![A softly lit stone alcove with plain walls, natural light and quiet, generous space](https://viacara.com/img/content/nd-sensory-feature-light.webp) # Sensory-Friendly Therapy Lighting, noise, space and breaks. What you can ask a professional to change, and why NICE says they should make those changes anyway. ## Sensory differences are not a *preference* They are part of the diagnostic picture. ICD-11 names lifelong hypersensitivity or hyposensitivity to sensory stimuli among the features of autism. They are not fussiness around the edges of it. That matters practically. A room that is quietly unbearable is not a small obstacle to therapy. It is the thing consuming the attention you came to use. Source: [Bach & Vestergaard 2023](https://viacara.com/support/neurodivergence/sensory-friendly-therapy/#ref-3) ## What NICE *recommends* These adjustments are set out in national clinical guidance, not in a leaflet. The national guidance tells services to consider the physical environment in which autistic adults are supported. It expects them to adapt: - Personal space, allowing at least an arm's length - Visual supports, such as labels giving clear cues about what happens where - Wall and furnishing colour, avoiding patterns and using low-arousal colours such as cream - Lighting, reducing fluorescent light, using blackout curtains or dark glasses, or increasing natural light - Noise, reducing external sound or supporting the use of earplugs or ear defenders Where the environment cannot be changed, the guidance says to vary the session instead. That includes taking regular breaks. Two further recommendations back this up. Professionals are expected to take account of your sensory sensitivities, and how they affect the work. Services are expected to deliver support in an environment suitable for those sensitivities. Source: [NICE CG142](https://viacara.com/support/neurodivergence/sensory-friendly-therapy/#ref-1) ![A lavender armchair in a plain corner beside a basket of ear defenders and a blanket, a green curtain drawn](https://viacara.com/img/content/nd-sensory-mid-light.webp) Small adjustments, rarely offered, easy to ask for ## *Important*, and rarely offered UK researchers asked autistic adults which adjustments mattered and whether they were available. Over five hundred people answered about mental health services. The adjustments were consistently rated as important. They were consistently reported as rarely available. A willingness to adapt mattered significantly more for mental health care than for physical health care. You may have asked for something like this before and not got it. That is common, and it is not an unreasonable request. Source: [Brice et al. 2021](https://viacara.com/support/neurodivergence/sensory-friendly-therapy/#ref-2) ## Things you can ask for You are allowed to ask before you book, not after. A professional who is going to be a good fit will answer these without friction. **About the room** - Can the overhead lights be off, or dimmed, with a lamp or daylight instead? - Is there a window, and can it be open or closed? - How much space is there between the chairs, and can I choose where I sit? - Is there background noise, music or a ticking clock? - Can I keep ear defenders or sunglasses on? - Can I bring something to hold, or something to do with my hands? **About the session** - Can you send me an agenda or a summary in writing? - Can we agree a signal for needing a break, so I do not have to explain in the moment? - Can we keep the same room and the same time each week? - Can you tell me in advance if anything is going to change? **About the practicalities** - Where exactly is the entrance, and what happens when I arrive? - Is there a waiting room, and can I wait outside instead? - Can I message rather than telephone? ## What *online* sessions solve Video sessions solve a large part of this without anyone having to adapt anything. You control the lighting. You control the noise. You are in a room you already know. There is no journey and no waiting room. You can keep a pet or a blanket with you. Some people find eye contact easier on video, and some find it harder. Either way, that is useful to know about yourself. It is not better for everyone. Try it if in-person sessions have cost you more than they gave. ## How to *say* it You do not need to explain or justify any of this. A short message is enough. > Before we start, a few things that help me. Overhead lighting makes sessions much harder. Keeping the same time each week makes them easier. > > If I need a short break I will say so. Is that workable for you? If the answer is anything other than a straightforward yes, you have learned something useful early. Thanks for your interest. We're not taking on new clients at the moment. ## Want a space that works for your *senses*? We ask what matters to you, then find professionals who fit. Leave your email and we'll let you know as soon as we're ready for you. This conversation helps us find you the right support. What you share helps us understand what you're looking for and find someone who fits. Your email keeps you updated on what's happening next and isn't shared with anyone we introduce you to. [Privacy policy](https://viacara.com/privacy) [Terms of service](https://viacara.com/terms) ## References 1. NICE (2021). *Autism spectrum disorder in adults: diagnosis and management (CG142), recommendations 1.1.8, 1.3.2 and 1.8.9*. [Link](https://www.nice.org.uk/guidance/cg142/chapter/Recommendations) 2. Brice, S., Rodgers, J., Ingham, B., Mason, D., Wilson, C., Freeston, M., Le Couteur, A. & Parr, J. R. (2021). *The importance and availability of adjustments to improve access for autistic adults who need mental and physical healthcare: findings from UK surveys*. BMJ Open. [doi:10.1136/bmjopen-2020-043336](https://doi.org/10.1136/bmjopen-2020-043336) 3. Bach, B. & Vestergaard, M. (2023). *Differential diagnosis of ICD-11 personality disorder and autism spectrum disorder in adolescents*. Children. [doi:10.3390/children10060992](https://doi.org/10.3390/children10060992) ## Related ### [Therapy When You Are Autistic](https://viacara.com/support/neurodivergence/autism/) Does talking therapy work for autistic adults? NHS data says yes, slightly less well than for others. Here is what good support looks like. ### [What to Expect from a First Consultation](https://viacara.com/guides/what-to-expect/) Everything you need to know about your first therapy or coaching session, from what to say to how to prepare. ### [Finding the Right Practitioner](https://viacara.com/guides/finding-a-practitioner/) A practical guide to finding a mental health practitioner who fits your needs, preferences and budget.