25 Therapy Adaptations You Didn't Know You Could Ask For
- Becky
- 2 minutes ago
- 4 min read
Most people assume therapy looks a certain way. You sit in a chair. You make eye contact. You answer questions. You talk about your feelings. You stay focused for 50 minutes. For some people, that works perfectly well. For others, it can feel exhausting, awkward, overwhelming or simply not how their brain works best.
One of the things I wish more people knew is that therapy isn't supposed to be one-size-fits-all. Good therapy is collaborative. It's about finding a way of working that supports your nervous system, communication style, sensory needs and way of processing information. This is particularly important for neurodivergent people, trauma survivors, people experiencing burnout and anyone who has spent years feeling like they have to adapt themselves to fit into the world around them.
Here are 25 adaptations you may not realise you can ask for.
Communication Adaptations
1. More processing time
You don't have to answer questions immediately. Some people need time to think before they know what they feel or think.
2. A clear session agenda
Knowing what will be discussed can reduce anxiety and improve focus.
3. Written summaries
Some clients find it helpful to receive a brief summary of key points or agreed actions.
4. More structured sessions
Not everyone thrives with open-ended conversations. Sometimes more guidance and structure feels safer and more productive.
5. Permission to bring notes
You don't need to remember everything. Notes can be a valuable support.
Online Therapy Adaptations
6. Turning off self-view
Seeing yourself on screen can be distracting and draining.
7. Camera-off sessions
Some people think and process more clearly when they aren't being visually observed.
8. Telephone sessions
For some clients, removing the visual element altogether improves focus and reduces overwhelm.
9. Walk-and-talk therapy
Movement can support thinking, emotional processing and regulation.
10. Screen breaks
Short pauses can make online therapy more manageable for people with fatigue, chronic illness or sensory sensitivities.
Sensory Adaptations
11. Using fidget tools
Many people concentrate better when their hands are occupied.
12. Holding a comfort object
A familiar object can support regulation and grounding.
13. Weighted blankets or lap pads
Deep pressure can help some nervous systems feel calmer and more settled.
14. Adjusting lighting
Bright lights can be distracting or overwhelming for some people.
15. Using headphones
Reducing background noise can improve focus and processing.
Movement Adaptations
16. Standing during sessions
You don't have to stay seated if sitting still makes it harder to concentrate.
17. Walking during sessions
Movement can help some people access thoughts and emotions more easily.
18. Knitting, crocheting or doodling
These activities often support attention rather than distract from it.
19. Using a stability ball
Gentle movement can improve focus and regulation.
20. Stretching or changing position
You don't have to remain still to be engaged in therapy.
EMDR and Trauma Adaptations
21. Tactile bilateral stimulation
EMDR doesn't have to involve eye movements. Tapping or tactile devices may feel more comfortable.
22. Alternatives to visualisation
Not everyone can imagine a peaceful beach or safe place. Resources can be built around sensations, music, movement, people or real-world locations.
23. Slower pacing
Trauma work doesn't have to be rushed. Sometimes slower is safer.
24. More preparation before processing
For many clients, building stability and resources first is the most important part of therapy.
25. Permission to say "This isn't working"
Perhaps the most important adaptation of all. If an exercise doesn't work for you, that's useful information. If visualisation feels impossible, that's useful information. If sitting still makes it harder to think, that's useful information too. Therapy is not about forcing yourself into a model that doesn't fit. It's about understanding how your mind and nervous system work, then building therapy around that.
There Is No Such Thing As Being Bad At Therapy
Many people arrive in therapy carrying the same pressure they bring everywhere else. The pressure to get it right. To say the right thing. To be insightful enough, emotional enough, motivated enough or healed enough.
I see this particularly often in people who have spent years adapting themselves to fit around others. People who have become experts at masking, monitoring themselves and trying to meet expectations.
The irony is that therapy can become another place where that performance continues.
Clients apologise for crying. They apologise for not crying. They apologise for forgetting things, needing breaks or feeling overwhelmed. Sometimes they apologise simply for having needs at all.
But therapy isn't an exam.
There isn't a correct way to heal.
Good therapy isn't about becoming a better client. It's about creating a space where you can show up more fully as yourself.
You are allowed to ask for what helps.
You are allowed to have needs.
And you are allowed to take up space exactly as you are.
Looking for Therapy That Fits You?
If you've ever left therapy feeling like you were somehow doing it wrong, you're not alone.
You don't need to be a perfect client to benefit from therapy. You don't need to have the right words, make eye contact, sit still, complete every task or know exactly what you need.
Therapy should work with your brain, your nervous system and your way of processing the world.
If you're looking for support with trauma, anxiety, neurodiversity, eating difficulties or burnout, I'd be happy to help.
About Becky
I'm Becky Grace, a BABCP-accredited CBT therapist and EMDR therapist and Registered Mental Health Nurse specialising in complex trauma, neurodiversity and eating disorders. I work with people who often feel different, misunderstood or exhausted from trying to hold everything together. Many of my clients have spent years masking, people-pleasing, overthinking or adapting themselves to fit environments that were never designed with them in mind.
My approach is collaborative, compassionate and neurodiversity-affirming. I believe therapy works best when it adapts to the person rather than expecting the person to adapt to therapy. Whether we're working with trauma, anxiety, eating difficulties, burnout or identity, my goal is to help you understand yourself more deeply and build a life that feels more sustainable and authentic.
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