Seeing the Individual Not the Label

The following article was taken from our Autism-Informed Practice course.

In therapeutic practice, particularly with neurodivergent individuals, it is crucial to recognise the person beyond the diagnostic label. While diagnoses like autism spectrum disorder (ASD) offer insight into an individual’s experiences, they can also contribute to harmful stereotypes and misconceptions. This article explores the importance of seeing the individual, not the label, and offers therapeutic strategies for counsellors and psychotherapists to support neurodivergent clients effectively.

A nuanced understanding of neurodivergence emphasises the diversity within conditions like autism, challenging outdated ideas that categorise individuals by oversimplified labels such as “high” or “low” functioning. Counsellors must engage with clients as complex individuals, acknowledging their struggles and strengths.

Learning Outcomes

• Understand the impact of diagnostic labels and their role in shaping perceptions of neurodivergent individuals.
• Identify and challenge common myths and stereotypes surrounding autism.
• Appreciate the shift from terms like “high-functioning” and “low-functioning” and the move toward more dynamic, individualised understandings of autism.
• Implement identity-first language preferences in therapeutic practice based on the client’s needs.

Beyond Diagnostic Labels: Embracing Neurodivergence in Therapy

Understanding Neurodivergence and Diagnostic Labels

Diagnostic labels such as ASD help structure support systems and gain legal protections, but they can also lead to misconceptions that undermine a client’s individuality. Historically, labels like “high-functioning” or “low-functioning” emerged from early classifications of autism, including Hans Asperger’s work. However, these terms fail to capture the full complexity of neurodivergent experiences. Modern perspectives highlight that autism, for example, manifests in diverse ways, making labels overly reductive.

Research has shown that autism is not a rare condition but rather a spectrum that includes a wide range of behaviours, strengths, and challenges. Therapists should be wary of common myths, such as the idea that vaccines cause autism or that it only affects males. These misconceptions can influence public perception and therapeutic approaches, limiting the effectiveness of treatment and the support neurodivergent individuals receive​.

Debunking the Top Ten Myths About Autism

One of the most essential steps in rethinking neurodivergence is addressing common myths about autism, which perpetuate harmful stereotypes. Here are the Top Ten Myths about Autism debunked:

Moving Away from Functioning Labels

The concepts of “high” and “low” functioning have historically shaped the diagnosis and treatment of neurodivergent individuals, particularly those with autism. While initially developed to help clinicians understand different levels of need, these labels have been criticised for oversimplifying the autism spectrum. Clients labelled as “high-functioning” often find themselves denied necessary support, while those deemed “low-functioning” face stigma and reduced expectations in education, employment, and independence.

For practitioners, it’s vital to understand that these labels obscure the reality that all neurodivergent individuals may face significant social and emotional challenges, regardless of perceived intellectual or verbal strengths. The critical takeaway for therapists is to treat each client as unique rather than relying on generalised labels, which can create barriers to care and lead to unmet needs.

Benefits of a Medical-Model Diagnosis

While labels have their limitations, receiving an autism diagnosis can provide numerous benefits, mainly when framed within a medical model. Key benefits include:

• Understanding and self-awareness: Diagnosis helps individuals make sense of their experiences and behaviours.
• Access to support: Diagnosis often opens doors to tailored interventions, support services, and accommodations.
• Legal protections and accommodations: Individuals with a formal diagnosis can benefit from protections under laws like the Equality Act.
• Improved relationships: When family, friends, and coworkers understand a diagnosis, it can ease social interactions and encourage better relationships.
• Tailored strategies: Therapists can implement specific, practical strategies based on an accurate diagnosis.

It is important to note that the decision to pursue a diagnosis should be client-driven, respecting the individual’s journey and autonomy.

Language Preferences: Person-First vs. Identity-First

Language plays a significant role in the therapeutic relationship, mainly when working with neurodivergent clients. Traditionally, clinicians have been taught to use person-first language, such as “person with autism.” However, many in the autistic community now advocate for identity-first language, preferring terms like “autistic person” or even “autist.” This preference affirms that autism is an integral part of their identity rather than something separate or abnormal.

Therapists are encouraged to ask clients how they prefer to be addressed, recognising that preferences vary widely. A simple question—whether the client chooses “autistic person” or “person with autism”—can enhance rapport and demonstrate respect for the client’s identity.

