Founder of EK Psychotherapies Ltd. | Keynote speaker | Clinical Supervisor | CBT & EMDR Therapist and Consultant | ADHD/ASD Assessor | Trainer
Diagnosis Is Not the Finish Line
Waiting lists dominate the conversation around ADHD and autism services. But Elisha Kemp believes the real challenge goes much deeper than how long somebody waits for an assessment.
“We talk constantly about reducing waiting lists, but speed of diagnosis alone will not fix a system where people can struggle to understand neurodiversity, navigate complicated pathways and then find themselves asking, ‘What happens now?’ once a diagnosis is given.”
For Elisha, the difficulties can begin long before someone reaches an assessment. Individuals and families may spend years trying to understand why they experience the world differently, questioning whether they should seek a diagnosis and attempting to navigate systems that can feel confusing and difficult to access.
And receiving a diagnosis does not automatically resolve those challenges.
“A diagnostic report can provide validation and answers, but it should never be the end of the pathway. For many people, it is actually the beginning.”
Understanding what that diagnosis means in everyday life, recognising individual strengths and needs, processing years of masking or misunderstanding, accessing appropriate therapeutic support and learning what reasonable adjustments may help are all part of the journey.
Elisha argues that if we genuinely want to improve outcomes for neurodivergent people, we need to stop measuring success solely by how quickly someone receives a diagnosis.
The question should not simply be, “How quickly can we diagnose?”
It should be, “How well do we support that person before, during and after diagnosis?”
Because a diagnosis can provide an explanation. But the right understanding, support and pathway afterwards can change a life.
Elisha Kemp is the founder and director of EK Psychotherapies in Kingston upon Hull, and a BABCP accredited cognitive behavioural psychotherapist.
A Diagnosis Explains the Past. It Does Not Organize What Comes Next.
An explanation is not a plan. A diagnostic report settles the past and leaves the present unattended. “I think one of the biggest things we get wrong is treating diagnosis as the destination, when actually, for the person receiving it, it is often the beginning of an entirely new journey.”
The load falls hardest on adults who reach the answer late, and one post-diagnostic conversation has stayed with Elisha. As an adult diagnosed later in life, I had talked the outcome through, and the first response was relief, an explanation at last for years of difficulty. Then the register changed. They said something close to: “I understand why now, but what am I supposed to do with this? Nobody can give me those years back.”
None of the clinical work had failed. “We can clinically establish that somebody meets diagnostic criteria, write an excellent report and make appropriate recommendations, but there is still a human being sitting on the other side of that report trying to make sense of potentially decades of their life.”
The Pathway EK Psychotherapies Built for What Happens After Diagnosis
Elisha Kemp had watched the same shortfall from inside the NHS services that produce it, first in children’s mental health, then in an IAPT service. Her own ADHD and autism diagnoses came later, after that career was already underway. “Working within CAMHS and IAPT taught me the importance of evidence-based, clinically robust care, but receiving my own ADHD and autism diagnoses later in life showed me just how significant the before and after can be.”
The seats differed and the pattern did not. “I met incredibly committed professionals, but I also kept seeing people having to fit themselves into services rather than services being built around the person.” Thresholds, waiting lists and time-limited interventions were doing what the funding allowed. “Neurodivergent people especially can present differently, communicate differently and need therapy delivered differently.”
Founding EK Psychotherapies in November 2022 cost her the security of an established organization and a predictable income. What she built with it was a route rather than an appointment. “I didn’t build EK to create another pathway for people to fit into; I built it to create a service capable of fitting around them.”
“I looked at what happened at every stage from the person’s perspective, from that first conversation when somebody is wondering whether they might be neurodivergent, to what happens in the weeks and months afterwards,” Kemp says. The clinical team held the assessment itself. Kemp concentrated on everything arranged around it.
Kemp’s own role in an assessment is a bounded one. “I undertake components of the clinical assessment and formulation, while the formal diagnostic decision is made through the appropriately qualified and registered psychologist within the multidisciplinary team, under their clinical oversight and in accordance with relevant NICE guidance.”
The pathway is live and taking referrals for adults and children. Assessment runs through a multidisciplinary clinical team, with preparatory support for individuals and families beforehand, and therapeutic support, neurodivergent-informed coaching and psychoeducational workshops afterwards. Further structured aftercare is still in development.
“I initially thought the assessment itself would be the part people valued most, but increasingly I think the conversation afterwards can be just as important,” Kemp says. The pathway does not yet have a number, and she declines to supply one. “Because the pathway is still relatively new, I would be uncomfortable giving impressive-looking percentages that we haven’t formally measured yet.”
