The article discusses the need to adapt psychiatric communication to differences in patients’ ways of processing information and constructing meaning. In clinical encounters, conversation is not merely information transfer but an interaction between two interpretive models. These differences are particularly evident in psychotic disorders, autism spectrum conditions, and attention deficit hyperactivity disorder, where messages may be integrated into delusional beliefs, interpreted literally, or retained only fragmentarily over time. This may result in misunderstandings, misjudgment of cooperation, and reduced treatment adherence. The authors conceptualize communication as predictive understanding and provide practical recommendations for modifying interview style, including structuring information, semantic precision, and checking comprehension, illustrated with clinical case examples.