Little research has been done on the treatment of schizoid personality disorder. This is partly because people with this diagnosis typically do not experience loneliness or compete with or envy people who enjoy close relationships.

People with this disorder rarely seek treatment, and little is known about which treatments work. Talk therapy may not be effective, because people with schizoid personality disorder have difficulty relating well to others. Therefore, treatment can be difficult because of initial reduced capacity or desire to form a relationship with a health professional. A non-intrusive support group can alleviate feelings of solitude, and fears of social interactions and close relationships. Individual therapy, in most cases, has proven relatively ineffective and often temporarily addresses immediate conditions instead of seeking to eliminate the disorder entirely.

Medications

Medications are not usually recommended for schizoid personality disorder. However, they are sometimes used for short-term treatment of extreme anxiety states associated with the disorder. The presence of anxiety, usually caused by fear of other people, may mean that a diagnosis of the related schizotypal personality disorder is more appropriate.

Psychotherapy

Individual therapy that successfully attains a long-term level of trust may be useful in certain cases of schizoid personality disorder by giving patients an outlet to transform their false perceptions of friendships into authentic relationships. As a therapist-client relationship develops, a patient can start to reveal imaginary friendships and terrors of dependency. Individual psychotherapy can gradually affect the formation of a true relationship between the patient and therapist.

Long-term psychotherapy should not be pursued because of its poor treatment outcomes and the costs inherent in lengthy therapy. Instead, therapy should focus on simple treatment goals to alleviate current pressing concerns or stressors within the individual’s life. Cognitive-restructuring may be proper to address certain types of clear, irrational thoughts that are negatively influencing the patient’s behaviors. This therapeutic plan should be clearly defined at the onset of treatment. Stability and support are the keys to good treatment with someone who suffers from schizoid personality disorder. Care should be taken not to “smother” the person with schizoid personality disorder and be able to tolerate possible “acting-out” behaviors.

Group therapy is another potentially effective form of treatment but it generally is not a good initial treatment. Although patients may initially withdraw from the therapy group, they often grow participatory as the level of comfort is gradually established. Protected by the therapist, who must safeguard people with this diagnosis from criticism by others in the group, patients have the chance to conquer fears of intimacy by making social contact in a supportive environment.

Social consequences of serious mental disorders—family disruption, loss of employment and housing—are sometimes calamitous. Comprehensive treatment, including services existing beyond the formal treatment system, is crucial to ameliorate symptoms, assist recovery, and redress stigma. Self-help programs, family self-help, advocacy and services for housing and vocational assistance complement and supplement the formal treatment system.