Historical and Ethical Context: Hans Asperger and Diagnostic Labels

The legacy of Hans Asperger, after whom Asperger syndrome was named, has become ethically contentious. Research revealed Asperger’s collaboration with the Nazi regime, where his classification of “high-functioning” and “low-functioning” children contributed to eugenics programs. This history complicates the continued use of functioning labels.

Many neurodivergent individuals, especially those diagnosed with Asperger syndrome, may find these historical revelations upsetting, as their diagnosis forms an integral part of their identity. As professionals, it is essential to be sensitive to these concerns and the potential emotional impact on clients.

Ethical Considerations in Autism Classification

The history of autism classification presents additional challenges for therapists. The legacy of Hans Asperger and his collaboration with the Nazi regime complicate this, his work contributing to eugenics-based practices. While some continue to view Asperger’s as a figure who helped specific neurodivergent individuals, these revelations add complexity to the use of terms like “Asperger syndrome”.

This historical context emphasises sensitivity when discussing diagnoses with difficult or painful connotations. Practitioners should be mindful of historical factors affecting current diagnostic practices and how clients might feel about terms linked to harmful legacies.

Reflective Learning Tasks

As you apply these insights in your practice, consider these reflective learning tasks:

• Language Use: Do you use identity-first language (e.g. “autistic person”) or person-first language (e.g. “person with autism”)? Reflect on your approach and discuss it with colleagues or supervisors.
• Client Preferences: Consider any challenges you may face in asking clients how they prefer to be addressed. How could these challenges impact your therapeutic relationship?
• Documentation and Language: Consider how the client might perceive the language you use in client notes, especially under the Data Protection Act, which gives them the right to access these notes. Would terms like “challenging” or “awkward” be appropriate?

These reflections will help create a more inclusive and respectful therapeutic environment for your neurodivergent clients.

Final Remarks

As a counsellor or psychotherapist, moving beyond diagnostic labels and truly seeing the individual before you is essential. Recognising the diversity and complexity of neurodivergence will enable you to provide more effective support. By challenging common stereotypes, debunking myths about autism, and adopting a client-centred approach, you can offer more empathetic and tailored care.

The shift away from terms like “high-functioning” and “low-functioning” reflects a deeper understanding of the autism spectrum as varied and dynamic. This change enhances your therapeutic interventions and addresses the ethical concerns of historical figures like Hans Asperger. Being mindful of this history will help you approach each client with sensitivity.

By embracing updated diagnostic frameworks and respecting your clients’ language preferences, you’ll help them feel seen and valued. Understanding the benefits of a formal diagnosis—such as access to support, legal protections, and greater self-awareness—can guide you in supporting clients without pushing them toward a label they may not need or want.

By meeting the learning outcomes from this article, you’ll be better equipped to offer meaningful, informed support. You’ll be able to recognise both the unique challenges and the potential for growth in every neurodivergent client, helping them thrive in ways that are right for them.

References and Further Reading

Baron-Cohen, S. (2015). Leo Kanner, Hans Asperger, and the discovery of autism. The Lancet. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00337-2/fulltext

Gillette, H. (2023). Understanding Why the Term ‘Asperger’s’ Is No Longer Used. Healthline. Available from: https://www.healthline.com/health/autism/why-is-the-term-aspergers-no-longer-used#summary

McCarthy, J. (2018). Rain Man at 30: Damaging Stereotype or ‘the Best Thing That Happened to Autism’? The Guardian. Available from: https://www.theguardian.com/film/2018/dec/13/rain-man-at-30-autism-hoffman-cruise-levinson

National Autistic Society. (2023). Asperger Syndrome (‘Asperger’s’). National Autistic Society. Available from: https://www.autism.org.uk/advice-and-guidance/what-is-autism/the-history-of-autism/asperger-syndrome

One Central Health. (2020). 10 Myths about Autism Spectrum Disorder. Available from: https://www.onecentralhealth.com.au/autism/10-myths-about-autism/

Sher, D. A. (2020). The Aftermath of the Hans Asperger Exposé. The British Psychological Society. Available from: https://www.bps.org.uk/psychologist/aftermath-hans-asperger-expose

Turda, M. (2023). Confronting Eugenics. The British Psychological Society. Available from: https://www.bps.org.uk/psychologist/confronting-eugenics