Abstract

Abstract Background Autistic adults are at increased risk for mental health (MH) conditions. As such, there is a need for effective MH care services that meet the unique needs of autistic clients. However, a deeper understanding of the therapy experiences and preferences of autistic adults is necessary to inform future enhancements to clinical practice for this population. Aim This study aimed to qualitatively examine the perspectives of autistic adults regarding past MH therapy experiences through semi‐structured interviews.Method: Autistic adults ( N = 19, ages 21–51 years) completed a demographics survey and participated in individual interviews to share experiences and recommendations. Findings Reflexive thematic analysis revealed three over‐arching themes and eight sub‐themes. Overall, findings highlight therapeutic approaches that are important to autistic adults. Specifically, participants emphasised the value of the following strategies: (1) cultivating a safe space informed by an understanding of autism; (2) demonstrating a flexible and collaborative approach to therapy that is responsive to clients' needs; and (3) considering clients' preferences regarding talking in session when supporting personal growth and skill development. Limitations The study was limited by a relatively non‐diverse sample in terms of racial and ethnic identity and potential recall bias due to the retrospective nature of the investigation.