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Be Well, Think Well: Supporting Individuals with Autism and Psychotic Disorders

Image of a hand squeezing a rubber brain.Working with individuals who have autism and a co-occurring psychotic disorder can be challenging. This page will provide you with some tips to help make your work more effective.

Build a relationship

Try to establish a bond with the individual. Be consistent, attentive, and follow through on what you say you are going to do. These are all ways you can help build trust and strengthen your relationship. Developing trust is important when dealing with individuals who have a psychotic disorder due to the paranoid thinking that often comes with the diagnosis.

Don't challenge delusions

Individuals with psychotic disorders often have delusions: things they believe, but are not true or real. You may want to help them by telling them that what they’re thinking isn’t true or real. However, that may cause more harm than good. Even though it’s not true, they fully believe the delusion. Challenging their ideas may make them angry and hurt your relationship with them. This is especially important for people with autism who tend to be more rigid in their thinking.

Focus on their feelings

If an individual is experiencing a hallucination or delusion it’s more important to focus on what they feel is happening rather than what is actually happening. What they’re feeling may not be obvious by their behavior, so it’s a good idea to ask. Offer choices of different emotions they may be feeling to help them identify their emotions. Individuals with autism sometimes struggle with explaining their feelings, and the added stress of hallucinations or delusions may add to the challenge.

Stay calm

You are likely to hear some things that may be shocking, uncomfortable or frightening. Stay calm if you hear these kinds of statements. This can help you de-escalate the individual. Even if you feel scared or anxious or upset, if you are able to appear calm and relaxed, they may be able to do the same. Take some deep breaths before you engage, and make sure you’re ready to interact with them in a relaxed manner.

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This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.