Adapting psychological therapies for autistic older adults: Developing guidance for the adaptation of governed psychological therapies for autistic older adults

Autistic people face unique challenges when accessing mental and physical health services, and there is an increasing need for psychological therapies to be accessible, autism-informed, and reasonably adjusted. An understanding of the need for reasonable adjustments has increased in recent years but what this means in practice can vary greatly among individuals (Harper et al., 2019) and little is known about the specific needs of older autistic adults (Mansour et al., 2025). This paper outlines a consultation aimed at mapping the issues psychologists encounter when adapting psychological therapies for autistic older adults. The consultation, involving experts by experience and clinicians, identified key themes, including the need for neuroaffirmative therapies, sensory adaptations, and flexible communication methods. There is no ‘one-size-fits-all’ therapy for autistic people and adaptations must account for individual needs, particularly when it comes to older adults with co-occurring conditions like dementia. Key recommendations included emphasising a neurodiversity-affirming approach, accommodating sensory needs, and ensuring staff are trained to work effectively with autistic people. The consultation also highlighted the importance of understanding the unique diagnostic experiences of older adults, many of whom may have lived without an autism diagnosis for most of their lives. A critical need for specialised staff training and systemic support was emphasised. In conclusion, the paper underscores the importance of developing autism-informed health care for older adults with psychologists playing a vital role in improving accessibility and support for autistic older adults in mental health services.