Introduction:
Neurodivergent individuals, including people with neurodevelopmental conditions such as autism, attention-deficit hyperactivity disorder, dyspraxia, dyslexia, or Tourette syndrome, frequently experience co-occurring mental health challenges (CMHCs) and report reduced quality of life (QoL). While psychological support can be beneficial, limited research has examined the therapeutic relationship when working with neurodivergent individuals or explored how integrating their strengths and passions (focused interests) may enhance engagement in therapy and contribute to improved QoL.


Purpose:
This study explored associations between engagement in passions and QoL, alongside neurodivergent individuals' perspectives on what supports the therapeutic relationship and their overall therapy experience. The research aimed to inform neuroaffirmative, relational, adaptable and applicable therapeutic practices.


Method:
The study was co-produced with collaborators with lived experience. A convergent parallel mixed-methods design was employed. Data were collected through online surveys incorporating the Recovering Quality of Life scale (ReQoL-10) and co-produced qualitative questionnaires exploring adjustments to support therapy and the therapeutic relationship. Participants (N = 182; 103 neurodivergent, 79 non-neurodivergent; aged 18-60 years) had current or past experience of therapy. Quantitative and qualitative strands were analysed separately and integrated to produce meta-inferences.


Results:
Greater engagement in passions was positively associated with QoL in both groups, although not at a statistically significant level. Qualitative findings elucidated this association and highlighted: (1) the value of flexibility and inclusion of passions or focused interests in therapy, (2) the importance of a non-judgemental stance grounded in clinician knowledge and acceptance of neurodivergence, and (3) empathic reciprocity and mutual understanding grounded in relatability and shared interests.


Conclusions:
Findings suggest that meaningful engagement with passions and neuroaffirmative relational practices may support and strengthen therapeutic relationships and contribute to enhance QoL and overall well-being among neurodivergent adults with CMHC. Co-produced training, support and adaptations may further improve therapy accessibility and effectiveness