The context in which psychosis emerges is explored in relation to current theory and research. The family, social and cultural context is found to be highly significant in regard to the likelihood of psychosis emerging, the focus of therapeutic endeavour and treatment outcome. In particular, the ideas, beliefs and expectations of caregivers appear to exert a profound effect on outcome. Although belief is to the contrary, current research in relation to schizophrenia indicates that a typical course involves a long period (years) of relative incapacity followed by recovery.