This paper outlines the efforts of a small group of practitioners to work towards a randomized controlled trial (RCT) of psychodynamic therapy for psychosis. It presents arguments for such a trial and briefly reviews the existing evidence, concluding that although there are no well-designed RCTs of a contemporary approach to psychodynamic therapy for psychosis, the non-RCT evidence supports the view that for some individuals who experience psychotic states, psychodynamic therapy can be a worthwhile treatment. The latter part of the paper discusses some of the issues that need to be considered in designing an RCT of psychodynamic therapy for psychosis, including the views of people with personal experience, feasibility issues, and the likely impact of the exact nature of the therapy provided, the population studied and the outcome measures selected