A pilot RCT of cognitive therapy (CT; based on Fowler, Garety, and Kuipers, 1995) for early psychosis adjunctive to treatment as usual (TAU) compared to TAU alone is presented. Recruitment is problematic and numbers are small. Levels of symptomatology are low at baseline; and both CT (n = 12) and TAU (n = 9) groups improve, with few significant group differences and high levels of individual variation. This pattern is common to other studies (Jackson et al., 1998; Lewis et al., 2002). The body of evidence to date seems to suggest that CT for early psychosis is not strongly indicated as an adjunctive treatment for all people with early psychosis, but should perhaps focus on the sub-group of patients whose recovery is incomplete.