Understanding the Experience of Autism Diagnosis in Adulthood: A Qualitative Study

Introduction
Autism Spectrum Disorder (ASD) is commonly identified in childhood, yet an increasing number of adults—particularly those with high-functioning autism—receive their diagnosis later in life. For these individuals, diagnosis often reshapes self-identity and opens new possibilities for therapeutic support. Psychotherapy plays a crucial role in this process, yet many autistic adults encounter challenges when engaging in mental health services. This study addresses the underexplored intersection of late autism diagnosis, identity reconstruction, and psychotherapy.

Goals and Methods
The aim was to examine how adults diagnosed with high-functioning autism after the age of 18 make sense of their diagnosis, with particular focus on psychotherapy and self-understanding. Five individuals diagnosed with high-functioning autism in adulthood participated in the study, offering five semi-structured interviews. Data were analyzed using Interpretative Phenomenological Analysis (IPA) to capture participants’ lived experiences.

Results
Four superordinate themes were identified: (1) “I always felt different”: Struggling to build a relationship with the self and others; (2) The search for an answer and self-understanding; (3) Reframing the self: Life after diagnosis; and (4) The therapeutic space: Barrier or breakthrough. These themes reflected lifelong feelings of difference, the emotional complexity of diagnosis, the duality of relief and grief, and the central role of therapy adapted to neurodivergent needs.

Conclusions
The findings highlight the importance of increased training for psychotherapists in recognizing and supporting high-functioning autism in adulthood. Empathy alone is insufficient; effective therapeutic practice requires structure, clarity, and emotional safety. The findings also suggest that creative forms of expression, such as art, may provide valuable avenues for self-understanding and growth in therapy. This study calls for neurodiversity-affirming, individualized approaches that foster self-acceptance and improve outcomes, bridging qualitative research and psychotherapeutic practice.