Early Intervention in Psychosis (EIP) is an international mental health movement. In this paper the authors briefly describe an Early Intervention in Psychosis Service for 14–18 year olds. In particular, the personal and professional challenges of developing and working in such a service are outlined. The integration of a psychotherapeutic stance with more conventional psychiatric practices is illustrated. Specific issues relating to working with adolescents and across the child/adult divide in such a setting are also explored. The psychodynamic and systemic issues are highlighted throughout this paper using examples, based on real scenarios, involving individuals, families and organizations. Finally, some possible future directions of the Early Intervention movement are discussed.