding what to tell an employer, a partner, or your family, and what you owe nobody

Autistic adults and late discovery

Autism in adults gets missed constantly, especially in people who learned early to perform their way through. If you spent your life studying other people so you could pass, that is not a personality. It is work, and it is exhausting, and most people around you have no idea you are doing it.

Late-discovered autistic adults often arrive carrying two things at once. There is relief, because the story finally fits. And there is grief, because the story could have fit twenty years ago and nobody told you. Both belong in the room. We do not rush either one.

I do not require a formal diagnosis for any of this. Self-identification is enough to start.

If you are wondering about assessment

A lot of people come in unsure whether they want testing, or whether they can afford it, or whether it would change anything. That is a fair question and the answer is not always yes.

I do not do ADHD or autism assessment myself. What I can do is help you think it through: what a diagnosis would actually get you, whether you need one for accommodations or medication, and what it costs in Boulder County right now. I wrote up the local landscape on a separate page so you can look before you decide.

Adult ADHD assessment in Boulder County: routes, costs, and where to go

You can also just start therapy. Plenty of people do, and sort out the assessment question later or never.

Getting to the doctor when that is the hard part

Booking means a phone call. Describing what is wrong means finding words for something you may not have clearly registered, in ten minutes, for someone you have just met. If you have been talked over before, or told it was anxiety, you walk in already braced.

So it waits. Then it waits longer.

Interoception, the sense of what is going on inside your own body, runs differently for a lot of neurodivergent people. Hunger, pain, tiredness and illness can stay quiet until they are loud. None of that is carelessness.

Regular care is where most things get caught early, and the research points the same way. A 2026 study of autistic adults on Medicaid found that the health problems affecting that group most were ordinary, treatable ones, and its authors described much of the harm as preventable with better access to routine care.

Li G, DiGuiseppi CG, Blanchard A, Russell MT, Ing C. Autism Spectrum Disorder and Life Expectancy Among Medicaid Beneficiaries. JAMA Netw Open. 2026;9(9):e2633251.

Gut symptoms are worth raising specifically. A 2026 review pooling 23 studies and more than 1.9 million people found they are substantially more common in people with ADHD, constipation and irritable bowel syndrome among them. The researchers were clear that this is an association and not evidence that ADHD causes it, and they list several candidate explanations, including irregular eating, medication side effects, and differences in gut bacteria. Their own suggestion was that clinicians should ask about it. Most never do. If your stomach has been a low-level problem for years, put it on the table.

Blake S, Shantikumar S, et al. The Association Between Attention-Deficit Hyperactivity Disorder and Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis. J Atten Disord. 2026.

Some of what we can work on:

• Writing down what you want to say before you go
• Deciding what to disclose and what is none of their business
• Noting a symptom when you notice it, instead of reconstructing it in the room
• Getting the appointment booked at all
• What to do after an appointment goes badly, so it is not the last one

I do not manage anyone's medical care. Getting through the door is ordinary therapy work, and a reasonable thing to bring in.

How I work with neurodivergent adults

Affirming, first and foremost. The goal isn’t to make you more neurotypical, or to fix you. It’s to help you understand how you’re wired and build a life that works with it. I keep the pace and the format flexible, we can meet online, in my Boulder office, or on a walk. I say things plainly, and I’m happy to adjust how we work if the usual therapy setup doesn’t fit you.

Underneath that, I lean on acceptance and commitment therapy (ACT) and plain conversation, with the occasional bit of story or metaphor when it helps. It’s practical, and it’s collaborative. You’re the expert on your own experience.

My style is practical and coaching-informed. Alongside ACT, I use structured executive-function support, CBT and DBT-informed skills, solution-focused work, motivational interviewing, and mindfulness, adapting the work to each person’s communication, sensory, and learning needs. When relevant, I also draw on CBT-I for insomnia and pain reprocessing approaches for chronic primary pain.

The practical stuff, because it matters

Standard therapy is built around a particular kind of body sitting still in a particular kind of room. That does not work for everyone, and I would rather adjust the room than ask you to mask through your own therapy.

• Camera off is fine. So is looking away, pacing, or knitting while we talk.
• Walking sessions around Lafayette when the weather cooperates, if sitting across from someone is the hard part.
• I will say the thing plainly instead of hinting at it and waiting for you to read my face.
• If you go quiet because you are processing, I will wait rather than filling it.
• If you forget the appointment, we sort it out. It is not evidence about your character.
• Fidgeting, stimming, food, sunglasses, whatever you need. None of it is a clinical event.

Tell me what helps and what does not. If you do not know yet, we will find out together.

What the first few sessions look like

The first one is a free fifteen-minute consultation. You tell me roughly what is going on, I tell you how I work, and we both get a read on whether this is a fit. No pressure and no obligation.

After that, the first two or three sessions are mostly me getting the shape of your life: what is happening now, what has already been tried, what you actually want to be different. I am not running an intake script at you. If something urgent is in the room, we deal with that first.

By somewhere around session four, most people have a sense of what we are working on and whether it is helping. If it is not, I would rather hear that and either change course or help you find someone who fits better.

This isn’t about making you neurotypical

Being neurodivergent isn’t a defect to be corrected. A lot of what wears people down isn’t the ADHD or autism itself, it’s a lifetime of being asked to hide it. We’ll take that seriously. The work is about self-understanding, self-compassion, and the tools to make daily life feel less like a fight, not about becoming someone you’re not.