Introduction: While previous research has highlighted links between autism in adults and mental health outcomes, these have tended to focus on individual psychopathology versus wellbeing. This has contributed to a limited integration of key risk and protective factors, and their interconnected effects on positive mental health and wellbeing.

Method: To reflect current shifts (Leadbitter et al., 2021) in research, clinical practice, and advocacy toward more inclusive and neurodiversity-affirming approaches, a narrative review was conducted using an ecological-systems perspective. Consistent with positive psychology frameworks increasingly informing clinical work, wellbeing was understood according to the basic psychological needs theory (Deci & Ryan, 2000) and the character strengths framework (Peterson & Seligman, 2004).

Findings: Findings indicate that macrosystemic influences include deficit-based narratives and unfavourable or inaccurate media representations. These appear to have shaped clinical and research priorities toward symptomology and cure, potentially at the expense of more salutogenic applied research and strengths-based interventions. Such a cultural context influences the everyday social desirability, inclusion and treatment of autistic people. This poses significant external barriers to wellbeing such as ableism and disempowerment, and evidence-based neurodiversity-affirming service gaps. Individual responses such as masking were viewed as self-protective or safety measures against societal pressures.

Conclusion: Overall, our review suggests a limited understanding of the dynamics between individual and ecosystemic risk and protective factors for wellbeing in autistic adults. It also highlights the growing importance of research that seeks to support wellbeing and mental health in both systems-informed and neurodiversity-affirming ways.

This presentation aims to share results from a clinical trial piloting a mindfulness-based therapy to support adults with ADHD and depression and/or anxiety. It also invites attendees to consider what might encourage or hinder them from introducing different kinds of meditation practices with their clients living with ADHD.

There is growing evidence to support mindfulness-based interventions for adults with ADHD (Kim et al., 2025; Kretschmer et al. 2022); however, more research into mindfulness for adults with ADHD is required. This study trialled Mindfulness-Integrated Cognitive Behavioural Therapy (MiCBT), which has been found to help adults with chronic conditions (Cayoun et al., 2020; Pouyanfard et al., 2020) but had not yet been trialled within the ADHD community.

This study tested feasibility and acceptability of MiCBT for this population as well as potential efficacy to reduce depression and anxiety, and to increase emotion regulation, executive functioning, equanimity, and mindfulness. The trial followed the manualised protocol for MiCBT (Cayoun et al., 2018), with minor modifications as agreed by Dr. Cayoun.

MiCBT aims to develop emotion recognition and non-reactivity by supporting clients to practise daily body scanning techniques from the Buddhist Vipassana tradition. As these meditations advance and interoceptive awareness increases, the therapy integrates traditional CBT components, mainly: understanding the relationship between thoughts, feelings / sensations, and responses; exposure therapy; and support with inter-personal communication skills.

The findings from this survey paint a complex picture of how mindfulness may help adults with ADHD, with evidence that it can be both extremely helpful and extremely challenging for this community. This presentation will discuss the many significant and promising results, both quantitatively and qualitatively. It will also reflect on what appeared to be barriers for some, both in terms of participants who found difficulty with daily practice and the significant difficulty observed in recruitment. Additionally, it will discuss factors which may mediate the effect of the practice on outcomes measured, including interoception, self-efficacy, self-compassion, and group cohesion / social acceptance.

Finally, the presentation will consider implications of the research for our professional practice, as well as our evolving understanding of ADHD. I will offer my professional reflections as the therapist, and invite attendees to reflect on their own beliefs and assumptions about meditation and the ADHD mind, remembering there is great diversity within our ADHD clients, friends, and colleagues.