Over the preceding 20 years, specialist early psychosis programs have evolved internationally in order to provide a more timely treatment and to support young people in achieving symptomatic remission and eventual full recovery. However, there are considerable challenges to achieving these aims. First, despite research showing that 90% of patients who receive treatment achieve good short-term symptomatic outcomes, a majority remain at risk of recurrence of acute symptoms. These relapses can lead to ongoing, chronic psychosis. Second, patients with a first episode of psychosis are at risk of experiencing secondary illnesses, including depression, anxiety, and compromised physical health as a result of rapid and pronounced weight gain and related metabolic disturbances. Third, although most young patients with first-episode psychosis participate over the short term in effective psychosocial and biological treatment programs, continuing with treatment and maintaining early gains is a major challenge for the field. For example, at the Early Psychosis Prevention and Intervention Centre, a specialist service for treating early psychosis, we developed an effective cognitive-behavioral therapy-based program for the prevention of relapse among first-episode patients who had reached remission of positive symptoms for a period of one month. The program showed significant benefits compared with specialist early psychosis treatment alone in terms of relapse rates over the first 12 months, but treatment effects were lost by the 18-month follow-up.