Autism therapy · North County San Diego
Not therapy to make you less autistic. Therapy for burnout, anxiety, relationships, work, and everything a late diagnosis stirs up. Doctoral-level, neurodiversity-affirming care in Carlsbad and Vista, or online anywhere in California.
Phone is optional. You can start, and finish, the whole intake conversation in writing.
4.9 on Google · 90+ reviews · Doctoral-level, serving North County since 2018
If you already know
If you spent years assembling a way to pass as someone else, that is not a disorder showing itself. It is an achievement, and an expensive one, put together by a young person who read the room accurately and did what the room required. We start from respect for why you built it, not from a plan to take it apart.
For a long time our field studied autistic people more than it listened to them, and aimed its treatments at making autistic behavior less noticeable to everyone else. One consequence is that autistic adults who are managing, more or less, have had nowhere ordinary to bring the hard parts of their lives. That is what this is for: straightforward weekly or biweekly therapy on the exhaustion, the anxiety that never quite switches off, the friendships that went quiet, and the effort of staying legible to other people.
You will not be asked to make more eye contact, or to practice warmer expressions, or to justify why the room is too bright before it gets dimmed. Your autism is the context we work in. It is not the problem we are trying to solve.
Looking for a diagnosis instead?
We do not assess or diagnose autism through this service, and your therapist will not be the person who evaluates you. If what you actually want is a formal answer, go straight to the right place rather than starting here.
What people bring here
You do not need to have any of this neatly worded before a first session. Most people arrive with a rough version and we sort it out together.
The flattening that comes after years of running at a pace built for other people. Skills you had last year are gone, ordinary tasks cost twice what they used to, and rest does not seem to touch it. It is not laziness. It can overlap with depression, but autistic burnout is often described as involving prolonged exhaustion, reduced capacity, and increased sensitivity following sustained overload or masking.
Finding out at 28 or 45 reorganizes your whole history. There is relief, and there is grief for the version of your life that might have gone differently with an accurate map. Both belong in the room.
Scripts, rehearsed expressions, monitoring yourself in every conversation. Masking works, which is exactly the problem: it is expensive, invisible, and hard to put down even in places where it is safe to. Dr. Montañez on telling masking apart from social anxiety and people-pleasing.
A lot of autistic anxiety is not irrational. It is a reasonable response to environments that are genuinely hard to predict and to years of being told your read on a situation was wrong. See our anxiety therapy page.
Open-plan offices, unwritten rules, small talk as a performance review. Often the job itself is well within reach and the environment around it is what is unsustainable. We work on both what you can change and what you can stop blaming yourself for.
Being told you are too much, too blunt, too quiet, or not warm enough, by people who mean well. Therapy is a place to look at what is actually happening between you and others without starting from the assumption that you are the error.
Sound, light, texture, and interoception shape your day whether or not anyone else notices. We treat sensory reality as real information about what you need, not as something to push through more quietly.
After a lifetime of adjusting, the question of what you actually like, want, and feel can be genuinely hard to answer. This is slow work, and it is some of the most worthwhile work we do.
How we work
We do not practice ABA or other compliance-based behavioral approaches. What we offer instead is relational, depth-oriented psychotherapy: we treat your inner experience as the point, not your outward presentation. That is a description of what we do, not a judgment of clinicians who work differently.
In practice it means we say what we mean rather than expecting you to read it. We do not treat eye contact as a measure of engagement or flat affect as disinterest. Stimming is welcome. You can ask for a question to be asked more plainly, and you can tell us the room is too bright. Pace, structure, and sensory environment get adjusted to you, and the depth of the work stays exactly the same. If you want the longer account of the method, our depth-oriented therapy page goes further.
Late diagnosis
Plenty of the people we see got their answer in their thirties, forties, or later, often after a trail of other explanations: anxiety, depression, a personality problem, being difficult, being sensitive, not applying yourself. Having a new framework for understanding yourself can reorganize how you make sense of your history, and it is also a lot to absorb at once.
What follows is rarely simple relief. There is usually grief alongside it, for the years spent working twice as hard without knowing why, for relationships that went quiet, for the version of your life that might have gone differently with an accurate map. There can also be anger at the people who missed it, and a strange loneliness in suddenly knowing something about yourself that the people around you have not caught up to.
This is the part that a checklist cannot do for you and where doctoral-level depth work earns its place. Therapy can provide space to revisit those experiences with this new understanding and explore what they mean now. We go back through the history with you, at whatever pace that takes.
Autistic burnout
Autistic burnout and depression can look alike from the outside. Both flatten you, both drain interest, both make ordinary days expensive. They can also overlap, and they can occur together. When burnout is read as depression alone, the usual advice tends to follow: get out more, add activity, schedule something social. For someone in burnout, that advice can land as more demand on a system that has already run out.
Burnout is often associated with prolonged overload, masking, reduced capacity, and heightened sensory needs. Skills you reliably had last year can stop being available. For some autistic people, reducing demands, increasing recovery time, and addressing sensory or environmental stressors can be important parts of recovery, and once that steadies, the rest of the work becomes more possible.
Telling the two apart is one of the first things we do together, and it is worth doing carefully. Depression can genuinely be present too, sometimes underneath burnout, sometimes alongside it. If that turns out to be the picture, our depression therapy page covers how we approach it.
Masking and unmasking
Masking is not a bad habit. It is a skill you built, usually young, usually because it worked, and often because the alternative was not safe. Scripts for conversation, rehearsed expressions, constant self-monitoring, a running background calculation of how you are landing. It is effective and it is expensive, and most people have no idea how much of their day it is quietly consuming.
