Personality disorders are typically some of the most challenging mental disorders to treat, since they are, by definition, an integral part of what defines an individual and their self-perceptions. Treatment most often focuses on increasing coping skills and interpersonal relationship skills through psychotherapy.
Schizotypal Personality Disorder
As with most personality disorders, schizotypal personality disorder is best treated with some form of psychotherapy. Individuals with this disorder usually distort reality more so than someone with Schizoid Personality Disorder.
As with Delusional Disorder and Paranoid Personality Disorder, the clinician must exercise care in therapy to not directly challenge delusional or inappropriate thoughts. A warm, supportive, and client-centered environment should be established with initial rapport. As with Avoidant Personality Disorder, the individual lacks an adequate social support system and usually avoids most social interactions because of extreme social anxiety. The patient often reports feelings of being "different" and not "fitting in" with others easily, usually because of their magical or delusional thinking. There is no simple solution to this problem. Social skills training and other behavioral approaches that emphasize the learning of the basics of social relationships and social interactions may be beneficial.
While individual therapy is the preferred modality at the onset of therapy, it may be appropriate to consider group therapy as the client progresses. Such a group should be for this specific disorder, though, which may be difficult to form or find in smaller communities.
Medication can be used for treatment of this disorder's more acute phases of psychosis. These phases are likely to manifest themselves during times of extreme stress or life events with which they cannot adequately cope. Psychosis is usually transitory, though, and should effectively resolve with the prescription of an appropriate anti-psychotic.
There are not any self-help support groups or communities that we are aware of that would be conducive to someone suffering from this disorder. Such approaches would likely not be very effective because a person with this disorder is likely to be mistrustful and suspicious of others and their motivations, making group help and dynamics unlikely and possibly harmful.
Portions are from Internet Mental Health, Copyright © 1995-1996 by Phillip W. Long, M.D.