What Service Leaders Can Take From a Pathway That Does Not End at Diagnosis
There is no named method here, and Elisha Kemp does not offer one. What the practice runs on is a short set of operating rules, applied at the point where a service usually closes a file. The test she puts them to is what the diagnosis was supposed to do for the person in the first place. “A diagnosis should help somebody understand themselves, access appropriate support and begin making sense of experiences that, in many cases, they may have spent decades blaming themselves for.”
Treat the signed report as a handover rather than a discharge. A handover needs a destination attached to it: psychoeducation, an adapted course of therapy, coaching, or a session that translates diagnostic language into the person’s own week. Kemp’s own pathway now routes people that way as standard, and “we are now seeing people move through the service from initial enquiry and assessment into meaningful post-diagnostic support.”
Build the after around what people report struggling with rather than around what the report contains. At EK Psychotherapies those areas are emotional regulation, relationships, identity, masking, work, parenting and understanding themselves, and they were chosen because they are what people said. The target is the person’s ordinary week rather than their diagnostic status. “I want people to understand their neurodivergence, recognise their strengths, make sense of their experiences and learn how to live in a way that works with their brain rather than constantly fighting against it.”
Keep standardization and individualization separate. Four working rules from the years before she founded the practice sit underneath everything the service does: “listen to the person in front of you; never mistake standardisation for individualisation; be prepared to adapt when something is not working; and never become so focused on delivering a service that you forget the human being receiving it.” The failure mode on the other side of that is a service that adapts itself into having no standard at all. “Evidence-based practice and strong clinical governance are incredibly important to me, but they should sit alongside compassion, curiosity and flexibility.”
Install the measurement before the volume arrives, which is the one thing Kemp would change about her own build. “If I were doing it again, I would build formal outcome measurement into the pathway from day one.” What she wants measured is not throughput: “good neurodiversity care should be measured not simply by how many assessments are completed, but by what happens to people’s lives afterwards.”
Four Questions Kemp’s Team Asks Before a Report Is Filed
“We ask: What does this person actually need? What might we be missing? What needs adapting? And what happens next?” Three of the four are familiar clinical practice. The fourth is the one most pathways have no mechanism to answer, because the file closes before anyone asks it.
Kemp’s answer to a service leader who believes the work ends at the signature: “the report may complete the assessment, but it does not complete the person’s journey, and good clinical care has to recognise the difference.”
Who Is Elisha Kemp?
Elisha Kemp is the founder and director of EK Psychotherapies Ltd, a mental health and neurodiversity service based in Kingston upon Hull and working nationally across the UK, and a BABCP accredited cognitive behavioural psychotherapist. She began in NHS children’s mental health services in Hull in 2015 as a psychological wellbeing practitioner, qualified as a CBT therapist while there, and worked systemically with children, families, looked-after children and social care teams. From 2018 to 2021 she was a full-time CBT therapist and supervisor in the IAPT service at Navigo in Grimsby, assessing for risk and treatment planning and supervising trainees through their university placements. She founded EK Psychotherapies in November 2022, and from October 2023 to June 2025 taught and provided clinical supervision on the University of Hull’s Mental Health Wellbeing Practitioner programme, supporting students across academic learning, clinical skills and the application of evidence-based psychological interventions.
Her accreditations sit with the professional bodies rather than with an employer. She is accredited by the BABCP as a cognitive behavioural psychotherapist, a status renewed annually, and has been an EMDR Accredited Practitioner with the EMDR Association UK since 2021, adding TRN Formulation for Complex Cases through the same body in 2024. The assessment work rests on clinician training in ADHD, in the assessment and diagnosis of adults with ADHD, and in autism, completed between 2024 and 2025, alongside a Northumbria University qualification in cognitive behavioural therapy from 2017.
Kemp’s own ADHD and autism diagnoses came later in life, after the clinical career was underway. Her speaking work is at an earlier stage than her practice: professional events, podcasts, workshops, training sessions and invited guest-speaking for health, social care, education and business audiences, on neurodiversity, mental health and inclusive practice.
The argument she carries into those rooms is the one her own pathway was built to answer. A report can close an assessment. It cannot close the question the person asks next.
Elisha Kemp is the founder and director of EK Psychotherapies Ltd, a mental health and neurodiversity service based in Kingston upon Hull and working nationally across the UK, and a BABCP accredited cognitive behavioural psychotherapist. To connect with Elisha or learn more, visit her LinkedIn Profile or Official Website.
