The Modern Therapist's Survival Guide with Curt Widhalm and Katie Vernoy

What Therapists Need to Know About Neurodivergent Clients and Families: An Interview with David Smith, LCSW

Curt and Katie talk with David Smith about neurodiversity-affirming therapy, autism, ADHD, PDA, family systems, and burnout for neurodivergent therapists. David shares both clinical expertise and lived experience as an autistic therapist, offering practical guidance for working more effectively with neurodivergent clients and the families around them.

About Our Guest: K. David Smith, LCSW

K. David Smith, LCSW, is an autistic therapist who provides neurodiversity-affirming, trauma-informed therapy online in 5 states (Oregon, California, Idaho, Vermont, and Florida). He also provides clinical supervision for therapists working toward LCSW or LPC licensure in Oregon, particularly those who are neurodivergent themselves or who are passionate about supporting neurodivergent clients. In addition, he provides consultation, training, and workshops for medical practices and professionals, other therapists, employers, and school districts about ways to become more neurodiversity-affirming and supportive of neurodivergent people.

Key Takeaways

- Therapists often miss neurodivergence entirely and may treat anxiety, depression, or “thought errors” without considering whether a client is struggling in environments that were not built for their nervous system.

- Neurotypical therapists can work well with neurodivergent clients when they lead with curiosity, attunement, flexibility, and a willingness to adapt how therapy is structured.

- PDA can look like defiance, but David reframes it as an anxiety- and threat-based response to demands. Traditional rewards and consequences may backfire.

- Neurodivergence in families is often intergenerational, with different neurotypes shaping attachment, communication, expectations, and family roles.

- Neurodivergent therapists need more than generic self-care. Sustainable practice may require reducing demands, grounding, rest, and nervous-system-informed regulation.

Full show notes and transcript will be available at mtsgpodcast.com.

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Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
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How Clients Experience Therapy: From First Inquiry to the Waiting Room: An Interview with Michael Ashford

Curt and Katie talk with Michael Ashford about how clients experience therapy before the clinical work even begins. They explore what therapists can learn from customer service, communication, and marketing to create a smoother, more supportive experience from first inquiry through intake, onboarding, waiting room logistics, and practice policies. This conversation looks at how clarity, thoughtful systems, and strong boundaries can improve client experience while also supporting therapists.

About the Guest
Michael Ashford is the Senior Director of Marketing at Sign In Solutions and has spent the past decade building and leading marketing teams at companies large and small. Michael is a former award-winning journalist, a two-time TEDx speaker, and holds a Master’s degree in Communication from Kansas State University. Michael’s approach to marketing focuses on scaling companies through the power of effective communication, storytelling, and humanizing brands.

Key Takeaways

Client experience starts before the first session

Clear expectations reduce client stress and confusion

Website messaging, intake, and onboarding should feel seamless

Waiting room and check-in systems matter more than many therapists realize

Good customer service includes strong boundaries around time, fees, and cancellations

Full show notes and transcript: mtsgpodcast.com

Join the Modern Therapist Community:
Podcast Homepage: https://mtsgpodcast.com/
Linktree: https://linktr.ee/therapyreimagined
Facebook Group: https://www.facebook.com/groups/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann: https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano: https://groomsymusic.com/

Adapting EMDR for Neurodivergent Clients: Parts Work, Attunement, and Affirming Trauma Therapy, An Interview with Cathy Hanville and Christine MacInnis

Curt and Katie talk with Cathy Hanville and Christine MacInnis about how to adapt EMDR for autistic and ADHD clients with more flexibility, safety, and affirming care. They explore why standard protocols can miss important client needs, how parts work can support trauma treatment, and what therapists should consider when working with neurodivergent clients whose trauma is tied to masking, chronic correction, social rejection, and being misunderstood.

In this episode, we talk about:


Why EMDR often needs adaptation across all eight phases


How parts work can support neurodivergent clients in trauma treatment


The impact of masking, correction, and misunderstanding as trauma


Sensory, communication, and processing differences therapists need to consider


Moving away from compliance-based care toward attunement and collaboration

About the guests

Christine MacInnis, MSed, MS, LMFT owns Transcends Family Therapy in Torrance, California, specializing in neurodiversity and LGBTQIA+ affirming, trauma-informed care. She is additionally licensed in Arizona and Ohio, is an EMDRIA-approved consultant, and provides advanced training on neurodiversity-affirming EMDR, ADHD, and autism. Learn more at www.transcendstherapy.com.

