The aim of the study was to gain insight into the experiences of licensed mental health providers working with autistic children with co-occurring disorders and their treatment approaches. Eleven licensed mental health providers with over six months of direct care experience participated in semi-structured interviews. Interviews were recorded, transcribed, analyzed, and hand-coded for themes. Responses highlighted variation of approaches to treatment and perspective-shifting resulting from education on neurodiversity. Keywords: neurodiversity, best practice, therapeutic alliance, mental health providers

Psychotherapy research has long focused on provider competence and treatment efficacy. Mental health providers treat diverse client populations with varying, complex needs. Though estimates vary, the rate of children diagnosed with autism and a co‐occurring psychiatric disorder is relatively high. While behavioral approaches to treatment have been established as the gold standard, talk‐based therapies are increasingly common, and a broader range of providers are treating this population. There are gaps in the literature regarding empirically supported, targeted approaches, and provider sense of competency in addressing complex needs. The aim of this secondary qualitative analysis was to gain further insights into mental health providers' experiences of psychotherapy with autistic children with a cooccurring diagnosis. Eleven licensed clinicians participated in semistructured interviews. The following themes emerged: perception of competency, complex needs, and family involvement. Recommendations for a collaborative approach, increased opportunities for training, and standardized, targeted assessments and treatment protocols were made.