Which is why the advice to just unmask tends to fall flat. Dropping it everywhere at once is neither safe nor realistic: some rooms are genuinely not safe, some jobs are genuinely not forgiving. The useful work is more granular. Where is it costing more than it is buying? Where could you set some of it down? And underneath all of it, who are you when you are not managing anyone's impression of you? That last question takes a while, and it is worth the time.
Autism therapy, answered
Neurodiversity-affirming therapy treats autism as a difference in how a brain is built rather than a disorder to be corrected. The goal is not to help you appear less autistic. It is to help you understand how your mind actually works, build a life that fits it, and address what is genuinely painful, such as burnout, anxiety, isolation, or the aftermath of being misunderstood for years. Accommodations, stimming, and direct communication are treated as legitimate, not as things to unlearn.
Autistic burnout is a state of exhaustion, reduced capacity, and heightened sensory sensitivity that follows a sustained period of masking, overload, or environments that do not fit. It looks like depression from the outside, and many autistic adults are treated for depression first. The difference matters: depression care often pushes activity and social contact, while burnout usually needs the opposite first, which is reduced demand, sensory recovery, and permission to stop performing. Therapy helps you tell them apart and respond to what is actually happening.
Yes, and it is one of the most common reasons autistic adults start therapy. A late diagnosis is not an endpoint. It reframes decades of experience at once: the jobs that did not work, the friendships that went quiet, the sense of effort nobody else seemed to be spending. Therapy is where you work through the relief and the grief together, revise the story you had been telling about yourself, and decide what you want to do differently now that you have accurate information.
Not a different technique so much as a different set of assumptions. What matters is a therapist who does not read flat affect as disinterest, does not treat eye contact as a measure of engagement, does not interpret directness as hostility, and does not quietly aim at making you seem more typical. Pace, sensory environment, and communication style are adjusted to you. The depth of the work stays the same.
Meet your therapist
We name the clinicians who actually work with autistic teens and adults rather than listing the whole practice. Affirming work is a particular competence, not something every good therapist happens to do, and we would rather tell you exactly who does it than hand you a grid of faces and let you guess. Dr. Montañez works with AuDHD, ADHD, and executive functioning in teens and adults, with particular focus on late-diagnosed and high-masking clients, and she offers therapy rather than testing. If she is full or turns out not to be the right fit, say so on your free consultation and we will tell you honestly whether someone else here can help.
Licensed psychologist · AuDHD, late diagnosis + masking · Carlsbad & Vista
Read bioQuestions
Most autistic adults come to therapy for the same reasons anyone does: anxiety, exhaustion, relationships, work, and the question of who they are. What differs is the context. We work on autistic burnout, the aftermath of a late diagnosis, the cost of masking, sensory overload, being repeatedly misread, and building a life whose demands you can actually sustain. Therapy is not aimed at your autism. It is aimed at what is hard.
No. We do not offer ABA or other compliance-based behavioral approaches. Our clinicians practice relational, depth-oriented psychotherapy: we are interested in your inner experience rather than your outward presentation, and no part of the work is designed to make you appear less autistic. That is a description of what we offer, not a judgment of clinicians who work differently.
No. Many of the people we see are self-identified, are on a long waiting list somewhere, or are still working out whether autism explains their experience. None of that has to be settled before you begin. If you decide you do want a formal answer at some point, we can talk about that too.
Not on this service. This page is for ongoing therapy. Formal assessment is separate work with a separate process, and we offer it through our autism testing service, or our AuDHD evaluation if you think ADHD is in the picture as well. Your therapist here will not be the person who evaluates you.
The depth of the work is the same. The assumptions around it change. We do not treat eye contact as a measure of engagement or flat affect as disinterest, we say what we mean rather than expecting you to read it, and we adjust pace, session structure, and the sensory environment to what actually works for you. You can stim, you can look away, you can ask for a question to be asked more plainly.
It means starting from the position that your brain is a variation rather than a defect. The work targets what causes you pain, such as burnout, anxiety, isolation, or years of being misunderstood, and never your autistic traits themselves. Accommodations and self-knowledge are treated as legitimate goals, not as giving up.
Yes. AuDHD is common, and it is its own experience rather than two conditions sitting side by side, including the particular bind of having a brain that both needs routine and resists it. If ADHD is the more pressing piece for you, our ADHD therapy page is a good companion read, and ADHD in women covers late diagnosis in women specifically.
Yes. We work with adolescents as well as adults, including teenagers who have just been diagnosed and are trying to work out what it means for them. Our broader teen therapy page has more on how we work with this age group.
Yes, and a lot of people prefer to. You can write to info@coastaltherapygroup.com or use the form on our Get Started page and we will reply in writing. Nobody will insist on a phone call, and you can do the whole intake conversation over email if that is what makes it possible to start.
Individual sessions range from $230 to $300 per 45-minute session, depending on the clinician. We are an out-of-network practice and provide detailed superbills that many PPO plans reimburse. Current rates, the full fee table, and insurance details are on our Cost + Info page.
If a different piece is the pressing one right now, our anxiety therapy, ADHD therapy, and teen therapy pages are good next reads.
A quick, private self-check
Two short, private questionnaires you can take without talking to anyone: a screener based on the AQ-10, and one on how much you mask. Neither is a diagnosis, and neither asks for your email.
Reflective, not diagnostic. Your answers never leave your browser.
Ready when you are
One free 15-minute conversation with Kari, by phone or entirely by email. She will listen, answer your questions, and match you with a clinician who is a genuine fit. No pressure, and no runaround.
4.9 on Google · 90+ reviews · Serving North County since 2018
Where we are
Our autism therapists see clients at these two North County San Diego offices, and by secure video anywhere in California through online therapy. Both offices have quiet waiting areas and parking at the door, and we are glad to tell you in advance exactly what walking in looks like. Clients come to us from Carlsbad, Vista, Encinitas, Oceanside, San Marcos, and across San Diego County.
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