Complex presentations that need more than a generalist approach.
Most therapy models were not designed for autistic brains. They assume neurotypical processing speed, neurotypical social motivation, and neurotypical sensory tolerance. When those assumptions are wrong, therapy feels pointless or actively harmful.
I work with autistic adolescents and adults on the things that actually matter to them: managing the sensory and social demands of daily life, building relationships that work for their nervous system, addressing anxiety and depression that co-occur with autism (which is most of the time), and understanding their own profile in a way that reduces self-blame.
I also work with parents of autistic children and teens who need a therapist who understands the full picture, not someone who will recommend behavioral compliance as the goal.
Anxiety is not one thing. Generalized anxiety, social anxiety, OCD, and panic each require different clinical approaches. I trained at the OCD and Anxiety Treatment Center using ERP (Exposure and Response Prevention), CBT, and ACT. I know which tool fits which presentation.
For OCD specifically: ERP is the gold standard, but it has to be done correctly. Poorly delivered ERP can make OCD worse. If your previous experience with exposure therapy felt like torture rather than treatment, the problem was likely the delivery, not you.
When anxiety co-occurs with autism or demand sensitivity, the clinical picture gets more complicated. Standard anxiety protocols need modification. I know how to make those modifications.
If your child refuses everyday demands in a way that seems extreme and nothing you have tried has worked, you may be dealing with demand sensitivity, clinically known as Pathological Demand Avoidance (PDA). Reward charts, consequences, gentle parenting scripts, and standard behavioral therapy all fail with this profile because they target the behavior rather than the nervous system state driving it.
I co-developed the RELATE framework with Rachelle Manco, LCSW. RELATE is the first and only structured clinical intervention for PDA. It is mechanism-based, targeting the nervous system directly. I work with parents and with demand sensitive adolescents and adults.
More at relatepda.com
When your child has a complex presentation (autism plus anxiety, demand sensitivity plus depression, any combination that doesn't fit a clean diagnostic box), parenting advice from books and blogs stops being useful. You need someone who understands the interaction effects between conditions and can help you respond to the child you actually have, not the one the parenting books were written for.
I work directly with parents on shifting the approach at home. This is not family therapy with your child in the room. This is parent coaching: understanding your child's nervous system, adjusting the demand landscape, learning to read the window, and building a response pattern that works for your specific situation.
Depression, trauma, substance use, self-harm. These rarely show up alone, and treating them one at a time while ignoring the rest is why treatment stalls. My training and experience across multiple levels of care means I am comfortable holding the full clinical picture, not just the primary diagnosis.
Modalities I use: CBT, DBT, IFS (Internal Family Systems), EFT (Emotionally Focused Therapy), Motivational Interviewing, Brainspotting (Level II certified), ERP, and ACT. The approach depends on what you need, not what I default to.