Psychotic Experiences result from a break with reality. The individual may experience delusions, may hear voices, see visions, imagine the TV is sending messages, among other things. These experiences are generally frightening for the individual and for his or her family and often the person will require hospitalization. While such experiences are relatively rare in children, they are more frequent in adolescence, and may herald the onset of schizophrenia or manic depressive illness. Some may be drug induced, some may occur in the context of extreme stress. Psychological assessment, undertaken when the individual is settled enough to participate adequately can be helpful in determining to what extent the experience is reactive to external pressures, to what extent it reflects something more insidious, and to what extent the individual can be helped by psychological treatment, either in conjunction with a regime of antipsychotic medication or not. In our experience, it is rare for a person to completely lose the capacity to reflect on his or her actions, to completely break with reality, and when this self reflective function can be engaged, psychological treatment can be effective in helping the person manage their difficulties better, or gain greater mastery over them. Further hospitalizations can often be avoided. When a teenager experiences a break with reality, it is frightening both for the teenager and the family. Psychological assessment, support and treatment can be of great benefit at this time, and early intervention can ameliorate, or in some instances prevent, any further deterioration.