Table 3:

Overall Helpfulness of Mental Health Therapy: Themes and Subthemes

Theme	Subtheme	Number of Participants (%)†	Example Quotes
Therapist acceptance and understanding is crucial	Feeling heard, accepted, and validated	54 (20.1%)	“Being heard (not just listened to), not judged, affirmed, accepted for who I am.” “Talking to someone who doesn’t judge me… and who validates my experiences.”
	Therapist understanding of autism	31 (11.5%)	“Having a therapist that gets how my brain is wired differently. This allows us to better communicate.” “[The least helpful aspect of therapy was] not having a therapist who was really familiar with autism.”
Therapy offers tools for personal growth	Importance of talking through and processing issues	60 (22.3%)	“Having someone to talk through my thought processes and exploring them helps.”
	Gaining new perspectives	30 (11.2%)	“I find it more helpful to talk with the therapist… so I have an outside view of the situation. Sometimes I need to know how others view things to get perspective.” “[My therapist] helps me see issues or problems or successes that I don’t see on my own.”
	Developing self-understanding	15 (5.6%)	“[The most helpful part of therapy has been] to better understand myself and why I think and act the way I do.”
Talking in session can be difficult	Verbal communication expectations	17 (6.3%)	“[Therapists] always insist on talking. That is not the best way for me to communicate.” “Sometimes I have something I know I want to say, but most of the time my mind seems to go blank as soon as we sit down together.”
	Trouble talking about feelings	20 (7.4%)	“The general talk about feelings [is not helpful]. I don’t experience feelings like most people and that makes this difficult and not very helpful.”
Session format can help or hinder progress	Session structure affects the therapy experience	18 (6.7%)	“Having a clear agenda with well-defined goals [is most helpful].”
	Alternative activities can enhance therapy	14 (5.2%)	“I also find it helpful if there are toys to fidget with in the office, which most places seem to have. It’s extremely grounding.” “Pictures [are helpful] because I am a visual learner.”

^†Number and percentage of participants whose responses are consistent with this theme out of the subsample with prior mental health experience (n = 269).