<p>Autism spectrum disorder (ASD) is a developmental disorder characterized by lifelong struggles in the domains of social communication and reciprocal and repetitive interests. Despite the growing number of autistic adults, and the increasing number of autistic adults seeking therapy services for comorbid mental health concerns, there exists minimal guidance toward tailoring evidence-based treatment approaches to meet the presenting need. To this end, this article highlights clinical considerations, neuroaffirming accommodations, and strategies to help provide high-quality, informed treatment to this population. Specifically, we provide guidance on establishing rapport and building client engagement, setting realistic and meaningful goals with and for the autistic adult, adaptation of evidence-based therapies that are ASD-informed, and promotion of positive family supports.</p>