Cathy Hanville, LCSW (They/She) is a licensed clinical social worker in Pennsylvania and California, an EMDRIA-approved consultant, and a continuing education provider. They help therapists identify blind spots so they can provide gender- and neurodiversity-affirming care. Learn more at www.cathyhanville.com.

Cathy and Christine are under contract with Norton Publishing to write Neurodivergent Paths to Healing: Affirming EMDR and Parts Work for Autistic and ADHD Clients, expected in early 2027.

Key takeaways


Therapists often need to adapt EMDR for every client, not just neurodivergent clients


Neurodivergent-affirming EMDR requires flexibility, collaboration, and sensory awareness


Parts work can help therapists better understand protection, shame, and responses often mislabeled as resistance


Many neurodivergent clients carry trauma tied to masking, chronic correction, and social rejection

Full show notes and transcript: https://mtsgpodcast.com

Join our community


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Facebook Group: https://www.facebook.com/groups/therapyreimagined


Podcast Homepage: https://mtsgpodcast.com


Linktree: https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits


Voice Over by DW McCann: https://www.facebook.com/McCannDW/


Music by Crystal Grooms Mangano: https://groomsymusic.com/

When Clients Reject Your Diagnosis: How to Handle Pushback Without Losing the Therapeutic Alliance

What do you do when your client doesn’t agree with your diagnosis?

Whether it’s a parent resisting an autism or ADHD diagnosis, a client attached to a different label, or someone overwhelmed by what a diagnosis means for their identity, these conversations can feel high-stakes.

In this episode, Curt and Katie explore why clients push back on diagnoses and how to navigate these conversations without damaging the therapeutic relationship. They break down the role of stigma, identity, and real-world consequences, and offer practical strategies for staying collaborative while still doing effective clinical work.

Key Takeaways:


Why clients resist diagnoses (stigma, identity, and real-world impact)


How to respond without arguing or damaging the alliance


When disagreement means your assessment isn’t finished


How to focus on function and treatment instead of labels


Navigating documentation, insurance, and cultural considerations

Get the full show notes and resources at mtsgpodcast.com.

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

The Lasting Harm of Conversion Therapy: An Interview with Samuel Nieves

This interview was recorded in November 2025 in anticipation of the Supreme Court ruling in Chiles v. Salazar and released afterward. Rather than focusing on the legal details of the decision, Curt and Katie talk with Samuel Nieves about the harms of conversion therapy, how change efforts can be disguised as therapy, and what clinicians need to understand when working with survivors. Sam shares from his lived experience as a survivor and explains why the deepest harms often involve identity damage, loss of self-trust, and disconnection from one’s own lived experience.

About our guest:Sam Nieves has a Bachelor’s in Psychology. In 2019, he entered grad school to become a Licensed Marriage and Family Therapist, but left the field after 6 months of clinical experience. Since 2020, Sam has used his personal, clinical, and educational background to support survivors of conversion therapy. He is now a board member of the non-profit organization Conversion Therapy Survivor Network. Sam uses the online name “CantPrayMeAway” to share his own experiences as a client of conversion therapy and advocates for the end of all conversion practices worldwide.

Key takeaways:

Conversion therapy is broader than many therapists realize and can show up in subtle, disguised forms

SOGIECE (sexual orientation and gender identity or expression change efforts) offers a clearer framework for recognizing sexual orientation and gender identity or expression change efforts

The core harm of conversion therapy is often identity damage and loss of self-trust

Even well-intentioned therapeutic tools can become retraumatizing when they are used in the service of changing identity

Survivors may need therapists to move slowly, stay client-centered, and understand that therapy itself may have been part of the harm

Full show notes and transcript: mtsgpodcast.com

Join the Modern Therapist Community:
Linktree: https://linktr.ee/therapyreimagined
Facebook Group: https://www.facebook.com/groups/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann: https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano: https://groomsymusic.com/